Views: 6 Author: Site Editor Publish Time: 2022-07-28 Origin: Site
The condition of critically ill patients is complex, dangerous and rapidly changing, and there may be different degrees of complications and some unexpected situations during the transfer. Therefore, accurate and comprehensive assessment of the patient's condition by nurses before transporting the patient is the key to safe transfer. Before transporting all patients, emergency physicians and nurses together fully assess the possibility of transport, including the patient's consciousness, vital signs, medication, respiratory condition, and potential safety hazards that may occur during transport according to the patient's condition. According to the assessment, make appropriate preparations.
First, obtain the consent of the family When the nurse receives the medical order to transport the patient, she will contact the patient's family in the first time, explaining where the patient is to be transported, the purpose and how many family members need to accompany the patient, and how to cooperate, and informing the patient of the possible problems on the way, so as to avoid the doctor-patient dispute caused by the patient's lack of understanding when the patient has an accident on the way, which will affect the safe transport. Then sign the informed consent form for patient transport. Next, keep the patient's airway open and check whether the artificial airway is firmly fixed to prevent the catheter from slipping out during the transfer. Prevent asphyxia and misaspiration, and ensure adequate oxygen supply. Aspirate the secretions in the airway before transport. In addition, keep all kinds of tubes smooth, tightly connected and properly fixed to prevent distortion, pressure and dislodgement. Ensure that the infusion pipeline is smooth and the drug input is uniform so that the treatment is uninterrupted during the transfer.
Proper use of transfer tools including China Transport Chair for sale Preparation of items, drugs and instruments required for transfer Prepare different resuscitation drugs according to the patient's condition, such as epinephrine, atropine, lidocaine hydrochloride, niclosamide, loperine, diazepam, sodium lactate Ringer's solution, etc. At the same time, prepare cardiac monitors, oxygen bags, simple breathing airbags, aspirators, etc., and if necessary, prepare portable ventilators. When using portable oxygen cylinders to give oxygen, check whether the oxygen device is smooth, and try to avoid using oxygen bags for oxygen supply, because the oxygen concentration and oxygen flow rate of oxygen bags are difficult to estimate.
There are great risks in the transfer and examination of critically ill patients. Medical staff should contact the receiving department well before transferring patients to ensure that the receiving department has been informed of the patient's condition and is prepared. Nurses should estimate the distance to the department and the time required and contact the special elevator for emergency patients. In case of various tests, make an appointment in advance to ensure that the patient arrives in time for the various tests. The entire transfer process should be escorted by medical staff, and the nursing staff should keep records of the patient's consciousness, vital signs and accidental treatment during the transfer to prevent medical disputes.
The qualification and ability of the escorting personnel are related to the safety of the patient. In addition to the general staff, physicians and senior nurses with on-site cardiopulmonary resuscitation (CPR) skills should be available for the transport of critically ill patients, and they should have certain experience in resuscitation and emergency response capabilities. During transportation, timely and accurate judgment and treatment should be made according to changes in the condition.
The rapid onset and change of the condition of the critically ill patients in emergency medicine is a negative event for the patients, which must cause psychological stress, and the patients should be guided to respond positively to this stimulus so that they can adapt to the role change as soon as possible. Therefore, the psychological care of patients and their families should be done at the beginning of the transport work, so that patients feel safe. During the transfer process, nurses should work in an orderly manner and be skilled in their movements, place the patient in a comfortable position, accompany the patient at the end, and give careful, patient and thorough services to eliminate fear.
When determining the transfer of patients, handling requires accurate movements, and light, steady and fast, avoiding vibration. Patients with critical conditions or cervical and lumbar fractures should be transported by 3 to 4 people at the same time, keeping the head and trunk in a straight position. Patients should be transported with a restraint belt to prevent falling injuries, covered with good clothing, pay attention to warmth, position placement according to the condition and injury, general light casualties to take the supine position, cranial injury to the lateral position or head to the side to prevent the back of the tongue or secretions blocking the respiratory tract, chest injuries to take a semi-recumbent position or injury side down the low slope position to reduce respiratory distress, abdominal injuries to take the supine position knee pad high, so that the abdomen relaxed, shock patients to take supine in a concave position, etc. Patients with infusion should fix the needle to prevent it from coming out and causing extravasation of medicine; those with drainage tube should be fixed properly to prevent poor drainage caused by folding, twisting and pressure of drainage tube. Ensure that the intravenous infusion is smooth during the transfer so that the medication can be used during resuscitation. Keep the head at the end of the big wheel, which can reduce the vibration because of the slow and steady speed of the big wheel. The head is always at the high end when going up and down the slope to avoid causing discomfort to the patient. Medical personnel always guard the patient's upper body near the head end during the transfer process to facilitate observation of the patient's face color, pupils, respiratory changes, etc. Effective monitoring, bring a good transfer monitor during the transfer process, and closely monitor the patient's vital signs and mental status. Pay particular attention to the patient's respiratory rate, rhythm and depth. Patients with clear consciousness should have brief conversations at regular intervals to determine changes in consciousness. Patients with impaired consciousness should keep track of pupil changes by carrying a flashlight with them and make corresponding monitoring records. The therapeutic care measures that should be done on the way are not missed, and various therapeutic measures are kept effective. If the patient suddenly appears in respiratory cardiac arrest during the transfer, the patient should be immediately resuscitated in place, while calling nearby medical personnel to prepare drugs and instruments to assist in the resuscitation work, so as to win the first opportunity for the patient's resuscitation.
When transferring patients, after escorting the patients to the destination, medical and nursing staff of the receiving department will place the patients together, including lying position, liquid, drainage tube, oxygen, etc., and then make detailed bedside handover, including the handover of medical records, condition before and after the transfer and during the journey, vital signs, medication, special treatment measures, psychological state of the patients, etc. After the medical and nursing staff of the receiving department understand the handover content is correct, they will make the handover records. After the medical and nursing staff of the receiving department understand the content of the handover is correct, they will record the handover, and finally the medical and nursing staff of both sides will sign their full names to complete the handover process. This prevents the safe transfer of patients from being affected by errors during the handover.
To ensure that patients can be safely transported, nurses play a leading role, not only to fully assess the condition, but also to have excellent professional knowledge about China transport chair for sale, and to be able to deal with patients in a timely and correct manner when complications occur. It is necessary to establish a set of nursing routines for safe in-hospital transfer of critically ill patients.
