1 case of gas gangrene patient care _8659

yxfbbiedtj · Wysłany: Pią 17:29, 25 Mar 2011

1 case of gas gangrene patient care

Given bacterial culture and drug sensitivity test. 2 days after surgery, body temperature 39 ~ C, pulse 140 beats / min, see examination section of the right side of the wound has a large area of skin cyanosis, wound a large number of gas, and a bad smell, to give film and found the calf and thigh the middle of a large number of gas exist, according to the above symptoms, clinical diagnosis of gas gangrene. The orders were immediately prepared to do amputation. 2 2.1 Psychological care nursing: the need for amputation to tell patients to encourage them to correctly deal with disability, to restore its self-confidence, and preoperative preparation. 2.2 according to the patient's condition to live single patient isolation wards. The patient used medical equipment, such as stethoscope, sphygmomanometer, etc., are sterilized hand only. The property is subject to disinfection treatment of patients with out before, not contaminated articles placed in the clean area. Any contamination must be sterilized, and then routine cleaning. Health care workers into the ward, the need to wear a gown, wash your hands before operating, wash hands after handling. Staff injured hand or broken skin, should be replaced to avoid dressing or other care operations. Disease with ultraviolet irradiation room 2 times a day, each time 1 hour, cover the patient's eye, limb exposed. Patient's condition improved, transfer and discharge ward, patients do indoor disinfection, will be closed ward, open the bedside table, will be opening it out and hang the cover, mattresses, pillows put up with drugs such as lactic acid or formalin fumigation , and then open the doors and windows for ventilation. 2.3 in patients with wound care: close observation of patient temperature, blood pressure, pulse and respiration. Open 24 hours a postoperative wound drainage, to observe whether the drainage or odor, replace the dressing several times a day, regularly wash the wound with the oxidant,[link widoczny dla zalogowanych], changing the anaerobic environment, inhibit bacterial growth and reproduction. Used dressings concentrate sent to the incinerator burned. 2.4 Skin Care: Preventing pressure ulcers occur frequently changed supine, rolling, generally 2 to 3 hours turning over, and knock back a time, not more than 4 hours, turning should avoid pushing, pulling, dragging and other activities. In bone protuberance at the ring or with a cotton pad. Promote blood circulation, often with warm sponge bath, always check the pressure areas on a regular basis or with 5 massage the back pressure at the alcohol. To avoid local skin irritation, beds should be kept smooth and no wrinkles, clean and dry Dong Yan Ying Liu urgent Tongyu County's first hospital ● P - one hundred and eleven of Hand Surgery stenosing tenosynovitis is common disease. Occurs in many families with your fingers and wrists of women, family and other light industry workers and orchestra, the cause can be divided into acute and chronic injury and pre-factors. Infestation refers to the clinical manifestations of pain, snapping, and atresia, severe cases, finger movement disorder, which seriously affect the work and life of patients, clinical treatment methods more, but the results are mixed. The author in 1996, prednisolone acetate and lidocaine do local block therapy, combined with local heat, physical therapy practice, and achieved a better therapeutic effect, up 3 to 12 months there was no significant recurrence. Treatment and care is now on its experience as follows: 1 The clinical data of patients in this group 2O, 8 males and 12 females; treatment time from 2 to 6 cycles, 18 patients were cured and 2 patients had significant improvement in symptoms. 2 Methods 2.1 closed treatment: the prednisolone acetate lidocaine 25mg plus 2 2mi, with 5 narrow gauge needle into the tendon sheath and the tendon of the hand to ask, the time 1 week 1, 3 to 4 weeks for a course of treatment. 2.2 The Local care: the closure means to do every day suffering from local massage, hot packs, physical therapy, and guide patients to do tendon minor activities, scope of activities increased gradually, until the normal. Treatment: Hand Surgery stenosing tenosynovitis is common in the past have used local hydrocortisone acetate pine closed, have a certain effect, but because of its easy to secondary infection, side effects, but limited. Effect of surgery is good, but the patient is not easy to accept, we applied prednisolone acetate plus lidocaine local block, that is, the proliferation of swollen tendon sheath syndrome have anti-inflammatory effects, promote absorption, but also the town of pain, analgesic effect, no significant side effects. This method is simple, easy to master, out-patient nurses can be implemented, not only convenient for patients, but also to reduce the burden of patients, clinical easy to spread. Operation points: ① strict attention to aseptic technique must be disinfected with a strong iodine disinfection, local secondary sterile gauze, his hands do not touch the injured arm injection after injection, application of sterile dressing over 3 days, or such as caused by infection, secondary to purulent tenosynovitis, patients will have serious consequences. ② use the needle 5, a small needle, the Deputy should be injected less damage, while patients with less pain, should be accepted. ③ site should be asked into the tendon sheath and tendon, can play an effective role. Methods: Patients made flexor activity, touching the painful subcutaneous nodules in the distal or proximal to the needle can penetrate to the tendon and the tendon directly Xia Department of ~,,, inflammation of a tendon will be Kettle jeer ~ wall Li Wang