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成人机械通气患者的院内转运

Intrahospital transport of the adult mechanically ventilated patient.

作者信息

Stevenson Valerie Willis, Haas Carl F, Wahl Wendy L

机构信息

University Hospital Respiratory Care, Critical Care Support Services, University of Michigan Health System, Ann Arbor 48109, USA.

出版信息

Respir Care Clin N Am. 2002 Mar;8(1):1-35. doi: 10.1016/s1078-5337(02)00014-x.

Abstract

As the diagnosis and treatment of critically ill patients continues to advance, the frequency of intrahospital transport of ventilator-dependent patients increases. Once the risks and benefits of transport are established, even the sickest ICU patient can be transported safely when adequate time is taken and preparations are made before beginning the transport. Patients should be stabilized as much as possible and monitored before, during, and after transport. Those responsible for the patient should be trained to provide a safe outcome. This necessitates that caregivers receive education in patient evaluation, potential risks, complications, interventions, equipment operation, and troubleshooting that may be necessary when caring for ventilated patients outside the ICU. All members of the transport team should communicate effectively and be aware of their roles in the transport process to minimize delays and mishaps during transport and at the final destination. Written policies that define the level of personnel, level of training, level of support, and equipment necessary can facilitate the transport process. When choosing a device to provide ventilation, the patient's clinical condition should be determine which method is used for transport.

摘要

随着危重症患者诊断和治疗水平的不断提高,依赖呼吸机的患者在医院内转运的频率增加。一旦确定了转运的风险和益处,即使是病情最严重的重症监护病房(ICU)患者,在有足够时间并在转运开始前做好准备的情况下,也可以安全转运。患者在转运前、转运期间和转运后应尽可能保持稳定并接受监测。负责患者的人员应接受培训以确保安全转运。这就要求护理人员接受有关患者评估、潜在风险、并发症、干预措施、设备操作以及在ICU外护理通气患者时可能需要的故障排除等方面的教育。转运团队的所有成员应有效沟通,并清楚自己在转运过程中的角色,以尽量减少转运期间及到达最终目的地时的延误和事故。明确所需人员级别、培训水平、支持程度和设备的书面政策有助于转运过程。在选择提供通气的设备时,应根据患者的临床状况确定采用哪种转运方法。

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