Terasawa H
Emergency Department, Fukui Prefectural Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1994 Dec;32 Suppl:39-43.
The following six points should be kept in mind for the management of respiratory emergencies in the emergency room. 1 Gram's stain of a sputum smear may reduce the use of broad-spectrum antibiotics. 2 Routine use of a portable pulse oxymeter substantially reduce the number of arterial blood gas tests. 3 In critical illnesses, such as tension pneumothorax, diagnosis should be made and treatment should be begun without a chest X-ray film. 4 Bag-valve-mask systems should be used with a reservoir bag or a gas pocket to increase the concentration of oxygen. 5 To help prevent hypoxemia during endotracheal intubation, pulse oxymetry may be useful. 6 Ambulance personnel should be taught the importance of pre-hospital administration of high concentrations of oxygen to patients with acute respiratory failure, especially severe asthmatic attacks.
在急诊室处理呼吸急症时应牢记以下六点。1. 痰涂片革兰氏染色可减少广谱抗生素的使用。2. 常规使用便携式脉搏血氧仪可大幅减少动脉血气分析的次数。3. 在诸如张力性气胸等危重症中,应在未进行胸部X光片检查的情况下进行诊断并开始治疗。4. 袋阀面罩系统应与储气囊或气袋配合使用,以提高氧气浓度。5. 为有助于预防气管插管期间的低氧血症,脉搏血氧测定可能有用。6. 应教导救护人员对急性呼吸衰竭患者,尤其是重度哮喘发作患者进行院前高浓度给氧的重要性。