气管切开患者陪检转运护理方法的研究

Study on nursing methods of accompanying examination and transport in pat ients with tracheotomy

目的:研究气管切开患者的陪检转运护理方法,为此类患者的陪检转运护理提供参考依据。方法:选取2019年1月至2021年4月在广州市胸科医院ICU接受气管切开呼吸机辅助通气及检查转运的108例患者作为研究对象。在这些患者检查转运的过程中,均为其采取完善的陪检转运护理。观察这些患者转运期间病情的变化情况,总结气管切开患者的陪检转运护理方法及护理经验。结果:所选108例患者,转运过程中除实施气管切开呼吸机辅助通气外,均携带有各种静脉通路及管路。转运期间其生命体征均维持在正常稳定的水平,其中意识清醒的患者有66例,昏迷患者有19例,嗜睡患者有13例,烦躁患者有10例。为烦躁患者使用安全带固定体位,其中仅有少数患者接受2次转运。所有患者均由医生护士全程陪同转运,并使用救护车转运。全程使用便携式皮氧仪监测指脉氧,转运全程其指脉氧均在95%~100%之间,指脉氧维持在安全范围的比例达100%。转运途中无死亡病例,其中有2例患者因氧气不足需要更换氧气瓶。转运过程中有2例患者发生脱管,经妥善处理后无异常情况发生。108例患者转运过程中不良事件的发生率仅为1.85%(2/108)。在108例患者中,有104例患者(或其家属)对陪检转运护理满意,满意率达96.30%。结论:在气管切开患者的陪检转运过程中,医生、护士全程陪护,采取完善的护理措施,能够保证患者进行各项非床边检查过程中通气及供氧通畅,保证其转运过程中的安全稳定,减少意外情况的发生。

Objective:To study the nursing methods for patients with tracheotomy,and to provide reference for the nursing of patients with tracheotomy.Methods:A total of 108 patients who received tracheotomy ventilator assisted ventilation and examination and transportation in ICU of Guangzhou Chest Hospital from January 2019 to April 2021 were selected as the study subjects.During the examination and transport of these patients,they were taken good care of the examination and transport.To observe the changes of the condition of these patients during transport,summarize the nursing methods and nursing experience of patients with tracheotomy.Results:All 108 patients were equipped with various venous access and pipelines in addition to tracheotomy ventilator assisted ventilation.During transport,the vital signs were maintained at normal and stable levels,including 66 patients with consciousness,19 patients with coma,13 patients with lethargy,and 10 patients with irritability.Seatbelt fixation was used for agitated patients,only a few of whom underwent two transports.All patients were accompanied by doctors and nurses and transported by ambulance.The portable cutaneous oxygen meter was used to monitor the pulse oxygen during the whole process.The pulse oxygen was between 95%and 100%during the whole process of transport,and the proportion of pulse oxygen maintained in the safe range reached 100%.There were no deaths during transport,and two patients needed to replace their oxygen cylinders due to insufficient oxygen.In the process of transport,2 patients had decanted,and no abnormal situation occurred after proper treatment.The incidence of adverse events in 108 patients during transport was only 1.85%(2/108).Among 108 patients,104 patients(or their family members)were satisfied with the nursing care of accompanying examination transport,with a satisfaction rate of 96.30%.Conclusion:During the examination and transport of patients with tracheotomy,doctors and nurses accompanying the whole process and taking perfect nursing measures can ensure the ventilation and oxygen supply of patients during various non-bedside examinations,ensure the safety and stability in the transport process,and reduce the occurrence of accidents.