急诊科整体护理探索

1 急诊要分秒必争急诊科病人大多数入院时病情急、危重,要求急诊护士在“快”字上下功夫,时间就是生命,早一分种抢救就多一份抢救成功率,危重病人一踏入急诊科,为争取时间一路绿灯,一切从病人的需要出发,一切方便于病人,服务于病人,以解决病人的实际问题为导向,护理人员协助病人做各种检查及办理各种手续,急救车在接诊病人归途中通过无线呼叫把病人的情况告知急诊科,以便做好一切抢救准备工作。护理还实施了“一分钟吸氧,三分钟建立静脉通道”的快速抢救,为     

急诊绿色通道的内涵建设

急诊科是医院急、危、重患者最集中，病种最复杂、时间最紧迫、突发事件最多，抢救和管理任务最重的科室，是体现一个医院综合水平的窗口。建立和完善急诊绿色通道是急诊科管理的基本要素和重要环节，开放的急诊绿色通道为抢救生命赢得宝贵的时间，使接诊急诊患者或遇突发事件出现大批伤员时，能迅速及时投入抢救，做到“急而有序，忙而不乱”，确保急诊急救工作顺利进行。     

急诊护理发展探讨

随着急救医学的发展，我国医院已开始重视急诊科建设发展，许多大医院急诊科及其他单位组成EMSS(Emergency medicine service即急诊医疗体系)系统，又称生命绿色通道。它要求设施完善的急诊科，使急救病人院前抢救一抢救室抢救一急诊手术一术后监护(危重监护)一病房一体化，不出急诊区。这种布局要求护士必须成为以急救为主，样样拿得起的全科能力的护士；同时也对护理提出更高的要求。因此急诊护理的发展日益提到日程上来。     

急诊科护理特点对护士素质的要求与培养

本文结合临床分析急诊科护理工作的特点,提出了急诊科护士素质的基本要求,即护士面对紧急状况应沉着冷静,严格实施抢救程序,建立灵活的人力调配机制,合理搭配,强化培训,重视急诊护理质量监控。急诊科护士素质的培养是避免或减少护患纠纷的重要措施,也是提高急诊科危重病人的抢救成功率,挽救患者生命,促进患者康复的有效方法。     

急诊科护理特点对护士素质的要求与培养

本文结合临床分析急诊科护理工作的特点,提出了急诊科护士素质的基本要求,即护士面对紧急状况应沉着冷静,严格实施抢救程序,建立灵活的人力调配机制,合理搭配,强化培训,重视急诊护理质量监控。急诊科护士素质的培养是避免或减少护患纠纷的重要措施,也是提高急诊科危重病人的抢救成功率,援救患者生命,促进患者康复的有效方法。     

急诊危重病人的心理特点及护理

急诊科来诊的大多是危重病人，此类病人的特点是起病急、病情复杂多变、生命危在旦夕。必须采取紧急抢救措施，才能挽救病人的生命。急诊医护工作人员往往对来诊病人采取迅速有效的物理或药物抢救措施。挽救病人的生命。而忽略了心理护理对疾病的作用。近年来。由于监护病房和急诊观察室的建立和发展。提高了抢救成功率。也为我们进一步观察了解急诊危重病人的心理特点提供了条件。并积累了丰富的临床经验。我们医护人员只有充分认识到对急诊危重病人进行心理护理的重要意义，     

急诊医生的素质培养

急诊科是医院中抢救急危重患者生命最紧张、最繁忙的部门，担负着院前急救、院内接诊、紧急处置与院内各科的联系等职责。急诊医生在急诊工作中担负着重要角色，要正确处置患者，协调各种关系。特别是当前患者维权意识增强，医患纠纷隐患层出不穷，要求急诊医生具备良好的基本素质，是做好急诊工作的重要保证。急诊医生的素质培养，关系到急诊急救工作的质量，关系到一个医院乃至一个地区急诊急救的工作水平，甚至影响着整个医疗卫生事业的发展。重视急诊医生的素质培养，是急诊科管理的重点，也是整个医院发展的重要部分。     

战伤救护模式在成批伤病员救治中的实践与思考

在经济高度发展的今天,突发事件发生率逐年上升,成批伤病员抢救己成为医院急诊工作一项重要内容。我院地处沿海城市城乡结合部,又是工厂企业密集区,每年因各种工伤、交通事故、火灾、爆炸和中毒等造成的成批伤病发生率较高。1995年以来我院采取平战结合方式,应用军事医学发展中成功经验,以战伤救护模式组织各种成批伤病员抢救取得了良好效果。     

浅谈急诊护士对于危急性患者的心理护理

急诊科是抢救各种急性病、危重病的前哨，急诊护士应有较全面的应急能力，做到迅速、尽职与准确。过去，认为急性患者病情急，医护人员的任务就是以最佳的技术和最快的速度抢救患者，无需实施心理护理。但近十年来，随着现代护理模式的变化，由生物护理向生物心理护理的转变中，     

洗胃的护理管理

洗胃是急诊抢救各种经口中毒的常规措施之一，正确及时有效的洗胃是抢救成功的关键。因此，笔者所在医院急诊科多年来对洗胃进行严格的护理管理，现将重点环节的管理体会总结如下。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.