急诊科护理常规

急诊科护理常规 第一节 急诊科一般护理常规 1.值班人员必须坚守工作岗位，认真履行职责，使用文明礼貌用语，热情接待病人，要求对病人细心、耐心、有爱心。杜绝生、冷、硬、推等态度。 2.认真执行各项规章和护理操作规程，严格查对制度和床头交接班制度，防止差错事故发生。 3.严格执行各种急危重症抢救程序，抢救室内急救器械、药品、物品做到四固定:既定数量、定位置、定人管理、定时维修及保养，及时更新和补充，切实保证急救物品完好率100%。 4.分诊护士做好急诊和分诊预检工作，按病情轻、重、缓、急给予安排就诊。对危重病人急救，本着时间就是生命的原则，在医生到来之前护士可行必要的急救处理，争分夺秒畅通生命绿色通道。 5.负责院前急救工作，出诊班护士负责检查救护车上急救设施是否完好，保证病人在院外及转运途中得到医务人员及时有效的救治，院内负责护送危重病人作相关检查或转送到专科病房。 6.按照分级护理的标准，严密观察留观病人病情变化。及时完成各项治疗和护理，帮助解决病人的实际困难，为病人提供便民措施、各种健康教育和护理咨询等优质多元化服务，真正体现以病人为中心的人文关怀 7.做好传染病和消毒隔离工作，防止医院感染发生。 第二节 心跳、呼吸骤停的急救护理 一( 评估和观察要点 1. 突然意识丧失或伴有抽搐，叹息样呼吸，呼吸停止，大动脉搏field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 动消失，血压测不到，瞳孔散大，发绀明显。 2. 听诊心音消失，心电图:心室扑动与颤动，心脏停博，心电机械 分离无脉性室性心动过速。 二、护理要点 (一)紧急处理: 1.胸外心脏按压。2.开放气道。 3.人工呼吸。4.电除颤。5.心电监护。 6建立双静脉通道。7留置导尿 。 8床旁特别护理。 (二)确认有效医嘱并执行:1.抢救药物，如肾上腺素、利多卡因、阿托品、碳酸氢钠、多巴胺、激素等。2.配合完成除颤。3.积极治疗原发病，防治并发症。4.备临时起搏器。5.维持水电解质酸碱平衡。6.采用低温疗法，强化头部降温。7.给予高压氧治疗。 (三)监测:1.心率、心电图。2.体温、脉搏、呼吸、血压。3.意识、瞳孔、面色。4.尿量、中心静脉压。5.血气分析。6.末梢循环。 三、健康指导要点 1.复苏成功后，及时给予病人及家属心理支持，做好必要的解释工作。 2.积极治疗原发病。 3.指导患者进行相应的意识恢复训练，肢体功能训练，指导家属生活护理技巧。 四、注意事项 1.实施心肺复苏应迅速、准确。 2.人工呼吸与胸外按压交替进行。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 3.按压用力要均匀，双手不可离开按压定位点。 第三节 急性上消化道大出血的急救护理 一、 评估和观察要点 1.神志、生命体征、呕血、黑便的次数，颜色、性状和量。 2.皮肤甲床的色泽、肢体温度、静脉充盈情况。有无周围循环衰竭症状、有无并发感染、黄疸、肝性脑病等。 二、 护理要点 (一)、紧急处理:1.平卧，头偏向一侧，下肢抬高，保持呼吸道通畅，防止误吸。2.迅速建立有效的静脉通路，尽快补充血容量，大量出血时应立即配血，备血。3. 心电监护，禁食，留置胃管，胃肠减压。4.清除血迹污迹，保持环境安静，避免不良刺激，给予心理安慰。 (二)、确认有效医嘱并执行:静脉补液，必要时输血，使用制酸、止血药，必要时三腔二囊管压迫止血，内镜下止血或手术前准备。 (三)、监测:1.意识及生命体征、中心静脉压、出入量、2.呕血、黑便的量与性质，肠鸣音及其他腹部体征，血红细胞计数、血红蛋白、血细胞比容、肌酐、血尿素氮。 三、健康指导要点 1.保持良好的心态和乐观主义精神，正确对待疾病。 2.帮助病人和家属掌握上消化道出血的基本知识，消除各种诱因。 3.出血期禁食，出血停止后按序给予温凉流质饮食、半流质及易field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 消化的软食，逐渐过渡到普食。 4.注意饮食卫生，合理安排作息时间，适当体育锻炼，增强体质。 5.禁烟、酒、浓茶、咖啡等对胃有刺激性的食物。 6.指导病人正确服药，定期复查。 四、注意事项 1.准确呕血、便血的颜色及量、有效的胃肠减压，观察胃液的颜色、性质及量。 2.及时清除污渍，保持床铺、衣物整洁，工作镇静有序，及时安慰病人及家属，做好必要的解释工作。 第四节 急性心肌梗死的急救护理 一 评估和观察要点 1.突发心前期疼痛，压榨性，濒死感，持续时间长达1-2小时 2.血压下降，脉搏细数。 3.面色苍白或发绀，大汗。 4.心电图有典型的S-T改变。 5.心肌酶及同工酶增高。 二、护理要点 (一)、紧急处理:1.迅速安置病人，取平卧位。2.吸氧，流量4-5L/min。3.心电、血压监护。4.生命体征。5.做心电图。6.监测血氧饱和度。7.建立双静脉通道。8.留取血标本。 (二)、确认有效医嘱并执行:1.硝酸甘油舌下含服，并静脉持续滴注。2.止痛药，如吗啡。3.阿司匹林和氯吡格雷各300mg口服。4.溶栓药物的应用。5.B受体阻滞药物。6.抗休克、抗心律失常药。field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 7.冠状动脉造影/成形。 (三)监测:1.血压、脉搏、呼吸、心律、心率。2.心电图、心肌酶、同工酶、肌钙蛋白、肌红蛋白的动态变化。3.并发症:心律失常、心源性休克、心力衰竭。4.记录液体出入量。5.心理状态。 三、健康指导要点 1.避免各种诱发因素，如紧张、劳累、情绪激动、便秘、感染等。 2.合理调整饮食，适当控制进食量，禁忌刺激性饮食及烟、酒，少吃动物脂肪及胆固醇较高的食物。 3.注意劳逸结合，康复期可适当锻炼，锻炼过程中应观察有无胸痛，心悸、呼吸困难、脉搏增快等，一旦出现应停止活动。 4.按医嘱服药，随身携带硝酸甘油等扩张冠状动脉的药物，并定期随访。 5.指导患者家属当病情突然发生变化时应采取简易措施。 6.积极治疗高血压，高脂血症、糖尿病等疾病。 三、健康指导要点 1.绝对卧床休息，不可用力排便，谢绝探视，避免不良刺激。注意保暖，避免着凉。 2.观察并记录是否出现了溶栓后遗症，如出血，心律失常等，及时报告医师。 3. 备好抢救用品，包括各种抢救药品和抢救器械，如除颤仪、氧气、监护仪等要处于备用状态。 第五节 急性有机磷农药中毒的抢救和护理 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 一、评估和观察要点 1.明确毒物的种类、剂量、中毒途径及时间，评估患者中毒的情况，有无洗胃禁忌症，意识心理状态及合作程度，口鼻腔黏膜，口中异味等。 2. 密切观察神志瞳孔、生命体征、皮肤黏膜和尿量等。 3. 观察毒蕈碱样症状、烟碱样症状及中枢神经系统损害症状。 4. 严密观察阿托品化及阿托品中毒现. 二、护理要点 1.迅速彻底清除体表毒物，脱去受染的衣物，用肥皂水和清水反复洗净受染的皮肤，毛发，甲缝，忌用热水，以免增加毒物吸收;详细询问毒物种类、剂量及时间，测定血胆脂酶活力。 2.清除胃肠道内的毒物，口服中毒者，应及早反复催吐，洗胃、导泻等方法，清除胃肠道内的毒物，减少毒物的吸收，反复彻底洗胃至洗胃液澄清无味，再注入活性炭进行吸附和导泻。 3.卧床，口于最低位避免误吸，保持呼吸道通畅，高流量给氧，呼吸停止时行气管插管接呼吸机辅助呼吸，注意保暖。 4.抽血查血生化，胆碱酯酶及电解质，开放静脉通路，保证补液及抢救用药的有效使用。 5.心电监护，严密监测P、R、BP及SPO2。 6.反复、足量应用特效解毒剂阿托品、长效托宁、解磷定注射液及胆碱脂酶复能剂。注意观察阿托品化指征:瞳孔较前扩大，颜面潮红，口干、皮肤干燥、肺部罗音减少或消失、心率增快，体温可稍升高，轻度烦躁或恍惚等。避免阿托品中毒。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 7. 密切观察神志瞳孔，生命体征及皮肤黏膜的变化，监测中心静脉压及出入量，并详细记录。根据病情掌握输液速度;按医嘱用药并观察疗效;加强对症支持治疗。定期抽血查血生化，胆碱酯酶及电解质，血气分析等。 8.促进已吸收的毒物排出，应用补液，利尿、透析或血液灌流等方法促进已吸收的毒物排出。 9.加强基础护理，做好病人口腔，皮肤及各种管道的护理，严格无菌操作，避免交叉感染，预防并发症。清醒病人鼓励早进食，昏迷病人给予鼻饲胃管喂食，保证充足营养，尽早康复。 10.做好心理护理安慰，体贴患者，给予同情、理解，增加患者自信心，使其认识到自身的价值，减少其绝望感。 三、健康指导要点 1.指导病人及家属了解有机磷农药中毒的危害性，做好个人防护。 2.做好安全防护，防止坠床和外伤，专人护理，加强心理护理。 3.提供足够的营养物质。 4.被污染的衣物要及时更换，并洗净受染的皮肤，毛发及指甲，凡接触农药的用物用清水反复冲洗，盛过农药的容器绝不能再盛食物。 5.喷洒农药的过程中出现头晕、胸闷、流涎、恶心、呕吐等症状，应立即就医。 四、注意事项 1.要注意观察药物的毒副作用，特别是阿托品化及中毒的表现。 2.备好抢救用品，包括各种抢救药品和抢救器械，如除颤仪、氧field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 气、监护仪等要处于备用状态。 第六节 急性一氧化碳中毒的抢救和护理 一、评估和观察要点 1. 有无中毒的环境和条件。 2. 评估生命体征、意识状态，瞳孔、碳氧血红蛋白浓度，皮肤黏膜及症状。 二、护理要点 1(脱离中毒环境 打开门窗，迅速将患者移至空气新鲜处，解开领口，注意保暖，呼吸心跳停止者立即进行心肺脑复苏，必要时行气管插管或气管切开，给予人工机械通气。 2.纠正缺氧 保持呼吸道通畅，迅速给患者吸入高浓度(,60%)和高流量氧气(8-10L/min)，随后尽快作高压氧治疗，防止迟发性脑病。 3(心电监护，严密监测生命体征，神志瞳孔，出入量，血生化，血常规，碳氧血红蛋白，动脉血气，有无头痛、喷射性呕吐等脑水肿征象等。 4.脱水降颅压，防治脑水肿 遵医嘱应用甘露醇、呋塞米、氢化可的松或地塞米松静脉滴注。 5.改善脑组织代谢 应用大剂量维生素C、细胞色素C、纳洛酮等。 6.对症处理 高热病人，给予物理降温，重度昏迷者，可输新鲜血或血液净化治疗，及时纠正水电解质和酸碱平衡紊乱。加强基础护理，预防护理并发症。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 7.恢复期护理 患者清醒后仍要休息两周，给予高热量，高维生素，高蛋白饮食，加强肢体锻炼，如被动运动，按摩，针灸，以促进肢体功能的恢复。 三、健康指导要点 1.家庭用火炉，煤炉要安装烟囱或排风扇，定期开窗通风。 2.厂矿应加强劳动防护措施，煤气发生炉和管道要经常维修，定期测定空气中的CO浓度。 3.在生产有CO的场所停留，若出现头昏，头晕，恶心等先兆，应立即离开。 四、注意事项 1.要重视和坚持高压氧的治疗，特别是中重度中毒的患者，要注意观察迟发性脑病的发生。 2.备好抢救用品，包括各种抢救药品和抢救器械，如除颤仪、氧气、监护仪等要处于备用状态。 第七节 淹溺病人的抢救和护理 一、评估和观察要点 1. 评估生命体征、意识状态、心理状况，溺水的时间长短、水的性质、溺水前的情况，溺水后有无伴随症状。 2. 淹溺的程度 (1)轻度淹溺吸入或吞入少量水，神志清楚、血压增高、心率增快。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between (2)中毒淹溺溺水达1-2分钟，呼吸道有大量的水和呕吐物而发生窒息，或伴有放射性喉痉挛，呼吸不整或表浅，血压下降、心率减慢、反射减弱。 (3)重度淹溺溺水达3-4分钟，可出现窒息、发绀、呼吸道充满血性泡沫、淤泥或呕吐物，四肢冷、血压低、心音减弱、心律不齐，可诱发室颤，抽搐或昏迷，并可有肺部感染，心力衰竭，肺水肿等。 二、护理要点 1.立即清理呼吸道，迅速清除患者呼吸道内的淤泥，杂草和分泌物，置口咽通气管，确保呼吸道通畅。心跳呼吸未停者，迅速倒水，动作要敏捷。迅速将病人安置于抢救室，更衣保暖，注意保持呼吸道通畅 2.呼吸心跳停止者，立即行心肺复苏，气管插管，负压吸引，排出气管内水及分泌物，高流量给氧或接呼吸机辅助呼吸，心电监护，监测心率、血压、呼吸、氧饱和度的变化。 3.开放静脉通路，根据溺水的性质(淡水或海水淹溺)，遵医嘱用药，维持呼吸循环功能，防止并发症。 4. 严密观察神志瞳孔，生命体征、尿量变化并准确记录;严格执行医嘱，正确控制输液滴速，注意预防肺水肿的发生。 5.积极防治并发症:肺炎，肺水肿、脑水肿、急性肾功能衰竭等。 6.加强患者的心理护理，缓解患者紧张，恐惧的心理。 三、健康指导要点 1防止淹溺，做好安全教育工作，特别是小孩学游泳时，应有保护措施,游泳时最好有同行者，不去禁止游泳及偏僻的场所游泳，不在过于冰冷的水中游泳，且游泳时间不宜过长。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 2.有心脑血管疾病者，不宜游泳。 3.发生淹溺时，应在原地进行现场抢救，保持呼吸道通畅。 四、注意事项 1.掌握倒水动作: (1)将患者俯卧，下腹垫高，头部下垂，手压其背部，使积水倒出; (2)术者将患者双腿抱住，将其放在肩上并快步走动或小跑，使积水倒出; 2.对心跳呼吸骤停者立即施行徒手心肺复苏，有条件的给予肾上腺素和适量呼吸兴奋剂。 3.掌握先抢救生命同时预防并发症;复苏成功后维持正常呼吸及循环的原则，切忌因倒水时间过久耽误其它抢救措施。 第八节 电伤病人的抢救和护理 一、评估和观察要点 1.生命体征，神志瞳孔，电源的种类、电压、触电的时间、当时情况。 2.伤情 (1)心律失常，心脏骤停、电流通过心脏导致心肌细胞内离子紊乱引起室颤可危及生命。 (2)局部电灼伤伤口的大小，深度、颜色、位置。 (3)有无骨折，关节脱臼等。 二、护理要点 1.立即切断电源。 2.呼吸心跳停止者现场进行心肺复苏术。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 3.保持呼吸道通畅，吸氧，必要时进行气管插管，接呼吸机辅助呼吸。 4.持续心电监护，监测心肌损害和心律失常的情况。 5. 开通静脉通道确保用药途径，密切观察生命体征、神志瞳孔的变化，留置尿管，准确记录出入量。 6. 对症处理 处理局部伤口，保护创面，预防感染，合理使用抗生素，注射TAT。有骨折脱位的及时固定。 7.积极防治并发症，休克、脑水肿、肾功能不全、电解质失衡。 8. 加强基础护理，保持口腔、皮肤清洁，防止护理并发症发生。 9.心理护理 电击伤后会给患者心理上带来极大的恐惧感，应抚慰患者，消除恐惧感，使患者积极配合治疗。 三、健康指导要点 1. 普及安全用电知识，安装和维修电器、电线时要按规程操作。讲解电击伤患者的急救方法及现场救护知识。 2.局部创面禁用龙胆紫，红汞等有色素药物。 3.保持局部创面的干燥，防止创面感染。 四、注意事项 1.掌握救护原则:在现场采用最安全迅速的办法将患者脱离电源，避免触电者再损伤，保持绝缘状态，保证抢救者自身安全。 2.备好抢救用品，包括各种抢救药品和抢救器械，如除颤仪、氧气、监护仪等要处于备用状态。 第九节 严重创伤病人的抢救和护理 一、评估和观察要点 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 1(评估受伤时间，致伤因素、部位、伤后出现的症状、演变过程及处理经过。 2. 生命体征，神志瞳孔、对光反射、面色、四肢活动、胸腹式呼吸，有无上呼吸道阻塞、心包填塞、脑疝、张力性气胸、大出血等致命征象。 3.从头到脚进行检查，注意脱去全部衣服，查看伤情，避免漏诊。 二、护理要点 1.对全身伤情和危及生命的伤情进行准确评估，注意气道、呼吸、循环、中枢神经系统情况，确立损伤部位针对病情实施有效救治。 2.及时清除口咽部分泌物、血块等梗阻物，高流量给氧，必要时气管插管或气管切开，应用呼吸机辅助呼吸。呼吸心跳停止者立即进行心肺复苏。 3.迅速建立和保持两条以上大静脉通路，输液首选平衡液或全血，补充有效循环血量，积极抗休克，取血标本做输血前各项检查及交叉配血。 4.迅速处理活动性出血，包括伤口加压包扎、负压止血带止血、骨折的固定，控制明显的外出血;妥善保管离断肢体。 5.心电监护， 严密观察病情，随时检测生命体征，神志瞳孔，监测中心静脉压及尿量，准确记录出入量，观察有无泌尿系损伤，循环灌注情况及肾功能损害等， 6.进行对症处理，颅脑损伤患者及早应用脱水剂，预防脑水肿;休克者积极实施抗休克治疗;血气胸者立即配合医师放置胸腔闭式引流，张力性气胸应迅速在锁骨中线第二肋间行粗针头穿刺减压;腹腔内脏损伤者，积极配合医师行腹穿，B超、CT，脱出的脏器严禁还field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 纳腹腔，用无菌敷料覆盖，积极做好术前准备。 7. 加强基础护理和心理护理，预防各种并发症发生。 三、健康指导要点 1.对颅底骨折患者出现脑脊液耳漏、鼻漏，不能用棉球堵塞。 2.对胸部损伤患者说明吸氧、胸腔闭式引流、心包穿刺的注意事项，血压平稳取半卧位，利于呼吸及引流，减轻疼痛。 3.对腹部损伤的患者告知插胃管，尿管的意义，解释手术的必要性，禁食水的重要性，解除恐惧心理。 4.对肢体骨折的患者，在治疗前禁止肢体活动，以免引起再损伤。安慰患者，讲解石膏固定后的护理知识。 四、注意事项 1. 根据病情酌情给予镇静、镇痛，但颅脑、胸部损伤禁用吗啡或度冷丁。 2. 注意转运方式及转运工具的选择，脊柱骨折患者用硬板床护送，疑有 颈椎骨折应上颈托固定，限制其活动，避免加重脊柱损伤。 3.备齐各种抢救药品、物品，做好应急抢救工作。 第十节 留观病人护理常规 1.急症病人就诊后，由医生决定是否留观，需留观时当班护士，办理留观手续。 2.留观病人按入院病人护理常规护理，主管护士向病人及家属介绍观察室环境、入院须知、探视陪护制度及各种安全防范措施。 3.危重病人病情未稳定时设专人护理，密切观察病情及维持各种管道通畅，发现危险预兆立即报告医生，并做好记录。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between 4.留观时间一般为24小时，最多不超3天，病情缓解或需要住 院时，与病房联系好床位并护送，随即办理转科手续。 5.认真做好基础护理，遵医嘱用药，预防护理并发症。 6.病人死亡或确诊传染病时，一切物品按消毒隔离制度处理。 field is downwind, brooding House separate from the breeding shed, and ... Building chicken farms must also consider the construction of chicken manure treatment facilities such as septic tanks, methane-generating pit, do not let the chicken manure directly. Five to do a disease prevention and control, do not cut corners. Built into the chicken in chicken farm, will be required to do a variety of vaccine injections and disinfection in chicken farm, do not hold the chance, and do scientific farming. Reasonable problems in building a chicken coop hen house layout, can provide a good environment for chicken, making its full productive potential, so other than in understanding the physiological characteristics of the chicken itself, and must be properly planned and constructed sheds. A chicken layout considerations 1. Sites to choose away from populated areas, traffic convenient, away from the road 2. Gaozao terrain, a lot of sunshine. Winter sun as possible, summer wind, and not after the rain water. Larger, leaving room for development 3. Abundant water resources pollution-free, easy to access, sufficient power is guaranteed 4. Building structure, the economy, saving money, and saving energy, it is facing in accordance with local environmental and physiological condition, lighting is good, easy to ventilation, easy to operate, so conducive to cooling in the summer, to insulation in winter cold 5. Layout of premises should be reasonable, do distinguish between