ICU护理-临床重症监护新进展.ppt

* * * * * * * * * Airway: Assessment - Bagging - Troubleshooting issues - Trach care/ management - Extubation Arrhythmia: Identification - Intervention - Defibrillation / cardioversion - Medications Intubation: Medications - Potential issues Code: Roles: Emergency equipment - CPR - Medications - Etiology of event MegaCode: Roles / teamwork - Assessment - Communication - Response Pulm Htn: iNO - Assessment - Response - teamwork * * * Chronic Care and Rehabilitation(SOP) 心脏病人康复 II Cardiac Rehabilitation 心脏康复 Early mobilization of patient after acute event 早期下床 Psychosocial Management- depression/anxiety 缓解焦虑忧郁 Pharmacotherapy 药物辅助 Lipid lowering BP control Antiplatelet therapy Beta-blockers Angiotensin-converting enzyme inhibitors Kolb’s Experiential Learning Cycle Experience Reflection Conceptualization Experimentation Simulation Scenarios Infection control: lines and dressings Airway management Arrhythmia interpretation and management Hemodynamics / Cardiac Output Neuromonitoring Intubation Post-op Admission Roles in a code and emergency equipment Mega Code 心脏重症病人康复与随访 III Monitor long-term outcomes 测量长期效果 Maintenance of smoking cessation Lipid profiles Body Mass Index Hemodialysis Removes urea, creatinine, and uric acid Removes excess water Restores the body buffer system Maintains appropriate levels of electrolytes 重症护理发展关键 (1) 1. Prevention, detection and treatmetn of infection: Avoid nosocomial infection from various catheters or ventilator, gut decontamination and prevention of oral pharyngeal colonization 预防院内感染 重症护理发展关键 (2) New approach “Inflammation control”: by using “immunotherapy or antibody therapy”to lessen the development of SIRS 使用免疫治疗及抗体治疗处理炎症反应 重症护理发展关键(3) 2. Maintenance of tissue oxygenation to avoid Hypoperfusion and organ hypoxemia 促进组织关注 Lactate （乳酸值）level indicate the severity of impaired perfusion and lactic acidosis Decrease oxygen de