怎樣做一個稱職的巡回護士

1、怎樣做一個稱職的巡回護士一、巡回護士的定義巡回護士（Circulating Nurse）是指被指派到固定手術(shù)間內(nèi)、在無菌區(qū)以外，不直接參與手術(shù)操作、和器械護士、主刀醫(yī)生及其助手、麻醉醫(yī)生共同完成手術(shù)任務(wù)的護士。Definition：A circulating nurse is a registered nurse who works in the operating room environment. The circulating nurse does not scrub in, and performs job duties that cannot be done by staff tha

2、t is scrubbed in. What is a Circulating Nurse?二、巡回護士的主要任務(wù)http:/ circulating nurse is responsible for charting what is happening in the operating room, tracking supplies and equipment used, and may also act as an advocate for the patient, who is unable to act on their own behalf while under anesthesi

3、a. The nurse may have additional responsibilities including keeping the operating room clean, managing other staff, preparing the patient for the procedure and helping escort the patient to recovery.What Are the Responsibilities of Circulating Nurses?三、巡回護士工作的爭議四、巡回護士應(yīng)如何配合麻醉醫(yī)生的工作 Operating Room Prep

4、aration Anesthesia As the main coordinator in the OR, the circulating nurses assists the anesthesiologist by correctly positioning the patient to receive anesthesia. The position depends on the procedure that will be performed. If spinal anesthesia is required, for example, the patient is positioned

5、 in a quasi-fetal position. After the anesthesia is administered, the circulating nurse follows the anesthesiologists instructions for repositioning the patient and places his arms in arm boards and restraints to prevent him from inadvertently injuring himself. To prepare for the operation, she expo

6、ses the patients skin and, if necessary catheterizes him. Surgery End of SurgeryCirculating Nurse Duties整形外科醫(yī)院住院手術(shù)室承擔(dān)著醫(yī)院各科室的手術(shù),為保證每位患者手術(shù)安全順利的完成,手術(shù)室護士擔(dān)當(dāng)著重要的職責(zé).作為一名手術(shù)室護士除了要具備豐富的專業(yè)知識和嫻熟的專業(yè)技術(shù)外,還要有應(yīng)對各種突發(fā)問題的能力,最重要的是有高度的責(zé)任心和奉獻精神.以下對手術(shù)室巡回護士的具體職責(zé)作了一下總結(jié):五、巡回護士的職責(zé)（一）術(shù)前訪視 1.術(shù)前訪視病人是相當(dāng)重要的環(huán)節(jié),訪視時應(yīng)穿工作服,了解病情和所作手術(shù)，看病歷

7、并查看化驗單是否齊全是否有問題； 2.查看靜脈情況和全身狀態(tài)；3.對患者進行術(shù)前宣教,告知其術(shù)前禁食禁飲時間及注意事項,.告知術(shù)日所做操作,消除患者恐懼和緊張心理。1.手術(shù)間的清潔工作：對操作臺面、無影燈及手術(shù)床等用75%酒精擦拭，調(diào)解并維持室內(nèi)正常溫濕度；2.手術(shù)所需儀器的準(zhǔn)備：電凝、吸引器和電刀等連接好并檢查是否正常工作3.補充手術(shù)間內(nèi)無菌物品和藥品；4.鋪好手術(shù)床,如需擺體位的要準(zhǔn)備好體位墊；5.遵醫(yī)囑準(zhǔn)備好靜脈輸液液體，如是兩歲以下幼兒需輸入100ml葡萄糖氯化鈉注射液或者復(fù)方葡萄糖氯化鈉注射液。（二）術(shù)日晨準(zhǔn)備工作（三）接患者進入手術(shù)室 1.接患者前認(rèn)真查對病室,床號,姓名,性別,年

8、齡,手術(shù)名稱和部位； 2.再次檢查化驗單是否齊全和正常，查看體溫單，手術(shù)同意書和麻醉同意書； 3.詢問術(shù)前禁食禁飲時間有無,藥物過敏史，女病人是否在月經(jīng)期以及身上有無貴重物品或金屬物品； 4.患者帶藥和物要與病房護士交接清楚； 5.協(xié)助患者取舒適安全臥位,選擇合適肢體輸液； 6.協(xié)助麻醉誘導(dǎo)和插管,局麻鎮(zhèn)靜患者要用約束帶防止患者受傷； 7.一般手術(shù)時間大于4小時的要給患者導(dǎo)尿，并在接患者時告知 8.需要擺體位的要同麻醉醫(yī)生和手術(shù)醫(yī)生共同擺體位,并保證患者肢體處于安全舒適狀態(tài),防止擠壓傷害，重點保護眼睛和骨隆突等處。（四 ）手術(shù)開臺的配合 1.協(xié)助器械護士穿手術(shù)衣并清點器械和紗布； 2.協(xié)助醫(yī)生

9、術(shù)區(qū)消毒和鋪單； 3.協(xié)助醫(yī)生穿手術(shù)衣并安排器械護士和醫(yī)生就位、調(diào)解無影燈； 4.連接電凝和吸引器如用電刀應(yīng)貼好負(fù)極板； 5.遵醫(yī)囑配麻藥。（五 ）術(shù)中配合 1.術(shù)中密切觀察病情及生命體征變化,及時供給所需物品； 2.觀察輸液和尿量； 3.與器械護士共同管理好切下的標(biāo)本,皮和軟骨等,病理及時送檢 4.準(zhǔn)確執(zhí)行術(shù)中醫(yī)囑,做到三查七對二人核對,口頭遺囑應(yīng)復(fù)述一遍再執(zhí)行,提醒麻醉醫(yī)生記錄； 5.認(rèn)真書寫護理記錄單、部位確認(rèn)單和記賬單等,錄入耗材； 6.維持手術(shù)間的干凈整潔,維持室內(nèi)適宜溫濕度； 7.監(jiān)督術(shù)中無菌技術(shù)執(zhí)行情況,對違反者及時糾正,嚴(yán)格管理參觀人員； 8.遇有緊急情況要正確處理,及時通知護士長和麻醉科主任； 9.傷口關(guān)閉前與器械護士共同清點器械和紗布； 10.準(zhǔn)備包扎敷料協(xié)助包扎,適時通知下臺手術(shù)； 11.總結(jié)輸液量和尿量,記錄術(shù)畢時間；1.協(xié)助麻醉醫(yī)生拔管,患者未清醒前應(yīng)站在兩側(cè)不得離開,防止患者躁動；2.保護好靜脈通路,尿管和引流管等；3.拔管后患者生命體征平穩(wěn)遵醫(yī)囑與麻醉醫(yī)生、手術(shù)醫(yī)生一起將患者送入麻醉恢復(fù)室,局麻患者送回病房,與病房護士做好交接工作，保證患者安全；4.整理清潔手術(shù)間,為下一臺手術(shù)做準(zhǔn)備。（六）術(shù)畢