產(chǎn)后大出血演練腳本(具體)

產(chǎn)后大出血演練腳本(具體)產(chǎn)后大出血的應(yīng)急預(yù)案演練旨在提高醫(yī)護人員處理突發(fā)事件的能力，考驗他們的協(xié)調(diào)能力，并考核他們掌握產(chǎn)后出血急救流程。演練時間為2021年10月7日上午九點，地點為廣德路院區(qū)婦產(chǎn)一科。在剖宮產(chǎn)術(shù)后，患者子宮收縮不良，陰道大量出血的情況下，醫(yī)護人員應(yīng)立即告知醫(yī)生，給予子宮按摩，監(jiān)測生命體征，遵醫(yī)囑予以縮宮素等止血劑應(yīng)用，并向上級領(lǐng)導(dǎo)匯報。同時，給予保存導(dǎo)尿、氧氣吸入和心理護理。在演練過程中，當(dāng)患者出現(xiàn)陰道出血100毫升時，護士甲迅速請求支援，并安置患者平臥位頭偏向一側(cè)，給予氧氣吸入、心電監(jiān)護、保持患者呼吸道通暢，按摩子宮，遵醫(yī)囑立即給予腹部置冰袋6小時。護士乙推搶救車到病房配合急救，迅速建立第二條靜脈，醫(yī)生按摩宮底，給予患者卡孕栓2mg舌下含服，囑給予患者NS250ml+縮宮素20u靜滴，通知血庫為患者備懸浮紅細(xì)胞2u,血漿400ml。護士甲復(fù)述醫(yī)生口頭醫(yī)囑，醫(yī)生確認(rèn)無誤后給藥，護士乙做好用藥記錄及病情觀察，醫(yī)生將醫(yī)囑寫在醫(yī)囑本上。護士乙行心電監(jiān)護，快速報告患者生命體征，護士甲報告患者宮底臍下一指，腹軟，持續(xù)按摩子宮，陰道出血100ml。At11:20,NurseCreturnedfromthebloodbankwithblood.ThedoctorandNurseAconfirmeditandimmediatelyadministered2unitsofsuspendedredbloodcells.NurseBreportedthebloodpressureas101/49mmHg,pulserateof91beatsperminute,andbloodoxygensaturationof98%(withoxygen).NurseAmassagedtheuterusandfoundthecervixonefingerbelowthenavelwithvaginalbleedingof100ml.Thepatientwasinstructedtobeobserveduntil5pm.At12:30,thepatient'sbloodpressurewas100/48mmHg,pulserateof90beatsperminute,andbloodoxygensaturationof98%.NurseAmassagedtheuterusandfoundthecervixonefingerbelowthenavelwithvaginalbleedingof100ml.Suspendedredbloodcellswerebeingadministeredandthepatientwasinstructedtobeobserved.At13:45,NurseBreportedthepatient'sbloodpressureas97/60mmHg,pulserateof81beatsperminute,andbloodoxygensaturationof98%.NurseAmassagedtheuterusandfoundthecervixonefingerbelowthenavel.Thepatienthad420mlofvaginalbleedingsincethesurgery.NurseAadministeredamuscleinjectionofergotamineandadripof250mlNS+20uofoxytocin,andcontactedfor2unitsofsuspendedredbloodcellsagain.Bloodcellanalysisandcoagulationroutineweretaken,andthevaginalbleedingwascloselyobserved.ThelaboratoryresultsshowedWBC:22.77*109,N:95.3%,HGB:131g/L,PLT150*109,D-dimer46.6mg/L,fibrinogenconcentration:2.61g/L,andanticoagulantthrombin3:73.3%.ThepatientwasinstructedtobeobservedcloselybyNurseA.At14:20,NurseBreportedthatthepatientwasconsciouswithabloodpressureof105/60mmHg,pulserateof66beatsperminute,andbloodoxygensaturationof98%.Thecervixwasonefingerbelowthenavelandtheabdomenwassoftwithvaginalbleedingof100ml.Thepatientwasinstructedtobeobserved.At16:10,NurseBreportedthatthepatient'sbloodpressurewas108/61mmHg,pulserateof86beatsperminute,andbloodoxygensaturationof97%.Thepatienthad1680mlofvaginalbleedingduringandaftersurgery.Fourunitsofsuspendedredbloodcellsand400mloffrozenplasmawereadministered,and4000mloffluidwasinfusedwithaurineoutputof1800ml.Bloodcellanalysisandcoagulationroutineweretakenimmediately.Thelaboratoryresultss