1 More critically ill patients, 1 More rescues and heavy work pressure. The emergency department is the department with the most concentrated acute and critical patients, the most complicated diseases and the heaviest rescue task. In the face of critical patients, whether timely and correct diagnosis and rescue can be made is directly related to the safety of patients.
Life and future rehabilitation [(z 1. Because emergency nurses have been at this height for a long time,
Needle injury teaching enables soldiers to master the whole anti-stabbing practice, carry out stabbing education in time, and the safety operation procedures for needle injury hand protection are consistent.
Strengthen hardware construction, set up sharps collection boxes, etc. In order to reduce the occurrence of needle injury and enhance the confidence of nurses in preventing needle injury; Improve nurses' understanding of needle injuries and educate nurses to treat each needle as a needle infected with HV virus; I correct nurses' lucky psychology after injury, make them pay attention to and cooperate with the treatment of injury, and improve nurses' awareness of self-strengthening support system construction and preventing sharp instrument injury after acupuncture injury; Strengthen the mutual support between nurses and the support of nursing managers for injured nurses, so as to reduce the negative emotional reactions of nurses with acupuncture injuries, such as fear and the idea of escaping or leaving their jobs. Nurses should take a positive attitude towards the importance of acupuncture injury and seek psychological support after injury.
In high tension, there are many critically ill patients, many rescues, rapid changes and dangerous work.
There are many factors such as high risk, heavy workload, great psychological pressure, complex environment and changeable situation. In this case, nurses are under the greatest pressure and are most easily accepted.
Stimulated by the patient's death, it is easy to see the patient who I have taken care of wholeheartedly die.
Frustration reactions such as sadness, guilt and helplessness have greatly hurt the self-esteem and pride of "angels who give humanity" [J]0 1 Needle-stick injury is very likely and extremely harmful: Needle-stick injury is a kind of foot with deep skin.
Blood or body fluids contaminated by pathogens will be inoculated into the injured, which is the most common occupational hazard in nursing work. Emergency nurse
People often participate in the treatment and rescue of patients before they are completely diagnosed, including patients with infectious diseases in the incubation period and before diagnosis [(a y hepatitis is high in China.
Grasp the physical and mental health of the body. In order to maintain oneself
2. Create an atmosphere of physical and mental health: 3. Through social support and the science of nursing managers.
In the epidemic area, the carriers of I HV are also on the rise. Most emergency nurses acupuncture
The most terrible result after injury is infection with infectious diseases such as hepatitis H V. At present, for these diseases,
Management creates a healthy atmosphere for nurses. (1) social support refers to the spiritual and material help and support given by organizations from all walks of life, including family, relatives, friends, colleagues, partners, party groups, trade unions, etc. , reflecting the connection between a person and society.
Intimacy and quality [] 7. Social support is one of the important mediating factors between psychological stress and health. Organizing effective support for nurses is also helpful to their work.
Lack of effective treatment means that once infected, life, work, family and so on. Will change, and even survival will become a problem. At the same time, it may be transmitted to relatives and colleagues around you without self-awareness. After being injured by acupuncture, I feel very scared and passive. The possible reason is that I realize the great harm after acupuncture and think acupuncture is indispensable.
Avoidance after injury and lack of necessary support system. 1 Lack of effective psychological protection when emergencies come: In March 2003, a once-in-20-year severe acute respiratory syndrome (A S R) emergency across national boundaries caused social panic and psychological shock to clinical nurses in different degrees. Haemophilus influenzae A has the characteristics of unknown transmission route and strong infectivity. At the initial stage of the outbreak, Haemophilus influenzae A was ineffective.
Relieve stress. For example, in view of the anxiety state of nurses during SR, as a major.
Personnel should provide psychological consultation, guidance and protective measures for nurses in time. Take various forms.
Communicate with ward nurses, such as setting up hotline calls and consulting lectures. The hospital establishes a pressure support system to help medical staff solve specific difficulties in order to get rid of the sense of superiority in the future. In addition, in the education and training of nurses and nursing students, we should properly strengthen the training to deal with emergencies, so that they can feel physically and mentally at work.
Enough to deal with an emergency. ② Nursing managers should create a good environment for emergency nurses.
A relaxed, cheerful, United and enterprising working atmosphere, cultivate a dense, enthusiastic, meticulous, stubborn and humorous working team, and adopt specific psychological decompression measures, such as organizing regular sports.
The emergency system of the incident is not perfect, and the infection rate of medical staff is high in a short time, which makes nurses bear greater pressure than before [(s 7. At the same time, a large number of patients with fever were treated in a short time, and the nurses were very tired and worked in a completely closed environment. Understanding and understanding of S R A S
Insufficient protection, impatience and anger of patients also directly affect the feelings of nurses.
Lack of communication with the outside world and difficulty in getting support from relatives and friends and society are the reasons why nurses have negative emotions such as anxiety and depression. 2 Countermeasures to maintain the physical and mental health of emergency nurses.
2. Strategies for coping with high tension:. 1 ① Pay attention to self-protection, correctly handle the pressure of waiting for a job, and master the relaxation skills that suit you. Psychologists put forward: "The most common and effective way to relieve psychological stress is to leave the scene and have a rest, do some strenuous physical and mental exercises, and chat with friends and colleagues." ② Nursing managers should create a good environment.
Games, outings, cultural performances, etc. Relax and relieve stress. The establishment of psychological supervision and guidance institutions, the organization of psychological consultation groups or the use of psychological consultation institutions to maintain the mental health of nurses can take the form of individuals, groups, groups, regular consultation, lectures, training, etc., and formulate psychological crisis intervention programs for psychological crises caused by unexpected events. In short, nursing managers should pay attention to the physical and mental health problems of emergency nurses, maintain their mental health in time and effectively, relieve their psychological pressure, and fully mobilize the internal enthusiasm of every nurse who is willing to contribute to the cause of human health.
3 references
[Yingjusu, Xu, 1] Zhang. Socio-psychological factors affecting the health status of nurses in emergency department. 】 Chinese Journal of Nursing, 0; ( ) 2.2 43 1 : 1 0 907
. 4 4 2.
Jilin Medicine, April, June and 20th, Vol.2, No.47.
Nursing care of adult respiratory distress syndrome treated by ventilator
, Jiang Yabo, Xue (Department of Cardiology, Baisixin Hospital, Jilin Province, 4 1 00 Ping 30) 6
[Ventilator; Respiratory distress syndrome; The classification number of Nursing China Library is 43 R 7. 6 document identification code: b.
Article number: 0-1(0)-2114 422 604-0 00440.
Reasonable regulation and monitoring of 2 p e e p: e3p has a significant effect on the treatment of A D.
Mechanical ventilation is an important method to treat adult respiratory distress syndrome.
Segmental ventilator is an effective measure to treat A D before operation. Use the respiratory function to breathe accurately.
Fruit, but if it is not properly regulated, it can produce barotrauma, affect hemodynamics and renal function.
Effectively control oxygen therapy, reduce the work of spontaneous breathing and prevent respiratory muscle fatigue. Positive end-expiratory pressure
(E P can prevent alveoli from collapsing, and PE can increase gas exchange. Early active application of breathing.
Yes, it should be adjusted reasonably. So the principle is to ensure that F 20, >; I <% po8ng05a2
In this case, the lowest value is used. The specific adjustment method is: set P E to 4 EP-
Suction can improve the cure rate and survival rate of A D, and can RS.
Clinical data of 1
After 5 H0 1 n, check the blood gas, c 2, rn m 5i, if it is still P 2 0 m g a a2.
Among the 6 patients with A D in this group, there are 4 males and 4 females, and the intubation time is 5 8 n g. If the blood pressure drops after PE increases, there will be RS cases, cases and cases. Uh ... EP 0 If lung compliance decreases, don't increase it.
Cases, tracheotomy 1 case. The primary diseases were compound trauma in 3 cases and acute nephritis 1 case. After treatment, blood pressure should be adjusted (such as blood volume supplementation). At the same time, due to cases, abdominal infection 1, severe pancreatitis1; The average age of these patients is 3 years old. Years old (16 E increases intrapleural pressure, and 4 4 2-0 P P E affects venous return, resulting in decreased cardiac output, and blood pressure is years old). The duration of ventilator use is more than 6 years, and the longest d is 1 day, which can lead to circulatory failure in severe cases. Excessive positive pressure may also lead to pneumothorax. Intermittent positive pressure ventilation (P E. I V plus EP P Therefore, in the process of monitoring, it is necessary to closely monitor the changes of blood pressure, pulse and respiration of patients, and do a good job in nursing, check blood gas in time and adjust it according to the blood gas results in time.
Setting and monitoring of ventilator parameters:. 1 ① Oxygen concentration (q)4' 6% 2 is suitable for patients' basic nursing and psychological nursing F:/0 i 0 w. 4, and i26% can cause oxygen poisoning; 00, 0 F 24', i/. 1 4 Patients receiving ventilator treatment due to long-term bed rest, local
② The tidal volume () T: V is generally11g in adults, and 0.5/0 is too low, which easily leads to the imbalance of ventilation/blood flow ratio and affects oxygenation. ③ Ventilation per minute (V: -0/ M) was 8 1 L.
Mn i is more suitable. Excessive MV causes excessive discharge of carbon dioxide, leading to metabolic alkalosis;
Blood circulation disorder should be blocked. Turn over and press your body regularly and rub the pressed skin. If necessary, put an air ring or air cushion on this part (such as the tail) to prevent the occurrence of pressure ulcers.
2. Oral care: .24 oral care was given and% was cleaned with 3 boric acid water or 3 hydrogen peroxide.
If the M V is too small, it is easy to leave carbon dioxide vinegar and metabolic acid (PE: poison). ! EP) Generally 51cH5 Airway temperature:-35.23℃ at 2 pm.
2 airway care. 2.2. Keep airway unblocked:. 1.2 Suction sputum in time, keep airway unblocked, and ensure effective mechanical ventilation. Strictly abide by aseptic operation procedures when sucking sputum to avoid infection. The action should be light, so as not to damage the respiratory membrane. At the same time, pay attention to: ① consciously increase F, I and O a few minutes before sputum aspiration to keep arterial oxygen partial pressure (A at a safe level).
Remove oral cavity 12/ from mouth to mouth D to prevent oral inflammation and oral ulcer. 2. Urethral management: urethral catheterization, 0.34 nursing, perineal nursing 1.00 hours, 0 bark 5.
Rinse the bladder with penicillin solution12 times, and change the urine collection bag regularly; D. After the patient is conscious, the patient who urinates should remove the indwelling catheter as soon as possible to prevent urinary tract infection. 2. Psychological nursing: 4 4 conscious patients have a heavy psychological burden on using ventilator, so the purpose of mechanical ventilation and the methods that need to be coordinated should be explained to reduce their fear, enhance their confidence in overcoming the disease, cooperate with the treatment and promote their early recovery.
environment ② Appropriate control of sputum aspiration time.