使用翻身床辅助治疗大面积烧伤患者的管道护理  

Study on the pipeline nursing of patients with large area burnt during using a rollover bed

作　　者：熊想莲[1] 武小红[1] 李丽红[1] 黄守春[1] 冯斯斯 Xiong Xianglian;Wu Xiaohong;Li Lihong;Huang Shouchun;Feng Sisi(Department of Burn Surgery,The First People's Hospital of Foshan,Foshan,528000,Guangdong,China)

机构地区：[1]佛山市第一人民医院烧伤科,广东佛山528000

出　　处：《现代临床护理》2020年第4期45-49,共5页Modern Clinical Nursing

摘　　要：目的总结大面积烧伤患者使用翻身床辅助治疗时管道护理经验,以为制订提高此类患者管道护理质量措施提供依据。方法对本科室收治的17例留置各种导管的大面积烧伤患者,在使用翻身床辅助治疗中采取相应的护理措施,①翻身前,针对气管插管及气管切开而造成暂时失语的患者,采用自行设计的《翻身流程图》和卡通图示或通俗易懂的书面语言卡片介绍翻身目的、流程及注意事项及清理呼吸道;评估动静脉导管管道外部长度,以保证其在翻身时有足够的长度等;对鼻胃管、导尿管外部部分进行标记,夹闭导尿管,清空尿袋。②翻身中,关注气道通畅情况及严密观察患者血氧饱和度变化等;防止动静脉导管缠绕牵拉和脱出;保证鼻胃管及尿管固定不脱出。③翻身后,做好对气管套管进行检查,确认呼吸道是保持通畅状态;对照翻身前鼻胃管、导尿管固定状态,确定其没有脱出;开放静脉输液通管和导尿管。同时采用自行设计《翻身流程图》,根据流程图内容组织护士进行操作练习,确保护士掌握翻身床操作方法。结果本组留置各种导管的大面积烧伤患者,在使用翻身床辅助治疗20~51d中,无1例发生气管导管、动静脉置管、鼻胃管和导尿管脱出。结论确保护士掌握翻身床操作方法,是保证患者翻身时安全和顺利完成的基础。采取通俗易懂的沟通形式可提高患者的治疗和护理的依从性;根据不同的导管,在翻身前、翻身中及翻身后实施相应的护理措施,是提高管道护理质量的保证。Objective To summarize the experiences of the pipeline nursing in the use of rollover bed for patients with large area burned and to improve the pipeline nursing quality of this kind of patients.Methods Among 17 large area burn patients admitted in our department with all kinds of catheters in the use of rollover bed,corresponding nursing measures were taken.①For patients with tracheal intubation and tracheostomy and cause temporary aphasia before turning over for adjuvant therapy,a designed flow chart of emancipation and cartoon icon or written language card were shown to make them know the purpose,process and matters needing attention.The external length of indwelling arteriovenous catheter should be evaluated to ensure that it has sufficient length when turning over.The external part of the nasogastric catheter was marked,the catheter was clipped,the urine bag was emptied and turned over.②The airway patency was paid attention to and the change of blood oxygen saturation was closely observed.Prevent arteriovenous catheter from winding,pulling and prolapse.After the nasogastric tube and urinary tube were fixed,the trachea cannula should be examined.Open venous transfusion tube and catheter.Using self-designed flow chart,nurses learned how to operate,and finally mastered it.Results of large area burn patients with all kinds of catheters using rollover bed for adjuvant therapy within 20~51 d,the endotracheal tube arteriovenous catheter nasogastric tube and catheter getting out did not occurred.Conclusions Ensuring that nurses master the rollover bed operation method is the ground for patients'safety to complete the therapy.Ensuring that patients are easy to understand the operation can improve the patients'adherence to treatment and care.According to different catheters,relative nursing measures should be taken before and after turning over,which is the guarantee to improve the nursing quality of pipeline.

关 键 词：大面积烧伤 翻身床 管道管理 护理 

分 类 号：R473.6[医药卫生—护理学]