急诊护理人员对严重创伤患者低体温管理的现状调查  

A survey on the current status of emergency nurses in managing hypothermia in patients with severe trauma

作　　者：郭丽平 孙红[1] 徐亚昆 陈雪敏 张文璐 陈雪丹 朱继红[1] Guo Liping;Sun Hong;Xu Yakun;Chen Xuemin;Zhang Wenlu;Chen Xuedan;Zhu Jihong(Department of Emergency,Peking University People's Hospital,Beijing,China)

机构地区：[1]北京大学人民医院急诊科

出　　处：《实用休克杂志（中英文）》2024年第1期31-34,共4页Journal of Practical Shock

基　　金：北京大学人民医院研究与发展基金(项目编号:RDN 2021-15)。

摘　　要：目的明确急诊护理人员对严重创伤患者低体温管理的最新状况。方法采取便利抽样方法,应用自行编制问卷对北京市14家三级医疗机构的急诊护理人员进行调查。结果共回收有效问卷480份。绝大多数体温测量部位是代表体表温度的腋窝,而代表体核温度的鼓膜和体腔内(食管/直肠/膀胱)使用很少;科室配备主要也是测量体表温度的设备,测量体核温度设备的配备很少。仅少数人员可正确识别出严重创伤患者的低体温;常规体温测量是最常用的低体温评估方法,而客观评估方法应用不多;对严重创伤患者也缺少采取必要的低体温预防的保温措施。仅62.5%的人员所在科室有创伤患者低体温防治流程,仅51.67%的人员接受过创伤患者低体温防治培训。被动体表复温是最常用的方法,而主动体表和体内复温使用较少;棉被或毛毯是科室配备最多的复温设备,专用和高级的复温设备配备的不多。绝大多数人员在低体温患者复温过程中都可对生命体征进行观察,而对酸中毒和凝血异常关注不够。结论急诊护理人员对严重创伤患者低体温管理的认知和实践存在不足,需加强低体温防治培训和硬件支持。Objective To clarify the latest status of emergency nursing staff in managing hypothermia in patients with severe trauma.Methods Convenience sampling method was adopted,and a self-designed questionnaire was used to survey emergency nursing staff from 14 tertiary medical institutions in Beijing.Results A total of 480 valid questionnaires were collected.The vast majority of body temperature measurements are taken in the armpits,which represent the surface temperature of the body,while the eardrums and lumens(esophagus/rectum/bladder),which represent the nuclear temperature,are rarely used;The department is mainly equipped with equipment for measuring body surface temperature,and there is very little equipment for measuring body core temperature.Only a few individuals can correctly identify hypothermia in severely traumatized patients;Conventional body temperature measurement is the most commonly used method for assessing hypothermia,while objective evaluation methods are not widely used;There is also a lack of necessary insulation measures to prevent hypothermia in severely injured patients.Only 62.5%of nurse in the department have procedures for preventing and treating hypothermia in trauma patients,and only 51.67%of nurse have received training on preventing and treating hypothermia in trauma patients.Passive body surface rewarming is the most commonly used method,while active body surface and in vivo rewarming are less commonly used;Cotton quilts or blankets are the most commonly equipped rewarming equipment in departments,and there are not many specialized and advanced rewarming equipment available.The vast majority of nurse can observe vital signs during the rewarming process of hypothermic patients,but pay insufficient attention to acidosis and coagulation abnormalities.Conclusions There are many deficiencies in the knowledge and practice of emergency nursing staff in managing hypothermia in severely injured patients.In the future,it is necessary to strengthen training and hardware support for hypothermia pre

关 键 词：严重创伤 低体温 急诊护理 问卷调查 

分 类 号：R473.6[医药卫生—护理学]