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指南实施:患者体位摆放

Guideline Implementation: Positioning the Patient.

作者信息

Burlingame Byron L

出版信息

AORN J. 2017 Sep;106(3):227-237. doi: 10.1016/j.aorn.2017.07.010.

Abstract

Every surgical procedure requires positioning the patient; however, all surgical positions are associated with the potential for the patient to experience a positioning injury. The locations and types of potential injuries (eg, stretching, compression, pressure injury) depend on the position. Factors that may increase the patient's risk for an injury are the length of the procedure and risk factors inherent to the patient (eg, weight, age, frailty). AORN's updated "Guideline for positioning the patient" provides guidance on injury prevention practices for all surgical positions including supine, Trendelenburg, reverse Trendelenburg, lateral, lithotomy, prone, and sitting positions and modifications of these positions. This article focuses on the key points of the guideline covering the use of prophylactic dressings, neurophysiological monitoring, and safely positioning the patient in the supine and prone positions. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

摘要

每一台外科手术都需要对患者进行体位摆放;然而,所有外科手术体位都有可能使患者遭受体位相关损伤。潜在损伤的部位和类型(如拉伸、压迫、压力性损伤)取决于体位。可能增加患者受伤风险的因素包括手术时长以及患者自身固有的风险因素(如体重、年龄、身体虚弱程度)。美国手术室注册护士协会(AORN)更新的《患者体位摆放指南》为所有外科手术体位(包括仰卧位、头低脚高位、头高脚低位、侧卧位、截石位、俯卧位和坐位)以及这些体位的变体提供了预防损伤措施的指导。本文重点关注该指南的要点,包括预防性敷料的使用、神经生理监测以及患者仰卧位和俯卧位的安全摆放。围手术期注册护士在撰写和更新政策与程序时,应查阅完整指南以获取更多信息和指导。

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