救治群体性正已烷中毒患者的护理管理对策

目的 探讨救治群体性正已烷中毒患者的护理管理对策.方法 启动突发公共卫生事件护理应急预案,加强安全管理、群体性心理危机管理,强化职业卫生相关知识培训.结果 所有患者心理稳定,遵医依从性好,积极配合康复治疗.结论 有效的护理管理确保了正已烷中毒患者的治疗与护理安全.     

救治群体性正己烷中毒患者的护理管理对策

目的探讨救治群体性正己烷中毒患者的护理管理对策。方法启动突发公共卫生事件护理应急预案,加强安全管理、群体性心理危机管理,强化职业卫生相关知识培训。结果所有患者心理稳定,遵医依从性好,积极配合康复治疗。结论有效的护理管理确保了正己烷中毒患者的治疗与护理安全。     

群体性一氧化碳中毒患者的心理护理

目的报告一批群体性一氧化碳中毒患者的心理护理措施。方法运用症状自评量表（SCL-90）分析26例群体性一氧化碳中毒患者的心理问题,回顾性总结心理护理。结果26例患者全部依次康复出院。结论增强患者安全感,加强护患沟通,合理安排治疗措施,注意患者的心理需要,预防群体性癔病的发生是患者依次康复的重要因素。     

52例急性群体性有机溶剂中毒患者的护理体会

总结了52例急性群体性有机溶剂中毒患者的临床观察及护理体会。包括迅速启动应急预案、开通绿色通道、组织人员救治护理及心理干预等措施。认为重视群体性中毒患者的组织与抢救、严密的临床观察与护理干预、有效的心理沟通,对成功救治急性群体性中毒患者有着十分重要的意义。     

一批群体性毒鼠强中毒患者心理护理

目的：报告一批群体性毒鼠强中毒患者心理护理措施。方法：回顾性总结群体性162例毒鼠强中毒患者的心理护理。结果：162例患者全部脱险、康复。结论：建立良好的第一印象，合理安排组织，加强护患沟通，注意患者心理需要．预防群体性癔病的发生是患者全部康复的重要因素。     

11例群体性河豚鱼中毒患者的急救护理

目的 总结11例群体性河豚鱼中毒患者的急救护理措施.方法 迅速启动突发事件指挥系统,早期发现、早期治疗,迅速建立静脉通道,及时解毒、排毒,纠正水、电解质平衡,密切观察病情,选择机械通气最佳时机,确保有效通气.结果 本组11例中毒患者,4例重度中毒,3例应用机械通气,经过抢救及护理,11例患者无并发症发生,康复出院.结论 加强现场组织管理和各部门的协调合作,有效组织人员参与抢救,急救器械、物品处于良好应急状态,严密监测生命体征,加强气道管理,保证有效通气,加强心理护理,注重健康宣教,做好基础护理是抢救成功的关键.     

安全管理对采用高压氧治疗一氧化碳中毒患者心理状态的影响

目的 探讨安全管理对采用高压氧治疗一氧化碳中毒患者心理状态的影响.方法 对56例采用高压氧治疗的一氧化碳中毒患者实施安全管理,包括制订和实施安全管理制度、气压伤预防管理和心理疏导.采用Zung焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(Self-rating Depression Scale,SDS)测评安全管理前后患者心理状态的差异.结果 安全管理后患者抑郁和焦虑情绪发生率均较安全管理前降低,管理前后比较,均P＜0.05,差异具有统计学意义.结论 一氧化碳中毒患者在高压氧治疗过程中实施安全管理,可有效降低患者的负性心理,使其主动和积极配合治疗,从而保证治疗顺利完成.     

毒鼠强中毒34例抢救与护理体会

群体性毒鼠强中毒在临床上较为少见.我院于2004年10月9日收治了因食用掺有毒鼠强的面条而中毒的患者34例,经积极抢救和精心护理,患者全部治愈,现将其治疗和护理体会报告如下.     

群体性亚硝酸盐中毒的急救与护理

总结了14例群体性亚硝酸盐中毒的急救与护理措施。包括严密管理、合理分工,及早、彻底地清除毒物,保持呼吸道通畅,抗休克护理等。认为在群体性亚硝酸盐中毒患者救治中,正规化、科学化、程序化的护理管理模式以及积极的急救护理措施可明显提高急救质量和效率。     

群体性有机磷农药中毒病人的救护

目的探讨群体性有机磷农药中毒病人的有效救护.方法完善的组织管理机构;抢救措施到位,迅速清除毒物,予及时、彻底、有效的洗胃;早期诊断,明确毒物性质,迅速建立静脉通道,早期、足量应用特异性解毒药;保持呼吸道通畅;密切观察病情变化和进行有效的心理护理.结果4批共195例群体性有机磷农药中毒病人全部治愈出院.结论采用上述完善的组织管理机构和系统的抢救护理措施能确保群体性有机磷农药中毒病人的有效救护.     

群体可乐定中毒患者的急救管理与体会

目的 探讨应对突发群体中毒事件的急救组织管理工作.方法 迅速启动应急预案,合理配备人力资源,确保物资到位,实施有效的急救措施等.结果 80例可乐定中毒患者中,医院留观救治35例,转至上级医院45例.35例患者全部康复.无护理差错事故及投诉发生;患者满意度100.00%.结论 对突发急性群体中毒事件,合理调配人力、物力,...     

Acute cyanide poisoning in prehospital care: new challenges, new tools for intervention

Effective management of cyanide poisoning from chemical terrorism, inhalation of fire smoke, and other causes constitutes a critical challenge for the prehospital care provider. The ability to meet the challenge of managing cyanide poisoning in the prehospital setting may be enhanced by the availability of the cyanide antidote hydroxocobalamin, currently under development for potential introduction in the United States. This paper discusses the causes, recognition, and management of acute cyanide poisoning in the prehospital setting with emphasis on the emerging profile of hydroxocobalamin, an antidote that may have a risk:benefit ratio suitable for empiric, out-of-hospital treatment of the range of causes of cyanide poisoning. If introduced in the U.S., hydroxocobalamin may enhance the role of the U.S. prehospital responder in providing emergency care in a cyanide incident.     

流程再造在群体食物中毒急诊救护中的应用

目的：再造群体食物中毒急诊救护流程,提高患者救护效率。方法：从分诊、分流安置患者,启用急救梯队到组织分工,再造原来流程,制订了一套适合大批群体食物中毒的急诊救护方案,并成功应用于两起大宗群体食物中毒患者共计213人的急诊救护中。结果：缓解了因大批患者来诊而造成的急诊混乱局面,明显缩短了患者候诊时间与等待治疗的时间,提高了患者的满意度。结论：群体食物中毒急诊救护流程再造有利于提高群体中毒患者的救治效率。     

批量氯气中毒伤员救治的组织与管理

目的探讨批量氯气中毒伤员救治组织管理的方法,优化批量伤员急救流程,提高急救水平。方法迅速启动应急预案。实行救护人员编组,分为6组;根据病情分为氯气刺激反应及轻、中、重中毒4级,进入相应的诊疗区域。对27名氯气中毒伤员实施有效的救治。结果 27名伤员全部临床治愈出院。结论熟练实施急救流程是成功救治的基础,实施过程中合理调配人力、物力,做好医院各部门间组织协调,可确保救治流程的畅通,提高批量伤员救治成功率。     

基于JCI标准规范急救设备风险管理的应用

目的 通过开展JCI国际医院评审认证对我院急救设备风险管理制度进行重新拟定,旨在提高抢救效率,改善急救环境,确保医疗和护理质量安全。方法 将我院急救设备的管理工作按照时间顺序分为常规急救组和JCI急救组,2009年1月2009年9月为常规急救组,按照常规方法进行管理;2011年 7月2012年4月为JCI急救组,按照JCI认证制度进行管理。比较两组的急救护理质量以及医生、患者对护理工作的满意度。结果 JCI急救组的急救仪器设备完好率、护士急救技能考核率、医生和患者对护理工作的满意率较常规急救组有明显提高(p<0.01)。讨论JCI的认证标准规范了我院急救设备的风险管理制度,培养了一批高技能高素质的护理队伍,提高抢救效率,确保患者生命安全。     

The use of therapeutic plasmapheresis in the treatment of poisoned and snake bite victims: an academic emergency department's experiences

The objective of this study is to describe the clinical status, procedural interventions, and outcomes of critically ill patients with poisoning and snake bite injuries presenting to a tertiary-care emergency department for treatment with therapeutic plasmapheresis. Records of 20 patients who presented to our academic emergency department over a 2-year period and who underwent plasmapheresis for poisoning or snake bite were retrospectively reviewed. Plasmapheresis was performed using centrifugation technology via an intravenous antecubital venous or subclavian vein catheter access. Human albumin or fresh frozen plasma were used as replacement fluids. Data extracted from the patient record included demographic data, clinical status, and outcome measures. Sixteen patients underwent plasmapheresis because of toxicity from snake bite. Three patients were treated for drug poisoning (phenytoin, theophylline, bipyridene HCl) and one patient for mushroom poisoning. Haematologic parameters such as platelet count, PT, and INR resolved rapidly in victims of snake bite injuries after treatment with plasmapheresis. Loss of limbs did not occur in these cases. Seven patients required admission to the intensive care unit. One patient with mushroom poisoning died. Mean length of hospital stay was 14.3 days (range 3-28 days) for all cases. Plasmapheresis was a clinically effective and safe approach in the treatment of snake bite envenomation and other drug poisoning victims especially in the management of hematologic problems and in limb preservation/salvage strategies. In addition to established conventional therapies, emergency physicians should consider plasmapheresis among the therapeutic options in treatment strategies for selected toxicologic emergencies.     

Food poisoning

Food poisoning is encountered throughout the world. Many of the toxins responsible for specific food poisoning syndromes are no longer limited to isolated geographic locations. With increased travel and the ease of transporting food products, it is likely that a patient may present to any emergency department with the clinical effects of food poisoning. Recognizing specific food poisoning syndromes allows emergency health care providers not only to initiate appropriate treatment rapidly but also to notify health departments early and thereby prevent further poisoning cases. This article reviews several potential food-borne poisons and describes each agent's mechanism of toxicity, expected clinical presentation, and currently accepted treatment.     

A risk assessment based approach to the management of acute poisoning

Early assessment and management of poisoning constitutes a core emergency medicine competency. Medical and psychiatric emergencies coexist; the acute poisoning is a dynamic medical illness that represents an acute exacerbation of a chronic underlying psychosocial disorder. The emergency physician must use an approach that ensures early decisions address potentially time critical interventions, while allowing management to be tailored to the individual patient's needs in that particular medical setting. This article outlines a rationale approach to the management of the poisoned patient that emphasises the importance of early risk assessment. Ideally, this approach should be used in the setting of a health system designed to optimise the medical and psychosocial care of the poisoned patient.