一种胎儿中央监护与远程监护系统的研制

新型胎儿监护系统由一台中央主机和或干台床连监护仪联网组成，在医院院区内床边监护仪与中央机以专线连网，远程终端采用程控电话网作为信息传递的媒介。     

重症监护远程教学查房系统的构建

目的:创新重症患者管理、查房和教学的模式,构建重症监护远程教学查房系统.方法:针对重症监护病房的特殊性及其要求,通过信息化手段,借助现代音视频传输技术和数字处理技术来构建系统.结果:由重症监护病房(intensive care unit,ICU)重症示教系统、ICU视频示教移动手推车、数字化示教室、网络视频传输等组成的教学查房系统满足了ICU临床实践教学的要求.结论:该系统的使用,改善了教学效果,提高了教学效率,减少了ICU污染的机会,高水平发挥了重症医学临床实践教学的作用.     

重症监护信息系统的设计与实施

按照＂数字化医院＂建设的目标,我院在重症监护科室引进一套重症监护临床信息系统,通过该系统的实施,实现医疗过程中的生命体征数据等临床信息的数字化和网络化传输、完整共享HIS、LIS和PACS等系统数据、自动生成各种医疗文书,最终达到优化工作流程、降低劳动强度、提高医疗质量、降低医患风险、提升医院效益的目的.     

远程医院家庭监护网的研制

本文介绍了远程医疗家庭监护网的研制。介绍了远程医疗家庭监护网的系统构成和性能特点,它实现了将病区与病区、医院与医院、家庭与医院以及地区与地间联网,实现远程监护远程会诊。特别实用于社区医疗网的远程医疗监护。     

一种新型机场专用救护车的研制

目的：研制一种主要用于抢救遇险飞行人员和外场飞行卫生保障的救护车，该车也可用于平战时其他伤痛员的医疗救护。方法：采用越野底盘．后部装载承重医疗方舱。在方舱上安装由液压系统控制的可升降伸缩旋转吊臂；在吊臂顶端安装有可折叠吊篮。医疗方舱配有发电机、空调、清洗消毒设备、折叠式医疗台、空勤急救医疗设备等；可同时抢救2个卧位伤员．吸氧口可同时供多人吸氧。结果：救护车最大行驶速度95km／h；最大救护高度时模拟救护过程最短仅需3min。结论：该救护车不增加原有救护车的人员编配，满足各种路况要求，适用于战场环境，能快速抵达事故现场，迅速救出遇险飞行员．可满足外场飞行卫生保障、战时机场区域医疗救护保障和机动伴随保障需要。     

远程医疗家庭监护网的研制

本文介绍了远程医疗家庭监护网的研制.介绍了远程医疗家庭监护网的系统构成和性能特点,它实现了将病区与病区、医院与医院、家庭与医院以及地区与地区间联网,实现远程监护远程会诊.特别实用于社区医疗网的远程医疗监护.     

胎心监护电脑分析系统在临床的应用

1背景 胎心电子监护作为一个重要的监测胎儿宫内安危的产前监护手段已在国内外普在用。大样本的对照研究 (10万以上病例 )显示，监护仪改善了重症围产儿预后，对降低围产儿发病率和死亡率起到了重要的作用。 1.1存在问题 由于胎儿生理和病理状态的多样性，导致了胎心监护图形的多样性，致使人工分析判断胎心监护有很大的局限性，如不能准确地预告新生儿的酸中毒等。对图形的解释和看法在不同的专家间存在着差异，如对变异减速的评判和解释，专家的观点就很不一致。还存在着变异减速和晚期减速的混淆及对正弱波的确切判断，同时对减速图形…     

CA5040型救护车的研制

介绍了CA5040型救护车的底盘性能、仪器选型和布局设计等。通过试验验证，证明该车总体布局合理，内部环境合适，救护仪器齐全，保持了原车的基本性能，达到了设计要求。     

重症监护临床信息系统的应用

本文介绍了临床重症监护系统在我院的应用，该系统以危重病人的临床护理过程为主线，利用全过程、全方位的管理信息流，按照信息采集、信息整合、信息分析和信息输出的数据流程，建立ICU临床信息数据库，规范了临床重症监护的工作流程，减少了ICU护士记录患者体征和医疗护理文书的手工操作，完善了医疗、护理科研的统计查询分析，提高了工作效率和护理质量，为实现医院临床医疗信息网络化创造了条件。     

某高级重症监护型救护车车身骨架的有限元分析

目的:验证高级重症监护型救护车车身骨架的设计强度,发现设计不足,为后续设计的改进和优化提供理论依据。方法:建立车身的三维模型,利用有限元分析软件对车辆进行弯曲、扭转、转弯和制动等工况的分析。结果:高级重症监护型救护车车身骨架的平均应力小于材料的屈服强度,最小安全系数1.43,具有较高的安全性。结论:高级重症监护型救护车车身骨架设计能够满足救护车的设计使用需求。     

Doing care work on the fly – exploring the unnoticed socio-emotional skills of male ambulance staff

Prehospital ambulance work is a healthcare arena hitherto neglected by sociologists of health and illness. This is unfortunate because it is an interesting and dynamic area, and in contrast to most healthcare sectors, it is male dominated. Via ethnographic fieldwork, this article examines the particular caring practices and socio-emotional skills that ambulance staff use in practising prehospital care work. The empirical analysis outlines six recurring prehospital practices: medicine work, machine work, scene management, becalming work, communication work and bodywork. Each practice represents a different element of prehospital care practice and is best understood as a repertoire, as many different assemblages of these care practices can work effectively in prehospital situations. The article concludes that despite institutionalised blue-collar masculinity, numeric dominance and scarce formal education in ambulance psychology, male ambulance staff are generally proud and reflexive care practitioners.     

Inappropriate use of emergency ambulance services and the implications for primary health care in Japan

The number and per-capita emergency transports by public ambulancesand the percentage of transports of patients with non-emergencyconditions has been increasing in Japan, especially in urbanareas. Public ambulance services are, of course, essential fortransporting patients with crucial health problems. However,inappropriate ambulance use by patients who do not need emergencytreatment, but who need primary health care, means that thesepatients cannot get suitable health care, and diminishes theeffectiveness and efficiency of emergency medical-care servicesystems. The purposes of this study were to identify the factorsrelating to usage of public ambulance services in urban areas,to determine how to make these services more effective and moreefficient, and to discuss how to provide primary health-careservices so as to reduce the inappropriate use of public ambulanceservices. We investigated the accessibility of primary health-careservices, the characteristics of public ambulance service utilization,and the potential needs of the elderly for emergency-care servicesin two Tokyo wards: Edogawa andSetagaya. There were less healthresources, such as clinics, hospital beds and physicians, percapita in Edogawa than in Setagaya. Both the percentage of ambulancetransports of patients suffering from mild problems and thepercentage of ambulance transports on Sundays were higher inEdogawa than in Setagaya. Our survey showed that the percentagesof the elderly who would call for ambulances for each of threespecific health problems (fever, chest pain and ankle sprain)were all higher in Edogawa than in Setagaya. In both wards,elderly people living with their children and/or grandchildrenwere more likely to choose different health resources accordingto the specific problem being experienced than were elderlypeople living with other aged persons but without young people.The insufficient development of primary healthcare resourcesand systems increased the inappropriate use of high-cost emergencyambulance services by the elderly living in urban areas, wherefamily support is weakening. Health systems therefore need tobe reoriented so as to enhance accessibility to primary healthcareservices.     

全方位关怀在儿科重症监护室的应用效果

目的 探析全方位关怀式护理在儿科重症监护室(PICU)中的应用效果.方法 选取2018年1月-2019年12月广东省中山市人民医院PICU收治的100例患儿,随机分为对照组和观察组各50例,对照组患儿给予常规护理干预,观察组在对照组基础上给予全方位关怀式护理,收集两组的并发症发生率、家属对护理满意率和患儿的治疗配合度....     

负压救护车排风净化装置的研制与应用

目的研制一种负压救护车排风净化装置,使安装该装置的普通救护车通过电路连接、车厢加强密封等简单改造后,快速升级为具备负压隔离功能的负压救护车。方法采用一体化设计,集成动力排风、空气高效过滤、紫外线杀菌、负压监测与报警等功能与一体。分别使用物理气溶胶和病毒气溶胶检测该装置的过滤效率;装置正常运行后,通过微压差传感器测量救护车病员室的负压值;通过测量装置的排风量计算救护车病员室的换气次数。结果该装置的过滤效率、救护车病员室的负压值、换气次数均达到国家卫生行业标准要求。结论该装置过滤效率高,体积小,功能集成化,安装方便,在全国范围内为呼吸道传染病疫情的防控提供了装备支撑,取得了显著的社会效益。     

The craft of intensive care medicine

The practice of medicine is often represented as a dualism: is medicine a ‘science’ or an ‘art’? This dualism has been long‐lasting, with evident appeal for the medical profession. It also appears to have been rhetorically powerful, for example in enabling clinicians to resist the encroachment of ‘scientific’ evidence‐based medicine into core areas of medical work such as individual clinical judgement. In this article I want to make the case for a more valid conceptualisation of medical practice: that it is a ‘craft’ activity. The case I make is founded on a theoretical synthesis of the concept of craft, combined with an analysis of ethnographic observations of routine medical practice in intensive care. For this context the craft aspects of medical work can be seen in how biomedical and other types of knowledge are used in practice, the embodied skills and practical judgement of practitioners and the technological and material environment. These aspects are brought together in two conceptual dimensions for ‘craft’: first, the application of knowledge; second, interaction with the material world. Some practical and political implications of a ‘craft’ metaphor for medical practice are noted.     

The fragile spirituality of parents whose children died in the pediatric intensive care unit

Abstract

Spiritual care is recognized as a relevant dimension of health care. In the context of pediatric palliative end-of-life care, spirituality entails more than adhering to a spiritual worldview or religion. Interviews with parents whose critically ill child died in the pediatric intensive care unit revealed features of a spirituality that is fragmentary and full of contradictions. This type of spirituality, which we refer to as fragile, speaks of parents’ connectedness with the deceased child and the hope of some kind of reuniting after one’s own death. Acknowledging that fragments of spirituality can be part of parents’ experiences in their child’s end-of-life stage can be a meaningful contribution to compassionate care.     

重症监护病房护理小组工作模式的案例研究

目的 :探索目前重症监护室病房(ICU)护理小组工作模式的运行情况,分析不同小组工作模式的作用。方法 :采用案例研究法。用目标抽样法,采用滚雪球的方法选取上海市、北京市和广东省7家医院的8个ICU,每个选取1名护士,通过半结构式访谈收集资料。用内容分析法分析资料。结果 :ICU的小组工作模式分为小组长管床和不管床两种模式。结论 :ICU护理小组工作模式中,与管床模式相比,不管床模式能更好地体现组长的作用,体现分层管理,保证护理质量。     

EICU医院获得性感染调查

目的 了解医院急诊重症监护室病房(EICU)医院获得性感染流行病学特点及对抗菌药物耐药性,为合理应用抗菌药物提供参考.方法 对医院2008年6月-2012年6月EICU获得性医院感染患者感染病原菌及对抗菌药物耐药性进行回顾性调查分析.结果 入住EICU患者共2224例,发生医院感染132例、157例次,医院感染率5.94％、例次感染率7.06％;132例医院感染患者送检标本168份,分培养出病原菌67株,检出阳性率39.88％,其中革兰阴性菌42株占62.69％,革兰阳性菌24株占35.82％,真菌1株占1.49％;检出病原菌标本来源前3位为痰液、血液、尿液,分别占53.73％、20.90％、10.45％;铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌对氨苄西林、头孢唑林的耐药率达100.00％,耐药率较低的药物有亚胺培南、哌拉西林/舒巴坦;金黄色葡萄球菌对氨苄西林、苯唑西林、头孢唑林、呋喃西林的耐药率100.00％,耐药率较低的药物有亚胺培南、万古霉素、哌拉西林/舒巴坦.结论 EICU医院获得性细菌感染以革兰阳性菌为主,其对临床多种常用抗菌药物普遍耐药.     

The impact of an intensive care unit admission on the health status of relatives of intensive care survivors: A prospective cohort study in primary care

BackgroundRelatives of intensive care unit (ICU) survivors may suffer from various symptoms after ICU admittance of their relative, known as post-intensive care syndrome-family (PICS-F). Studies regarding PICS-F have been performed but its impact in primary care is unknown.ObjectivesTo explore health problems of relatives of ICU survivors in primary care.MethodsThis is an exploratory prospective cohort study in which we combined data from two hospitals and a primary care research network in the Netherlands. ICU survivors who had been admitted between January 2005 and July 2017 were identified and matched by sex and age with up to four chronically ill (e.g. COPD, cardiovascular disease) patients. In both groups, relatives living in the same household were identified and included in this study. Primary outcome was the number of new episodes of care (International Classification of Primary Care-2) for up to five years. Hazard ratios (HRs) for the total number of new episodes were calculated.ResultsRelatives of ICU survivors (n = 267, mean age 38.1 years, 41.0% male) had significantly more new care episodes compared to the reference group (n = 705, mean age 36.3 years, 41.1% male) 1–2 years (median 0.11 vs. 0.08, HR 1.26; 95% confidence interval (CI) 1.03–1.54) and 2–5 years (median 0.18 vs. 0.13, HR 1.28; 95%CI 1.06–1.56) after ICU discharge. No differences were found in the period before ICU admission.ConclusionRelatives of ICU survivors present more morbidity in primary care than relatives of chronically ill patients up to five years after ICU discharge.