非同步直流电复律术

非同步直流电复律术 【目的】用电除颤释放的短暂高能量脉冲电流，直接或间接作用于心脏，使全部心肌同时除极，中断一切折返通道，消除异位心律，恢复窦性心律。 【适用范围】主要适用于心室颤动或心室扑动时，心脏已丧失有效的机械性收缩功能，血液循环处于停顿状态的危急时刻。 【操作步骤】 1、心电示波提示存在室颤。 2、打开除颤器电源开关，将选择按钮置于非同步位置。 3、将除颤器电极板包上生理盐水浸湿的纱布(4或5层)或涂抹导电糊。 4、根据患者情况选定充电量;非同步电复一般选择300J，按下“充电”CHARGE按钮，将除颤器充电到所需水平。 5、正确放置电极板:一个电极板放置心尖部即左锁骨中线第4肋骨，另一个电极板放置心底部即胸骨右缘第2肋间。 6、放电:将电极板紧贴患者皮肤，嘱所有人员离开床旁，同时按下两个电极板上的放电按钮。 7、放电后立即观察心电图示波，行心肺复苏，观察患者神志，测血压、呼吸，做好特护。 8、如一次复律未成功，可重复操作1或2次。 9、除颤完毕，关闭除颤器电源，将电极板搽干净，收好备用。 【注意事项】 1、保证除颤器处于良好的备用状态。 2、除颤前先判断病情、示波图形、患者意识情况。 3、电极板放置部位要准确，并紧贴患者皮肤，避免有空隙，以防放电灼伤皮肤。 4、除颤器的把手要干燥，操作者的手注意不要接触到生理盐水纱布垫。 5、操作者及有关人员注意不与患者及病床接触，以免遭电击。 6、在颤动波粗大期内进行电除颤。 7、除颤后应尽早采取心脏复苏措施。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 经口气管插管术 【目的】解除呼吸困难，保持呼吸道畅通，为有创机械通气提供条件。 【适用范围】 1、急性呼吸道梗阻。 2、及时清除呼吸道内分泌物。 3、咽喉缺乏保护性反射。 、呼吸衰竭需正压通气治疗的患者。 4 【操作步骤】 1、准备物品，喉镜、气管导管、管芯、牙垫、10m1注射器、开口器、舌钳、插管钳、手套、绷带、宽胶布、寸带、听诊器、负压吸引装置、吸痰管、吸氧装置、简易呼吸器、呼吸机、抢救药品。 2、插管前根据患者性别，年龄选择适宜的气管导管【男性7.5-8.5号、女性7.0-8.0号，8岁以下儿童选择气管导管长度为(12+年龄?4)cm】，检查气管导管套囊是否松动、漏气;气管插管所需用物是否齐全，喉镜光源是否明亮。 3、将管芯插入气管导管中。 4、清除口、鼻腔分泌物，取下义齿。 5、准备患者体位。固定头部，后仰位，用右手拇、示指分开上、下唇，提起下颚并启开口腔，左手持喉镜沿有口角置入口腔，同时将舌体稍向左推开，使舌体位于喉镜上方外侧，调整镜片深度，借助光源以此可见舌根部、腭垂、咽后壁、会厌，然后上提喉镜，显露声门。 6、右手采用握笔式手法持气管导管，沿喉镜片对准声门裂，轻柔地插过声门进入气管内， -8ml的空气，使套囊后部进将牙垫置于上、下门齿之间，退出喉镜，并向气管套囊内注入6 入声门下1-2cm处，接简易呼吸器挤压1或2次，听诊肺部呼吸音，确定气管导管位置。再妥善固定气管导管和牙垫，记录气管导管在门齿的刻度。 7、采用胶布法和绳带法固定气管导管。 8、插管时动作迅速准确，切勿时间过长，如插管操作时间在30s内未能完成，应暂停操作，应用简易呼吸器高浓度氧气吸入后在重新操作。 9、在插管时，如声门显露困难时，右手按压喉结部位，有助于声门显露，或利用导管管芯将导管弯成“L”形，用导管前端挑起会厌，再行插入，导管进入声门后再将管芯退出。 10、气管插管完成后，必要时应使用约束带，限制双手活动。 11、整理气管插管用物并消毒，以备再次使用。 12、记录:插管时间、导管型号、气囊充气量和气管导管在门齿的刻度。 【注意事项】 1、插管过程中注意无菌操作。 2、插管前检查插管用物是否齐全，喉镜是否明亮。 3、插管操作时切勿时间过长，以免引起反射性心跳、呼吸骤停。 4、插管时，不能将患者门齿作为喉镜支点，而应将喉镜水平向上提起。 5、导管套囊充气不可过多，压力保持在15-25cmH2O,以免压迫气管黏膜。 6、应遵循知情同意原则，紧急情况下，先行气管插管术，在签写《检查、治疗(手术)志愿书》。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 气管插管患者护理常规 1、准备用物。床旁备氧气湿化瓶、吸氧管、负压吸引装置、吸痰盘(换药碗、血管钳、弯盘)、一次性吸痰管、气管湿化液、呋喃西林液，必要时备抢救物品。 2、保持室内清洁、整齐、安静、温湿度适宜，撤除地毯，注意空气流通，避免刺激性气味。 3、保持气管插管的位置适当 )气管插管后应怕胸片，调节插管位置使之位于左、右支气管分叉即隆突上1-2cm。 (1 (2)记录插管外露长度:经口插管者应从门齿测量，经鼻插管者应从外鼻孔测量。 (3)导管固定牢靠、避免移位:随时检查气管导管插入深度，避免导管移位，外露长度应每班测量1次并交班。 (4)选择合适的牙垫，应比导管略粗，避免患者将导管咬变形。 4、防止导管脱出 (1)防止患者自行拔管:对神志清醒者应讲明插管意义、配合方法及注意事项，对神志不清、躁动不安患者，应给予适当的肢体约束，必要时应用镇静剂。 (2)加强监护，注意观察患者体位变化，头部、四肢的活动度，给患者变体位时，床旁至少有1名医师或护士，注意调节好呼吸机管路，以防拉出气管导管。 5、保持患者头后仰位，以减轻导管对咽喉的压迫。 6、保持呼吸道通畅。及时吸痰，必要时气管内滴入生理盐水，每2h1次，每次0.5-1ml，痰黏稠时可随时滴入或遵医嘱行超声雾化吸入。 7、做好口腔护理。经口气插管时，口腔护理应由2人配合进行，每天更换固定胶布或寸带，污染时及时更换。一人固定气管插管，另一人做口腔护理，更换胶布、寸带、牙垫。做口腔护理前先吸净气管插管内的分泌物，再吸口、鼻腔分泌物，然后再做口腔护理，操作结束，核对导管的位置，做好记录。 、加强气囊管理 8 (1)高容量低压气囊应12h防气囊1次，每次3-5min，气囊压迫气管黏膜过久，会影响血液循环，导致气管黏膜损伤，甚至坏死。 (2)放气囊前先清除气囊上分泌物，先吸气道内分泌物，再洗净口鼻腔内分泌物，放气囊时，气囊以上分泌物可流入气管，应同时经导管吸引。 (3)气囊充气压力不要过高，气囊压应保持在15-25cmH2O。 9、预防和控制感染，严格无菌操作，每次吸痰后应更换吸痰管，吸引器长管每周更换消毒1次，吸痰盘每日更换1次，定期取气道分泌物做细菌培养。必要时行呼吸道隔离，防止交叉感染。房间定时做空气培养，紫外线照射消毒，每日1次。 10、密切观察呼吸情况，如有异常，应立即检查导管有无阻塞。 11、定时翻身、叩背，防止肺不张、肺部感染。 12、加强皮肤、背部护理，保持床单单位平整，保持皮肤清洁干燥，防止压疮。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 昏迷患者监护常规 1、准备用物，口腔护理盘、吸引装置1套、吸痰盘、手电筒、开口器、舌钳、牙垫、约束带。 2、密切观察病情变化，定时测量体温、呼吸、脉搏、血压、瞳孔大小及时光反射情况，如有异常及时医生，以便采取抢救措施。 3、预防意外损伤，保持呼吸通畅，头偏向一侧，以防止呕吐物或分泌物堵塞气道。口腔内如有假牙要及时取出，以防止误入气管。躁动不安者，徐加床挡及约束带，以防止坠床，如患者发生抽搐时，应用牙垫垫于牙齿咬合面，防止舌咬伤。 4、预防坠积性肺炎，每2h翻身、叩背1次，吸痰或刺激咳嗽并遵医嘱雾化吸入。注意保暖、防止受凉。 5、预防口腔炎，每日用生理盐水及过氢清洁口腔3或4次，或根据口腔内pH值采用不同的溶液清洁口腔。保持口唇湿润，可涂以润滑油以防唇裂。 6、防止角膜损伤，如患者眼睑不能闭合时遵医嘱应用滴眼液，每晚涂金霉素眼膏，同时加盖无菌纱布，保持眼部的湿润于清洁。 7、预防泌尿系感染，保持留置尿管的通畅，防止尿管受压、扭曲、脱出，保持尿道口清洁，遵医嘱每日用1:5000呋喃林液冲洗膀胱，每周更换尿袋2次。 8、有气管切开时按气管切开护理常规。 9、按医嘱给予鼻饲饮食，提高机体的抵抗能力，做好鼻饲护理。 10、保持大便通畅，遵医嘱给予通便药物。 11、预防压疮，保持床单位、衣服的清洁、整齐、干燥，定时翻身，翻身时避免拖、拉、拽，注意观察皮肤情况，如皮肤干燥且有脱屑者可涂以少量润滑剂。 12、准确记录24h液体处入量，保持出入量平衡。 13、保持肢体功能位，加强肢体功能锻炼，防止肌肉萎缩。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 休克患者监护常规 1、患者卧床休息，取平卧位或休克体位，持续给氧。 2、严密观察病情，主要是“一看二听三摸四测”，以基本判断休克的临床分期、失血量分级和休克程度的变化。 (1)看:神志，口唇，皮肤颜色，浅静脉，末梢循环充盈情况，呼吸频率、节律和深度。 (2)听:呼吸音，判断呼吸道通畅情况、呼吸道有无梗阻、痰堵及误吸等。 )摸:脉搏，皮肤温度。 (3 (4)测量:心率、心律和血压。 3、呼吸功能监测，遵医嘱进行血气分析，了解PaO2、PaCO2、HCO3、乘余碱(baseexcess,BE)等变化，监测氧耗量(oxygen consumption,VO2)、氧输送量(oxygen delivery , DO2)、氧摄取率(oxygen extraction rate , O2ext)等指标，持续监测脉搏氧饱和度，了解全身组织氧合情况。 4、循环功能监测，了解体循环灌注是否充分，指导抗体克的液体复苏。 (1)心肌供血及心律，进行心电监护、定时行12导联心电图检查，实时判断心电活动状态，了解心肌供血情况，及早发现心律失常及其先兆，指导应用合适的治疗药物，药物应用的疗效，防范药物的不良反应。 (2)前负荷:中心静脉压(central venous pressure,CVP)、肺毛细血管楔嵌压(pulmonary capillary wedge pressure,PCWP). (3)后负荷:肺循环的总阻力(pulmonary vascular resistance ,PVR)、外周血管阻力(sys-temis vascular resistance,SVR). )心肌收缩力:心排血量(cardiac output,CO)、心排血指数(cardiac index,CD)。 (4 5、肾功能监测，监测每小时尿量、尿比重，遵医嘱检查尿钠 、血肌酐、尿素氮水平，了解肾灌注状态和肾功能。 6、动态监测内环境变化。 (1)酸碱度:主要管局血气分析结果进行评价。 (2)胃粘膜pH值(pHi)、血乳酸。 (3)其他:电解质、血浆晶体渗透压、血浆胶体渗透压、血糖、血红蛋白、血细胞比容。 7、生化指标监测，遵守医嘱进行肝肾功能指标、治疗药物的血药浓度等监测。 8、液体输入监测，保持静脉输液通畅，遵医嘱应用血管活性药物，准确调节输液速度和量。 9、监测体温，给予保暖，改善末梢循环。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 机械通气患者监护常规 1、给氧期间应仔细倾听呼吸机运转是否正常。 2、掌握呼吸机常用模式及参数，严密观察各项监测数值，准确记录，如有异常及时报告医生。 3、严密观察病情，注意神志，观察发绀有无缓解，有无憋气出汗、躁动等。如严重缺氧、突然躁动等，应及时查找原因，报告医生，调节呼吸机参数。 4、呼吸机出现报警时，查找报警原因，并及时处理。 5、使用呼吸机以后，湿化液的作用可使痰液湿化易于排出，应鼓励患者咳嗽，定时进行振肺排痰，并及时吸痰。 6、保持集水瓶处于直立位，及时倾倒冷凝水。 7、注意观察呼吸机并发症，如气压伤、肺不张、过度通气与通气不足、感染、气管食管瘘、呼吸机依赖等，发现异常及时报告医生。 8、呼吸机使用参见《呼吸机使用》、《呼吸机使用与保养制度》。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 心肺复苏术 【目的】确保在较短的时间内恢复患者的呼吸、循环功能。 【适用范围】严重创伤、窒息、心脏疾病及药物过敏等引起的心搏骤停或出现严重病情变化的患者。 【操作步骤】 1、判断意识 双手排击患者肩部并呼叫患者(喂、喂～你怎么了);压迫眶上神经，观察有无反应;翻开眼睑观察瞳孔。观察心电图、血压、血氧饱和度变化。 2、摆放患者为复苏体位 (1)迅速使患者去枕平卧，揭开棉被，取下床头档; (2)胸部下按压板，解开衣扣，充分暴露胸部; (3)打开口腔，清除气道分泌物，有义齿者将义齿摘除，有舌后坠时置口咽通气道。 3、以仰头举劾法打开气道 左手放至患者前额，手掌向后压，使患者头后仰;右手示指、中指放在患者劾部向上托起，使气道伸直。 4、评估呼吸 抢救者面部贴近患者口鼻，头侧向患者胸部，评估呼吸10S。 耳听:耳听呼吸道有无气体通过声音。 面感:面部感觉呼吸道有无气体排出。 眼观:眼睛观察胸部有无呼吸运动。 5、判断患者无呼吸，立即给予2次人工呼吸，查看胸廓起伏。 (1)简易呼吸器人工呼吸法:EC法固定眼罩。右手拇指、示指呈C形握住面罩底部。罩住患者口鼻密闭气道，其余三指分开呈E形勾住患者下颚骨骨性部分，用力上托打开气道，左手挤压球囊。 (2)口对口人工呼吸法; ?右手中指和示指呈剪刀式托起下颚关节的下方，将下颚向上托起;拇指轻按于下颚部，使口张开。 ?用放至患者前额处手的拇指与示指捏闭患者鼻孔; ?抢救者深吸气后，张口紧紧包住患者口唇，形成一个封闭的气道用力吹气; ?吹气完毕，放松捏鼻翼的手，此时患者胸部向下塌陷，有气流从口鼻排出，同时有空气逸出的声音; ?如果通气成功，进行第二次吹气，两次吹入气体应在2-3s内完成。 6、患者呼吸道无梗阻，以耳听、面感、眼观、手摸法判断呼吸心跳10s。 手摸颈动脉搏动;右手示指、中指触摸到患者甲状软骨后，旁开1.5-2cm触摸颈动脉搏动。 7、患者呼吸、心跳骤停，紧急呼叫医生、护士、计时。 8、立即给予胸外心脏按压 (1)、右手食指和中指确定两乳头间的胸骨位置，左手掌根置于胸骨中段略下处部位，右手for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 掌置于其上，两手平行重叠交叉。或右手中指沿肋下缘摸到与胸骨交接处定位，示指靠上中指，左手掌根部挨着示指放在胸骨上，手指伸开，右手放在左手的上面，手指向下弯曲，与左手指交叉;左手指离开胸部。 (2)抢救者上身前倾，双肩对准患者胸骨上方正中，双臂绷直向下有规律的、平稳的进行按压。 9、胸外心脏按压30次，人工呼吸2次，以此法做5个循环，评估患者呼吸、心跳。 10、建立静脉通道，遵医嘱给予肾上腺素1mg静注。在静脉通道建立之前，可行气管内给药。 11、除颤，室颤时用非同步除颤，若不成功，首选利多卡因1.0—1.5mg/kg静注，每3—5min可重复，也可用溴苄胺5mg/kg、硫酸镁1—2mg、普鲁卡胺17mg/kg静注，然后再除颤。 12、呼吸、心跳恢复，观察心肺复苏有效指征 (1)测量血压，收缩压至8.0KPa(60mmHg)以上; (2)观察颜面、口唇、甲床及皮肤的颜色，发绀减轻，色泽红润; (3)取棉签一根，刺激睫毛有反应; (4)取手电筒观察患者双侧瞳孔对反光射，瞳孔较前缩小，表示大脑有足够的氧和血液供应。 、复苏成功后，继续高级生命支持。 13 14、撤除按压板，整理衣服，头部垫枕，盖好棉被。 15、将心跳骤停时间和心肺复苏时间准确记录于护理记录和病历中。 【注意事项] 1、发现心电示波呈一条直线时，护士首先要检查监护电极片是否脱落。 2、如患者为误吸、上消化道大出血等情况，需将患者头偏向一侧。 3、胸外按压时，不可压于剑突处以免导致肝脏破裂，患者需要平躺在地板或硬板上。 4、胸外按压时，不宜对胃部施以持续性的压力，以免造成呕吐。 4、胸外按压时，手指不可压于肋骨上，以免造成肋骨骨折。 6、胸外按摩时施救者跪下双膝分开与肩同宽，肩膀应在患者胸部正上方、手肘伸直、垂直下压于胸骨上。 7、心肺复苏术开始后抢救人员替换时，应尽量缩短中断时间，一般不超过5S。 8、紧贴胸骨之手掌根不可移开伤患胸部或改变位置以免失去手的正确位置。 9、若现场只有一位急救员，没有其他人可以寻求支援，必要时此急救员应先为患者施行1分钟有效的CPR后再寻求支援。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 经口气管内吸痰术 【目的】消除气管、支气管内痰液、保持呼吸道通畅，改善肺通气。 【适用范围】重症、体虚、昏迷、小儿等不能自行咳出痰液患者。 【操作步骤】 1、准备物品，无菌吸痰包、无菌手套、吸痰管、棉签、生理盐水、负压吸引装置。 2、携用物至患者床旁，向患者解释，取得合作。 3、协助患者取枕仰卧位，垫起肩颈部使其头向后仰。 4、打开吸痰包，备好吸痰盘，无菌碗中倒入生理盐水。 5、操作者戴手套，右手持止血钳夹取吸痰管尾端，左手持吸引器橡胶管上的玻璃接头，将吸痰管连于接头上，打开吸引器开关，将吸痰管插入生理盐水中试验是否通畅。 6、左手将吸引器橡胶管反折阻断负压，右手持止血钳夹吸痰管由患者口腔慢慢送至咽喉部，在患者吸气时迅速将吸痰管送入气管，达到所需深度(吸痰管从口腔插入气管内约25cm)，放开反折的橡胶管进行吸引，轻轻选装吸痰管，边吸边提，直至吸痰管退出气管。 7、吸痰管退出后插入生理盐水碗中，开通吸引器，冲洗吸痰管及吸引器官。冲净后取下吸痰管放入医用垃圾桶中。将吸引胶管的玻璃头插入盛有消毒液瓶内备用。 8、协助患者取舒适卧位，整理床单位。 9、整理用物，吸痰管置于床旁备用。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 【注意事项】 1、严格遵循无菌技术操作原则，无菌吸痰管每用1次更换1根，不可重复使用，以免引起感染。 2、严格掌握吸痰时间，以免加重患者缺氧，每次吸痰时间不超过15s，如果痰液未吸净，可间隔2—3min后再次吸痰。 3、昏迷患者可用压舌板将口启开。牙关紧闭的患者禁止强行撬开，防止损伤。 、吸痰管插入过程中保证无负压，以免损伤气管黏膜。 4 5、发现有血性分泌物，患者呼吸异常或呛咳等现象，应立即停止，及时与医生联系。 6、吸痰盘每24h更换1次。 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications ... If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet