急性胸痛患者急诊室精细化护理措施及实施效果

目的 分析急性胸痛患者急诊室的精细化护理措施及实施效果。方法 选择医院2020年7月-2021年12月收治的100例急性胸痛患者为研究对象,依据组间基线资料均衡可比的原则分为对照组和观察组,各50例。对照组采取常规护理,观察组在常规护理基础上实施精细化护理措施。比较两组的临床疗效,护理前后胸痛程度、焦虑心理评分,治疗开始时间、抢救时间、住院时间,以及患者护理满意度。结果 实施精细化护理后,观察组总有效率为98.0%,高于对照组的70.0%,差异有统计学意义（P<0.05）。精细化护理后,两组视觉模拟评分（VAS）、焦虑自评量表（SAS）评分均低于护理前,且观察组低于对照组（P<0.05）。观察组治疗开始时间、抢救时间、住院时间均短于对照组,差异有统计学意义（P<0.05）。观察组满意度为96.0%,高于对照组的68.0%,差异有统计学意义（P<0.05）。结论 对急诊室的急性胸痛患者实施精细化护理措施,可以有效提高临床疗效,减轻患者胸痛程度及焦虑情绪,缩短治疗开始时间、抢救时间、住院时间,同时提高患者护理满意度。     

急性胸痛患者院前急救的护理措施探讨

目的 观察急性胸痛患者院前急救的护理措施探讨分析.方法 将在我院近期(2019年1月-2021年1月)收治急性胸痛患者总计60例,根据患者入院是否通过院前急救护理进行分组,其中通过院前急救的胸痛患者30例将其设置为研究组,而另30例则为通过患者本身自行入院或其家属直接送入医院急诊者即未通过院前急救护理则将其设置为对照组...     

急性上消化道出血在急诊室观察与护理体会

急性上消化道出血是临床上常见的急症之一。由于其病情急，变化快，急性大量出血可危及生命。对本症必须及时诊断迅速明确出血原因，严密观察及精心护理，对治疗本症有极其重要的意义。现将我院急诊室近几年来收住该症患者280例的观察和护理体会总结如下：     

急性胸痛患者应用急诊护理途径的效果研究

目的:研究急诊护理途径在急性胸痛中的应用价值.方法:选择2016年4月至2017年6月接诊的急性胸痛病患92例,以数字抽签的形式将之随机分成试验和对照两组,每组46例.试验组应用优化急诊护理途径,对照组应用常规护理.观察两组护理后疼痛程度的改善情况,比较患者满意度等指标.结果:试验组护理后的VAS评分明显比对照组低(P<0.05).试验组的患者满意度(97.83%)明显比对照组(82.61%)高,差异具有统计学意义(P<0.05).结论:急性胸痛中对患者施以急诊护理,有助于缓解其疼痛,提高临床护理效率.     

急诊室护理工作体会

医院急诊室是抢救急危重病人的重要场所,其中急救护理又是护理工作的一个重要组成部分,抢救成败反映了一个医院的医疗质量,也是护理水平高低的综合体现。急诊护士应熟练掌握急救护理的知识、技能和急危重病人的心理特征,对降低病人的死亡率,减少残废率,促进人类健康将起到重要作用。就急诊室的护理工作谈点粗浅体会。1 急诊室室理制度要落实到位1.1 严格执行急诊室的岗位责任制度 “急诊”是指病人病情急,诊治要求快,时间就是生命。因此,急诊室工作要强调人员     

急诊急性胸痛患者的原因分析及诊治体会

目的探讨急诊急性胸痛患者的原因及诊治效果。方法选取2017年6月-2018年6月天津医科大学宝坻临床学院急诊收治的732例急性胸痛患者开展回顾性研究,对急性胸痛发病原因进行分析,对诊治体会进行总结。结果急性胸痛疾病发生原因有两种类型,一是心源性胸痛,包括急性ST段抬高型心肌梗死、不稳定型心绞痛、肺栓塞以及夹层动脉瘤;二是非心源性胸痛,包括肋间软骨炎、自发性胸闷、支气管肺炎、消化道疾病、胆道疾病、肺癌、膈下脓肿、胸膜炎及带状疱疹。732例患者总漏诊误诊率为8.33%,治疗总有效率为92.49%。结论急诊急性胸痛患者的发病原因包括心源性胸痛和非心源性胸痛,及早准确诊断有助于最大程度提高患者存活率和治疗有效率。     

急诊室急性胸痛患者的护理

目的:探讨急诊室急性胸痛患者的临床护理措施。方法:选取2015年1月至2016年6月来我院就诊的80例急性胸痛患者进行研究,随机分为常规组和观察组,各40例。常规组进行常规性护理,观察组在常规性护理基础上进行整体护理干预,比较两组患者的VAS评分情况和护理满意度。结果:与常规组患者相比,观察组患者的VAS评分明显较低,护理满意度明显较高,P0.05,差异具有统计学意义。结论:整体护理干预可以明显缓解急性胸痛患者的疼痛症状,提高患者的护理满意度,值得临床广泛推广。     

院内护理转运改良流程应用于急性胸痛患者护理转运过程中的效果探讨

目的探讨院内护理转运改良流程应用于急性胸痛患者护理转运过程中的效果。方法选取我院急诊科2018年1月至2018年12月收治的200例急性胸痛患者,按照急诊护理转运过程的不同将其分为对照组与观察组各100例。对照组采用常规护理转运流程,观察组采用院内护理转运改良流程。观察两组患者的转运成功率、猝死发生率及护理满意度。结果观察组的转运成功率为94.0%,明显高于对照组的85.0%(P<0.05)。观察组的猝死发生率为1.0%,明显低于对照组的7.0%(P<0.05)。观察组的护理满意度为98.0%,明显高于对照组的90.0%(P<0.05)。结论院内护理转运改良流程应用于急性胸痛患者护理转运过程中效果显著,可提高急性胸痛患者转运成功率,降低猝死发生率,促进护患关系和谐,提高患者的满意度,值得临床推广。     

急诊内科急性胸痛患者54例诊治分析

目的探讨54例急诊内科急性胸痛患者临床诊治方法及效果。方法随机抽取我院在2011年12月-2012年12月期间收治的54例急诊内科急性胸痛患者的临床资料进行回顾性分析,对本组急诊内科急性胸痛患者的诊法方法进行分析,并且探讨其临床治疗效果。结果54例急诊内科急性胸痛患者,经抢救治疗,50例痊愈,治疗有效率为92．6％,死亡4例,占7．4％。结论造成患者胸痛的原因有很多,其中心源性胸痛占据很大比例,需要临床医师要加强对病因的诊断和明确,提高急诊急救治疗手段,确保患者的生命安全,提高抢救成功率,有效地控制降低死亡率的关键。     

Redesigning the diagnostic pathway for chest pain patients in emergency departments

Patients presenting with chest pain at an emergency department in the United Kingdom receive troponin tests to assess the likelihood of an acute myocardial infarction (AMI). Until recently, serial testing with two blood samples separated by at least six hours was necessary in order to analyse the change in troponin levels over time. New high-sensitivity troponin tests, however, allow the inter-test time to be shortened from six to three hours. Recent evidence also suggests that the new generation of troponin tests can be used to rule out AMI on the basis of a single test if patients at low risk of AMI present with very low cardiac troponin levels more than three hours after onset of worst pain. This paper presents a discrete event simulation model to assess the likely impact on the number of hospital admissions if emergency departments adopt strategies for serial and single testing based on the use of high-sensitivity troponin. Data sets from acute trusts in the South West of England are used to quantify the resulting benefits.     

规范化护理程序在急诊科急性心肌梗死患者中的应用

目的研究急性心肌梗死患者实施规范化护理的效果。方法 2010年1月至2011年6月间住院收治的急性心肌梗死患者72例为对照组接受常规护理,2012年1月至2013年6月间住院收治的急性心肌梗死患者86例为观察组,接受规范化护理程序护理,比较2组的治疗效果。结果观察组患者死亡率（2.3%）、平均住院天数均（10.7±3.9）d,明显低于对照组患者,差异有统计学意义（χ2=6.263,t=10.774,P〈0.05）。结论规范化护理可以有效提高急性心肌梗死患者抢救效果,降低死亡率。     

Chest pain in the emergency department

The assessment of patients with chest pain is challenging for any emergency physician because of the spectrum of illness covered by this symptom. Patients may have a serious life-threatening condition or a trivial self-limiting illness. This article presents an approach to the assessment and early management of patients presenting with acute non-traumatic chest pain in the emergency department.     

Undertreatment of acute pain in the emergency department: a challenge.

OBJECTIVE: Evaluation and improvement of pain management in our emergency department (ED). DESIGN: This was a "before-after" study. For each subject, the nurse, the physician, and the patient were asked to rate the initial intensity of the pain on a Visual Analogue Score (VAS). The timing and the type of analgesics administered were then recorded and follow-up VAS was performed. SETTING: A teaching, community-based, 400-bed hospital. STUDY PARTICIPANTS: 140 patients admitted for acute pain related to orthopedic injuries. MAIN OUTCOME MEASURES: The gap between the VAS expressed by the patient and estimated by the staff, the proportion of patients receiving analgesics, and the length of time delays between admission and analgesic administration. INTERVENTION: The intervention included education of medical and nursing staffs, insertion of a VAS template in the patient's chart, initiation of routine VAS assessment and re-assessment, and implementation of a protocol for pain management with standing orders for nurses. RESULTS: The VAS gap between the patient and the nurse decreased significantly from 1.91 2.04 to 1.03 1.97 after the intervention (P = 0.01). The percentage of patients receiving analgesics rose from 70 to 82% following the intervention. Time from admission to analgesia decreased from 80 +/- 68 min (mean +/- SD) before the intervention, to 58 +/- 37 min after the intervention (P = 0.05). CONCLUSION: Inadequate pain management in the ED appears related to poor staff assessment of pain and may be improved by routine VAS recording and by a nurse-based pain protocol.     

急诊科老年胸部创伤患者抗菌药物预防性使用的不合理因素分析

目的 分析急诊科老年胸部创伤患者抗菌药物预防性使用的不合理因素,并提出应对措施,以进一步规范合理应用抗菌药物.方法 选取近年来某院急诊科治疗的老年胸部创伤患者作为研究对象,对患者临床资料进行回顾性分析,观察患者治疗过程中预防使用抗菌药物情况,总结存在的不合理因素,并提出应对措施.结果 经过治疗,有247例患者临床治愈,治愈率为66.0％;好转患者81例,好转率为21.7％;死亡46例,病死率为12.3％;期间共发生感染83例,感染率为22.2％;共有287例患者使用抗菌药物预防性治疗,使用率达76.7％;其中不合理应用为89例,不合理应用率达31.0％;抗菌药物不合理使用因素主要为无指征用药占19.1％、用药时机选择不对占18.0％和药物选择不合理占13.5％;由于抗菌药物不合理使用发生感染43例,占感染总数的51.8％.结论 通过对老年胸部创伤患者抗菌药物预防性使用情况进行分析,针对存在的不合理因素进行有效控制,能够为老年胸部创伤患者合理使用抗菌药物进行预防性治疗提供可靠依据,对于减少抗菌药物的滥用和保障患者健康具有重要意义.     

急诊心理护理对急诊患者护理效果的影响分析

目的:评析急诊患者应用心理护理对于提升护理效果的作用.方法:选取我院2019年2月至2020年2月接诊的急诊患者98例,使用抽签法分为对照组(方法:常规护理)和观察组(方法:急诊心理护理),每组各49例,对比两组急诊患者的整体护理效果.结果:观察组收缩压(125.36±11.52)mmHg、舒张压(82.54±4.64...     

Understanding the meanings of ischemic chest pain of patients admitted in the emergency room

Nursing professionals who work in emergency units are constantly facing patients with ischemic chest pain. This study aimed at understanding the meanings of patients with ischemic chest pain when they are in the emergency room. It is a study with qualitative approach that was carried with ten patients admitted in an emergency room in a private hospital in the south zone of S?o Paulo city. Data were collected through semi-structured interviews and analyzed according to content analysis approach. Resulting thematic axes were: meaning of chest pain and feelings when facing the symptoms. As results it was possible to observe the fear of death, family concerns were more significant. It was concluded that patients with ischemic chest pain need special support from the nursing team in order to decrease or diminish those feelings.     

Patients with acute chest pain - experiences of emergency calls and pre-hospital care

Acute chest pain is a common reason why people call an emergency medical dispatch (EMD) centre. We examined how patients with acute chest pain experience the emergency call and their pre-hospital care. A qualitative design was used with a phenomenological-hermeneutic approach. Thirteen patients were interviewed, three women and 10 men. The patients were grateful that their lives had been saved and in general were satisfied with their pre-hospital contact. Sometimes they felt that it took too long for the emergency operators to answer and to understand the urgency. They were in a life-threatening situation and their feeling of vulnerability and dependency was great. Time seemed to stand still while they were waiting for help during their traumatic experience. The situation was fraught with pain, fear and an experience of loneliness. A sense of individualized care is important to strengthen trust and confidence between the patient and the pre-hospital personnel. Patients were aware of what number to call to reach the EMD centre, but were uncertain about when to call. More lives can be saved if people do not hesitate to call for help.