Ecklund M M
AACN Clin Issues. 1995 Nov;6(4):588-601; quiz 680-2. doi: 10.1097/00044067-199511000-00009.
Critically ill patients have multiple risk factors for deep vein thrombosis and pulmonary embolism. The majority of patients with pulmonary embolism have a lower extremity deep vein thrombosis as a source of origin. Pulmonary embolism causes a high mortality rate in the hemodynamically compromised individual. Awareness of risk factors relative to the development of deep vein thrombosis and pulmonary embolism is important for the critical care nurse. Understanding the pathophysiology can help guide prophylaxis and treatment plans. The therapies, from invasive to mechanical, all carry risks and benefits, and are weighed for each patient. The advanced practice nurse, whether in the direct or indirect role, has an opportunity to impact the care of the high risk patient. Options range from teaching the nurse who is new to critical care, to teaching patients and families. Development of multidisciplinary protocols and clinical pathways are ways to impact the standard of care. Improved delivery of care methods can optimize the care rendered in an ever changing field of critical care.
重症患者有发生深静脉血栓形成和肺栓塞的多种危险因素。大多数肺栓塞患者的下肢深静脉血栓形成是栓子来源。在血流动力学受损的个体中，肺栓塞会导致高死亡率。对于重症护理护士而言，了解与深静脉血栓形成和肺栓塞发生相关的危险因素很重要。理解病理生理学有助于指导预防和治疗方案。从侵入性到机械性的各种治疗方法都有风险和益处，需针对每位患者进行权衡。高级实践护士，无论是直接还是间接角色，都有机会影响高危患者的护理。选择范围从教导初涉重症护理的护士，到教导患者及其家属。制定多学科方案和临床路径是影响护理标准的方式。在不断变化的重症护理领域，改进护理方法的实施可以优化所提供的护理。
