Mayo Clinic, Rochester, MN, USA.
Western State University College of Law, Irvine, CA, USA.
J Prim Care Community Health. 2022 Jan-Dec;13:21501319221116249. doi: 10.1177/21501319221116249.
This case involves a patient with severe COVID-19 pneumonia and massive pulmonary embolism requiring mechanical ventilation. His clinical course was complicated by delirium likely triggered by his critical illness and failed initial extubation, isolation from family, and escalating fear and desperation. In hopeful preparation for subsequent successful extubation, a unique approach was taken to decrease the risk of panic, delirium, and decompensation leading to reintubation. As a means of orienting him to his treatment pathway and to provide encouragement for continued recovery, an impromptu patient-directed checklist was constructed. The recovery checklist, written in simplified language, outlined the stages of severe illness that the patient had overcome after his emergent intubation. The list also outlined the tasks he needed to complete prior to hospital discharge. Unexpectedly, the checklist received a great deal of engagement from both the patient and medical team and played an important role in this patient's successful recovery and rehabilitation.
本病例涉及一位患有严重 COVID-19 肺炎和大面积肺栓塞的患者，需要进行机械通气。他的临床病程复杂，可能是由他的重病引起的意识混乱，以及最初的拔管失败、与家人隔离、不断增加的恐惧和绝望所触发。为了为随后的成功拔管做好有希望的准备，我们采取了一种独特的方法来降低恐慌、意识混乱和失代偿导致重新插管的风险。作为一种让他了解治疗途径并为持续康复提供鼓励的方式，我们临时为他制作了一份面向患者的检查表。恢复检查表用简化的语言概述了患者在紧急插管后克服的严重疾病阶段。清单还概述了他在出院前需要完成的任务。出乎意料的是，检查表得到了患者和医疗团队的积极参与，并在患者的成功康复和康复中发挥了重要作用。
