群体烧伤伤员空运后送的护理做法与体会

目的 进一步研究群体烧伤病员远距离空运后送的护理组织与实施.方法 对2006年34例烧伤伤员空运后送护理的全过程进行了回顾分析.结果 34名伤员全部为男性,病重25人(占73.53%),病危3人(占8.82%),100%合并吸入性呼吸道损伤;重度吸入性损伤16人占47.06%,中度吸入性损伤18人占52.94%.空中飞行距离约1 600km.按空运申请、空运前医疗护理准备、运送伤员到达登机点、组织伤员登机、实施空中医疗护理、组织伤员离机与交接、进行飞机的清洁与消毒、补充药材等8个阶段逐步展开救护.结论 对于群体烧伤伤员空运后送,转运前的护理准备非常重要;对群体伤员进行分类编号管理,是防止护理工作混乱的基础.空中转送的医疗与护理具有独特性,但现代化的监护增加了转运的安全;统筹使用空中与地面的护理力量,可以提高护理组织绩效.     

群体烧伤伤员空运后送的护理做法与体会

目的进一步研究群体烧伤病员远距离空运后送的护理组织与实施。方法对2006年34例烧伤伤员空运后送护理的全过程进行了回顾分析。结果34名伤员全部为男性，病重25人（占73．53％），病危3人（占8．82％），100％合并吸入性呼吸道损伤；重度吸入性损伤16人占47．06％，中度吸入性损伤18人占52．94％。空中飞行距离约1600km。按空运申请、空运前医疗护理准备、运送伤员到达登机点、组织伤员登机、实施空中医疗护理、组织伤员离机与交接、进行飞机的清洁与消毒、补充药材等8个阶段逐步展开救护。结论对于群体烧伤伤员空运后送，转运前的护理准备非常重要；对群体伤员进行分类编号管理，是防止护理工作混乱的基础。空中转送的医疗与护理具有独特性，但现代化的监护增加了转运的安全；统筹使用空中与地面的护理力量，可以提高护理组织绩效。     

组织陆运和空运成批特重型烧伤患者的护理管理

通过总结成批特重型烧伤患者陆运和空运的护理组织与管理方法,为平时从陆地和空中转运大批量特重烧伤患者提供经验,同时为实战条件下组织进行伤员的前接转运提供有益的参考。     

地震伤员空中转运的护理管理

目的 探讨地震伤员空中转运的护理管理.方法 地震伤员空运前的准备需制订科学、合理的转运预案和工作流程;转运过程中的护理需严格核对伤员基本情况,做好乘飞机伤员的管理,仔细观察伤情变化,发现异常情况及时处理.结果 96例地震伤员转运过程中顺利,全部安全到达目的 地,未发生并发症.结论 转运前的充分准备、转运中的严格核对和严密观察伤情变化,发现异常情况及时处理,是保证空中安全转运地震伤员护理质量管理的关键.     

大批量空中转运地震伤员的护理

报告了大批量空中转运汶川地震伤员的护理.于2008年5月21-30日实施了18次空中转运,飞行时问近40 h,转运了615名地震伤员.转运前做好人员配置,航空信息采集,伤员准备,物资准备和飞机准备;转运中做好伤员搬运与安置、病情观察和心理护理;到达目的 地后做好与接收医院的交接工作.本组伤员全部安全转运至目的 地,未发生任何意外.     

芦山地震住院伤员伤情和转运方式调查

目的 探讨芦山地震住院伤员伤情和转运方式,为救治大规模伤病员提供依据。方法 采用“军卫一号”医院信息系统和自编“4·20四川芦山地震住院伤员调查表”,收集整理成都军区总医院收治的芦山地震住院伤员资料。结果 全院累计收治65名地震伤员。主震时受伤共63人,占96.92%。被建筑倒塌等砸伤28名,占43.08%;逃生时跌碰伤23人,占35.38%;意外损伤14人,占21.54%。伤员救援方式：自救32人,占49.23%;互救23人,占35.38%;地方救援10人,占15.38%;军队救援34人,占52.31%。空中转运伤员26人,占44.83%。结论 为应对未来地震等突发事件和重大灾害,科学救治大规模伤员,应科学合理设置应急病区,广泛开展防震减灾教育,加强灾区自救互救,迅速派出救援医疗队并组织伤员空中转运训练。     

成批特重烧伤病人空中转运的护理

现代科技、工业条件下群体烧伤病人增加,成批重度烧伤病人的救治需要一个技术力量雄厚和医疗设备条件好的烧伤治疗中心.飞机转运病人是最快捷的方法之一.国内有关空中转运成批危重烧伤病人过程中的护理特点及措施少有报道.我院2005年6月3日接收特重烧伤病人16例,根据上级指示及救治需要,分三批次利用救护车及飞机等运输工具成功转运10例伤员于千里之外的烧伤专科医院.现将转运过程中的护理报告如下.     

成批特重烧伤病人空中转运的护理

现代科技工业条件下群体烧伤病人增加，成批重度烧伤病人的救治需要一个技术力量雄厚和医疗设备条件好的烧伤治疗中心。飞机转运病人是最快捷的方法之一。国内有关空中转运成批危重烧伤病人过程中的护理特点及措施少有报道。我院2005年6月3日接收特重烧伤病人16例，根据上级指示及救治需要，分三批次利用救护车及飞机运输工具成功转运10例伤员于千里之外的烧伤专科医院。现将转运过程中的护理报告如下。     

论未来战争空运后送的护理管理模式

在社会信息化、经济全球化、军事高科技化及国防战略格局多极化的现代社会里,战争的形态也随之发生了质的变化。面对未来高科技局部战争,空军卫勤保障尤其是护理卫勤管理应从战略的高度,认真审视未来战争联合作战空运医疗后送的保障需求,认真疏理空运医疗后送的研究成果,认真部署空运医疗后送准备任务,认真研究空运医疗后送保障的现实问题和对策。护理工作贯穿于卫勤保障的始终,其质量直接关系到病死率、伤残率的多少和伤员的预后效果。即直接关系到空军卫勤保障能力。     

批量伤员急诊救治和空运后送探讨

目的：探讨批量伤员院在联合国维和部队二级医院的急诊救治和空运后送的组织与实施模式,以进一步提高维和部队批量伤员救治质量。方法回顾性总结马里加奥“4·26”车祸事故和基达尔“5·13”地雷爆炸中,批量塞内加尔伤员在中国二级医院急诊救治和空运后送的相关资料,分析其抢救和空运后送模式的可行性及救治效果。结果经二级医院迅速、合理、高效的组织与救治伤员,本组14例伤员除1例死亡外,其余均成功获救。结论联合国维和部队二级医院对批量伤员采用快速分流救治,损伤控制手术,及时安全的空运后送模式,可以最大限度地提高批量外伤伤员救治的成功率。     

维和部队二级医院伤员空运后送前的护理

笔者报道中国首支维和医疗队驻刚果(金)第5战区二级医院13例伤员空运后送前的护理。总结后送前掌握后送标准及时机、后送程序、后送人员职责,做好伤病员的心理准备、生命体征的评估、充分物品准备以及从医院至机场后送过程中的护理,为我军伤病员分级救治和后送提供借鉴。     

意识障碍患者长途转运的安全护理

通过对96例意识障碍患者长途转运过程中的护理，认为采取积极合理的护理措施对保证意识障碍患者长途转运过程中的安全有着重要意义。认真详细地做好转运前的各项准备工作是保证安全转运的基础。充分了解患者的病情，做好患者家属的思想工作是保证安全转运的前提。严密观察病情变化，保证患者的呼吸道和其他管道通畅是保证患者安全转运的必要护理措施。     

大面积烧伤并严重复合性创伤患者的预见性护理

目的：探讨对大面积烧伤并严重复合性创伤患预见性护理方法,提高抢救成功率及护理质量。方法：对6例患采取了“超快”实施救治,“超早”采取措施,“超前”预防性护理及加强创面护理。结果：严重腹部挤压伤2例,颅内损伤与内出血2例,股动脉断裂1例,脑外伤与腹腔内出血1例的合并性损伤及皮肤烧伤全部治愈。结论：在救治大面积烧伤合并严重复合性创伤中,预见性护理极为重要。     

Management of severe burn injuries in neonates

Although rare, burns suffered by neonates can be fatal. Many complex difficulties are faced during the management of burns in neonates because of the neonate's complex physiological and pathological changes. We compiled a retrospective review from the treatment of four burned neonates (including a premature neonate). All four neonates suffered bath-related burns in the hospital as a result of careless nursing when being bathed. The total body surface area burned ranged from 1 to 60% in these patients, and all survived the burn injury. All the patients were treated in the Burn Intensive Care Unit with close co-operation of burn surgeons and neonatologists. Based on our experience as well as a review of literature, management recommendations are proposed as the following: 1) prompt and aggressive fluid resuscitation, 2) early administration of oxygen and keeping the patient warm, 3) application of specific biological dressing and recombinant human growth hormone if necessary, 4) establishment of a multidisciplinary team, and 5) removal of necrosis tissue early and aggressively. Furthermore, a very important issue is also discussed, which is about the prevention of newborn burns in the neonate unit in developing countries.     

Burns caused by medical therapy

A burn injury may occur as an unexpected consequence of medical treatment. We examined the burn prevention implications of injuries received in a medical treatment facility or as a direct result of medical care. The records of 4510 consecutive admissions to 1 burn center between January 1978 and July 1997 were retrospectively reviewed. A cohort of 54 patients burned as a result of medical therapy was identified and stratified by location (home vs medical facility) and by mechanism of injury. Twenty-two patients were burned in a medical treatment facility, including 12 patients who were burned as a result of careless or unsupervised use of tobacco products. Thirty-two patients were burned as a result of home medical therapy, including 9 patients who had scald injuries from vaporizers, 8 patients who were burned by simultaneous use of cigarettes and home nasal oxygen therapy, and 11 patients who were burned by therapeutic application of heat. In contrast to previous studies, no patient was burned by the use of medical laser devices. To further decrease burn risk from medical therapy we advocate the prohibition of cigarette smoking in any medical facility. Continued tobacco use may represent a contraindication to home oxygen therapy. Given the lack of proof of efficacy combined with the potential for burn injury, the use of vaporizers to treat upper respiratory symptoms should be discouraged. Patients with diminished sensation or altered mental status are at increased risk of burn injury from bathing or topical heat application and merit closer monitoring during these activities.     

Prospective Observational Study of United States (US) Air Force Critical Care Air Transport Team Operations in Iraq

Background: Current United States (US) military doctrine emphasizes rapid evacuation of casualties to fixed medical facilities remote from the theater of war. To support this strategy, the Air Force has formed Critical Care Air Transport (CCAT) teams consisting of a physician, nurse, and respiratory therapist. Study Objective: To describe the characteristics of US Air Force CCAT team operations at Balad Air Base, Iraq over a 1-year period. Methods: Balad Air Base was the primary collection point in Iraq for patients requiring evacuation outside of the country during the study period. The study authors deployed sequentially to Balad Air Base as CCAT team leaders. All patients transported by the authors were enrolled in the study. Injuries, illnesses, demographics, and in-flight data were collected prospectively. Results: There were 133 patients transported on 61 separate flights between Iraq and Germany. Trauma was present in 65% (87/133) of all patients transported. Lower-extremity injuries were the most prevalent among combat-related trauma patients. Cardiac conditions were the most common diagnoses among the medical patients. Fifty-seven percent of patients were mechanically ventilated. Hypotension was the most common in-flight complication, occurring in 17% (22/133) of patients. No flights were diverted or turned back due to an unstable patient. No patient died during flight or in the 24 h after the flight. Conclusions: US Air Force CCAT teams can safely transport multiple critical patients over long distances while providing intensive care interventions. Medical patients make up over one-third of patients requiring CCAT team transport.     

Roles and functions of military flight nursing: aeromedical evacuation

Evacuating the injured is an important part of disaster medicine. Aircraft provide timely access to distant and remote areas and, in an emergency, can evacuate sick or injured individuals in such areas quickly and safely for critical treatment elsewhere. Aeromedical evacuation (AE) comprises the two categories of fixed-wing ambulance service and helicopter emergency medical service (HEMS). Each aims to accomplish unique objectives. In Taiwan, the Second Taiwan Strait Crisis in 1958 established the unique role and functions of medical flight nursing. Significant knowledge and experience has been accumulated in the field since that time in such areas as the effects of high altitude environments on individuals and equipment; physiological, psychological, social and spiritual factors that affect the injured and / or response team members; and emergency care delivery techniques. All have been essential elements in the development and delivery of comprehensive medical flight nurse training. Medical flight nursing belongs in a special professional category, as nurses must master knowledge on general and special-case casualty evacuation procedures, relevant instruments and equipment, triage, in-flight medical care, and aircraft loading requirements related to transporting the sick and injured. The internationalization of medical care has opened the potential to expand medical flight nursing roles and functions into disaster nursing. Although military considerations continue to frame medical flight nursing training and preparation today, the authors feel that creating strategic alliances with disaster nursing specialists and organizations overseas is a future developmental direction for Taiwan's medical flight nursing sector worth formal consideration.     

Aero-medical evacuation with interventional lung assist in lung failure patients

OBJECTIVE: Acute respiratory failure can make long distance transport by air extremely difficult. Despite pressurised cabins, the pressure will fall to about three quarters of one atmosphere, and the oxygen partial pressure will fall proportionally. Interventional lung assist (iLA) is a well documented treatment in the critical care unit, but has not been evaluated scientifically in long range aero-medical evacuation. The present animal study was performed to test the feasibility of treating lung failure with iLA during intercontinental air evacuation in a military setting. METHODS: Eight adult female pigs were cannulated in the right axillary artery and the right jugular vein. An arterio-venous iLA device (Novalung) was connected. The ventilator was adjusted to below half of the needed minute volume before the use of iLA. The animals went through different modalities of transportation in ambulances, helicopters and aircraft. Two of the pigs were tested in a hypobaric chamber, and the remaining two animals underwent a 7.5 h intercontinental transportation from Denmark to Greenland in a Hercules C130J transport airplane. RESULTS: It was possible to maintain physiological PaCO(2) and PaO(2) in normal flight altitudes with iLA. Compared to pump-driven ECMO systems iLA is safer and more efficient. The current study demonstrates the feasibility of iLA during military aero-medical evacuation.     

经内镜气囊扩张治疗贲门失弛缓症的护理

[目的]探讨内镜下气囊扩张治疗贲门失弛缓症的护理措施。[方法]对38例贲门失弛缓症病人行术前充分准备、心理护理、术中娴熟的配合、术后饮食及并发症的观察及护理。[结果]38例病人应用气囊扩张治疗贲门失弛缓症1次～3次后成功率100%,无护理并发症发生。[结论]内镜下气囊扩张治疗贲门失弛缓症方法有效,损伤小,术前充分准备、术中密切配合、术后严密观察并发症是治疗成功的重要保证。     

Personal experience of aeromedical evacuation of patients in the Balkans

Nurses in the Princess Mary's Royal Air Force Nursing Service (PMRAFNS) undertake a variety of different roles in providing nursing care to Armed Forces personnel wherever they may serve. One such role is the evacuation by air of sick or injured personnel. This article discusses the experience of a nurse lecturer in the PMRANS who undertook the role of aeromedical evacuation liaison officer in the Balkans for a 4-month period during winter. The role is described and details of how the aeromedical evacuation of patients was organized is presented. The benefits of evacuating patients by air are discussed along with some of the potential problems that were encountered in the Balkans, including logistical problems and the vagaries of the weather. Finally, several examples of the types of patients evacuated are presented.