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1、2021-8-61 Artificial airway management in ICU General hospital of Ningxia medical university ICU: Wang Lijuan 2021-8-62 The concept of artificial airway (人工氣道)(人工氣道) Concept: (概念) Artificial airway are breathing passages (呼吸通路)with a catheter(管道) which is inserted (插入)into the trachea (氣道) or direct

2、ly inserted into the trachea through the upper respiratory tract(上呼吸道) ,and assisted ventilation (機械通氣)and treatment of lung disease(肺部疾?。? tracheal intubation ( (氣管插管)氣管插管)and tracheostomy tube (氣切套管)(氣切套管) 2021-8-63 Artificial airway management(管理)(管理) l Maintenance(保持) of artificial airway(人工氣 道)

3、 function(功能) l Keep respiratory tract (呼吸通路)unobstructed (通暢) l Prevent (防止)complications(并發(fā)癥) The most basic requirements(基本要求)(基本要求) of artificial airway Fixed(固定) Airtight(密閉) Unobstructed (通暢) successfully manage artificial airway 綜合關系綜合關系:強調由幾個部分推出一個結論或者對象 The key(關鍵)(關鍵) and details(細節(jié))(細節(jié)) o

4、f airway management Oral care:(口腔護理) Secure fixation(安全固定) Teeth pad (牙墊)of nursing keep airway unobstructed通暢 Body position:(體位) Click to add Title Prevent mucosal(粘膜) injury 2021-8-66 lAvoid(避免 )the pipeline water(積水瓶中的水) pouring (灌入) the artificial airway and timely pouring(傾倒). Another important

5、 things To prevent the pipeline distortion(打折), keep the pipelines unobstructed(通暢) 2021-8-67 Teeth pad of nursing(牙墊的護理)(牙墊的護理) lEach shift (每班)check teeth pad and Cannulation(檢查) of the close(松緊度) degree,prevent the teeth pad transposition (移位) lOn the injury or tracheal intubation (氣管插管)to be bit

6、ted (咬扁) and patient in danger,especially spring tube(彈簧管). Air bag management (氣囊的管理)(氣囊的管理) l Maintain appropriate(合適的)pressure of 25-30cmh20(centimeter water column) l Airbag is deflated(放氣) before the full removal of oral and nasopharyngeal (鼻咽部)secretions(分泌物), in order to prevent the aspiratio

7、ns and reduced respiratory tract infections. l Each shift choose the air bag pressure,prevent the occurrence of catheter ablation(脫落). 2021-8-68 Body position(體位)(體位) lThe United States of America CDC: No semi- recumbent position contraindication(無體位禁忌 癥) ,head elevation(床頭抬高) 3045 degrees lObjectiv

8、e(目標): to prevent gastroesophageal reflux (胃食管反流)inhalation(吸入), and prevention of aspiration(誤吸) and prevention the occurrence(發(fā)生) of VAP(ventilator associated pneumonia,呼吸機相關性肺炎) 2021-8-69 Temperature(加溫)(加溫) and humidity(加濕)(加濕) lThere are two types of devices(裝置)about temperature and humidity. l

9、Heated humidifier(濕化加 溫器)T24h lBacteria filter(細菌過濾器 ,也稱人工鼻)T24h heated humidifier(濕化加溫器) l Heating water to generate(產生) steam inhalation after, mixed gas, can achieve the dual(雙重) purpose of humidification and heating. lThe appropriate (最佳) temperature of Suction(吸入) gas is 32-36 degrees 2021-8-6

10、11 2021-8-612 Bacterial filter(細菌過濾器(細菌過濾器) ) Artificial nose: On the filtration of bacteria(清 除細菌) have certain effect, it can reduce the chance of pipeline be contaminate(污染) by bacterial (細菌) for number of patients who have less sputum(痰液). lThe ventilator heated humidifier (濕化器)and bacterial fil

11、ter (人工鼻)can not be used at the same time(同時). lit seemed that artificial blocked(人為阻塞) the exhalation passage.(呼氣通道) 2021-8-613 Remember(切記) Remember(切記) lProperly connected (正確連 接)breathing pipeline(呼 吸管路). . lThe suction pipe(吸氣端) connection in the humidifier. lIt seems to blow bubbles( 吹泡泡)吹泡泡)

12、into the water continuous(持續(xù)的)(持續(xù)的). 2021-8-615 Prevention of airway obstruction(堵塞)(堵塞) lArtificial airway management in the most severe clinical emergency,used to threaten the life of patients! 人工氣道管理中最為嚴重的臨床急癥, 常常威脅病人生命! obstruction of the catheter(管道堵塞)(管道堵塞) lReason: sputum bolt(痰液堵塞) or a fore

13、ign body ( such as blood clot etc.)(異物,如血凝塊) obstruction(堵塞) of artificial airway. obstruction of the catheter(管道堵塞)(管道堵塞) lProcessing: washing airway(沖洗人工氣道), irritative cough(刺激患者咳嗽), sputum diluting the sputum bolt or foreign body aspiration(稀釋痰 液將痰栓或異物吸出). . obstruction of the catheter(管道堵塞)(管道堵

14、塞) lEmergency treatment: should immediately (立即) removing endotracheal intubation or tracheostomy tube(拔除氣管插管或氣切套管), and then restart the establishment of artificial airway(重新建立人工 氣道). 2021-8-619 Summary:(總結)(總結) lAirway management important is in detail 氣道管理重在細節(jié) lDetails determine the quality of nu

15、rsing 細節(jié)決定護理質量 lquality of nursing decide the quality of life and safety 質量決定生命安全 2021-8-6 20 Nightingale Maxim(格言)(格言) Nurses work object is not a cold stone, wood and paper, but the blood and life of the human, the nurses job is a fine art in the fine, one reason, is the nurse must have a sympathetic h

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