2021年心跳呼吸骤停应急预案处理流程教学内容.pdf

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1、此文档仅供收集于网络，如有侵权请联系网站删除只供学习与交流心跳呼吸骤停应急预案处理流程一、处理原则眼科专科医院不同于综合性医院，急诊急救的处置能力较弱。因此在发现病人的生命处在危险境地时，首先考虑的是如何快速有效的转往综合医院救治，转移前做好院前急救的相应准备，这也是眼科专科医院处理危急重症病人的首要原则。1、及时发现危急重症病人：1）入院病人的筛选：凡入院病人，须仔细询问病人的既往患病史，认真检查患者的各项生命体征并认真做好体格检查；须完善心电图、三大常规、肝肾功能、血糖、凝血功能、电解质检查，及时排查有可能出现急症的患者；2）内科医师巡查：建立内科医师巡查病房制度，对高龄、检查异常的病人进

2、行重点查房；2、及时报告1）急需心肺复苏或生命垂危者：安排人员拨打120、通知医院医务部，立即启动应急管理系统，同时应刻不容缓立即进行抢救；2）有致命危险的危重患者：立即通知医院医务部，拨打120 电话，做好120 急救车来院的充分准备；3）暂无生命危险的危重患者：立即通知医院医务部，拨打120，做好转院的准备。4）无生命危险合并内外科重症：通知医务部，安排转诊。3、建立医院转诊制度：为保障快速有效的转诊病人，医院应建立转院制度、转院流程，需要转诊时，人员、车辆、经费能及时到位。各级医院应维护好就近综合性三级甲等综合医院关系，做到转诊病人到达医院时能开放就诊绿色通道。4、“黄金十分钟”急救车到

3、达医院一般需要10 分钟左右，特殊情况塞车时间可能会更长一些，做好黄金十分钟的抢救工作非常重要。急救车到达之前至少要做好静脉通道开放、吸氧等常规性抢救工作，并根据不同疾病或症状有针对性的做好其他相应处置工作。5、做好急救物品配备、急救培训工作：确保急救物品配备完整，建立定期巡视检查制度；重视医务人员的急诊急救培训考核工作，建立定期培训、考核工作。要求各医院将体外除颤器纳入急救物品体系。6、如患者在120 到来之前就已经死亡，应由120 救护车将患者尸体转移到综合医院。精品w o r d 学习资料 可编辑资料-精心整理-欢迎下载-第 1 页，共 6 页此文档仅供收集于网络，如有侵权请联系网站删除

4、只供学习与交流二、心跳、呼吸骤停病人抢救紧急预案目的实施基础生命支持，建立病人循环，呼吸功能，保证重要脏器的血液供应，尽快恢复心跳、呼吸，促进脑功能的恢复。要求当心跳、呼吸骤停时，护士当机立断、争分夺秒、全力以赴，积极进行抢救。紧急预案吸氧呼吸心跳停止呼救通知医生、家属心前区锤击基础生命支持吸痰开放气道手法开放气道：仰头举仰头抬颈法双手抬颌法手术：环甲膜穿刺气管插管气管切开人工呼吸：口对口口对鼻简易呼吸器呼吸机胸外心脏按压按压深度：胸骨下陷45cm 按压频率：100 次/min 按压：人工呼吸=30：2 呼吸未恢复呼吸恢复死 亡吸 氧心跳恢复心跳未恢复复苏成功死 亡进一步生命支持记 录精品w

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11、编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8此文档仅供收集于网络，如有侵权请联系网站删除只供学习与交流三、徒手心肺复苏术操作规程及标准（成人）目的：提高血氧含量及动脉血氧饱和度，纠正机体缺氧操作流程及质量标准标准分扣分实得分准备人员：着装整洁2 用物：纱布，开口器，舌钳，口咽通气管，弯盘4 操作流程判断呼救体 位拍肩并大声呼唤

12、病人，判断有无意识3 高声呼救，通知相关人员2 病人去枕平卧，解开衣领，暴露胸部3 气道处理开 放气 道仰头举颏法：抢救者站在病人右侧，左手置于病人前额上用力向后压，同时右手食指和中指放在病人下颌骨下缘，将颏部向上向前抬起8 托颌法：操作者双手将下颌角托起，使其头仰，下颌骨前移使气道打开（用于颈椎损伤或疑有颈椎损伤者）人工呼吸检查呼吸呼吸：听有无呼吸声，感觉有无呼气，查看胸部是否有起伏，5 10s 3 起初吹气吹气 2 次，每次持续时间1s 2 随后吹气每次吹气量500600ml，维持 1012 次/min（约每次56s/次）5 吹气方法（口对口或口对面罩）操作者一手捏住病人鼻孔，深吸一口气，

13、双唇紧紧包绕住病人口唇用力吹气，连续两次，同时视察病人胸部是否起伏。吹毕放开鼻孔，让气体自然由口鼻逸出操作者一手紧压面罩，另一手将下颌角托起，保持气道通常，操作者用嘴包住过滤器口用力吹气，连续两次8 胸外心脏按压检查脉搏摸颈 A 搏动：气管侧23cm，胸锁乳突肌前缘凹陷处，检查时间510s 4 按压部位两乳头连线与胸骨交叉部位5 按压手法一手手掌放于胸骨按压部位，另一手掌根部放在此手背上，双手掌根重叠，手指不接触胸壁，手掌与胸骨水平垂直5 按压深度利用上身重量垂直下压，使胸骨下陷4 5cm 5 按压速度按压频率100 次/min,按压与放松时间比为1：1 5 按压与呼吸比例单双人均为30：2，

14、每 5 个循环或2min 检查 ECG 有无规则的 QRS 波形或扪脉搏5 反复进行（5 个循环）按压部位准确，用力适当，节奏均匀，持续进行，迅速放松使胸骨复原、放松时手掌根部不离开胸壁5 评估效果病人有反应，自主呼吸、脉搏恢复，停止抢救5 整 理整理床单位，协助病人取舒适的卧位2 质量评定1、操作熟练，方法正确5 2、人工呼吸、心脏按压有效10 3、物品处理正确，记录准确4 理论提问精品w o r d 学习资料 可编辑资料-精心整理-欢迎下载-第 3 页，共 6 页文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1

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22、人安全5 操作流程1、携用物至床旁，核对病人，解释取得合作5 2、检查、选择鼻孔，用湿棉签清洁鼻孔5 3、打开总开关开流量表调节氧流量连接鼻导管确定氧流通畅15 4、测鼻导管需插入深度（鼻尖至耳垂的2/3），蘸水湿润后轻插入并固定，询问病人的感觉，如有无鼻咽部不适、恶心等15 5、观察病人用氧反应，记录用氧时间及流量10 6、停止吸氧时，拔出鼻导管关流量表关总开关开流量表开关放余气关流量表，记录停氧时间12 7、清理用物，整理床单位6 质量评定1、护患沟通有效，关爱病人4 2、操作熟练，用氧安全，病人缺氧症状得到改善6 4、用物齐备，处理规范4 理论提问5 总分100 监考签名精品w o r

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24、N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:C

25、P1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7

26、N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:C

27、P1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7

28、N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:C

29、P1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8此文档仅供收集于网络，如有侵权请联系网站删除只供学习与交流五、吸痰法目的：1、清除呼吸道分泌物，保持呼吸道通畅，保证有效通气操作流程及质量标准标准分扣分实得分准 备人员：着装整洁，洗手、戴口罩3 用物：电动吸引器或中心吸引装置，无菌治疗盘内放治疗碗，碗内盛生理盐水及无菌吸痰管数根（成人121

30、4 根）、无菌手套、弯盘、医疗废弃物袋、听诊器。必要时备压舌板、舌钳、开口器及简易呼吸器，电极板5 病人：评估病人病情、呼吸道通畅及缺氧情况5 操作流程连接吸引器打开开关检查吸引器性能调节负压（压力4053.3kPa，儿童吸痰压力40kPa）关开关5 核对病人，清醒病人给予解释取得合作，根据病情按需给予翻身、拍背，病人头转向操作者，昏迷病人可使用压舌板或开口器帮助张口5 打开吸引器开关戴手套接吸痰管试吸生理盐水，检查管道是否通畅8 将吸痰管插入鼻腔或口腔，吸净口咽部分泌物8 更换吸痰管折叠导管末端插入气管内适宜深度放开导管末端，轻柔、灵活、迅速地左右旋转上提吸痰管吸痰8 每次吸痰时间不超过15

31、 秒，如痰未吸尽，连续吸痰不超过4 次6 吸痰完毕，取下吸痰管，放入医疗废弃物袋内6 观察病人的呼吸道是否通畅，听诊呼吸音，评价病人反应（面色、呼吸、心率、血压等），观察口鼻粘膜有无损伤8 为病人擦净口鼻分泌物，取手套5 协助病人取舒适体位，整理床单位和用物，消毒5 洗手，记录病人情况、痰量、性状等4 质量评 定与病人沟通有效，关爱病人4 动作轻柔准确，吸痰有效，无粘膜损伤，严格遵守无菌操作规程6 用物齐备，处理规范，吸痰管一次性使用4 理论提 问5 总 分100 监 考签 名精品w o r d 学习资料 可编辑资料-精心整理-欢迎下载-第 5 页，共 6 页文档编码:CP1S2C4K3Y2

32、HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X

33、7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2

34、HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X

35、7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2

36、HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X

37、7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2

38、HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8此文档仅供收集于网络，如有侵权请联系网站删除只供学习与交流六、简易呼吸器使用法目的：维持和增加机体通气，纠正低氧血症操作流程及质量标准标准分扣分实得分准 备人员：着装整洁、洗手3 用物：简易呼吸器，面罩（流量表、湿化瓶）、吸痰管、口咽通气管，检查呼吸器活瓣是否漏气，面罩与呼吸器相连正确5 操作流程使病人平卧解开衣领、腰带，头后仰，托起下颌、开放气道10 迅速清理呼吸道分泌物，有假牙者将假牙取

39、出6 正确放置口咽通气管8 氧气管与呼吸器连接，开氧气流量表46L/min 10 上呼吸器，左手拇指、食指呈“C”型按住面罩，中指、无名指、小指呈“E”型，托起下颌，使面罩与口鼻紧贴，不漏气15 用右手挤压呼吸囊，反复有规律地挤压与放松，频率 1020 次/min，挤压、放松呼吸时间比11 13 观察记录病人反应、效果、时间6 整理用物，清洁面罩3 质量评定放置口咽管及呼吸器方法正确，通气有效6 操作熟练，动作迅速，准确5 关爱病人，病人无创伤及并发症5 理论提问5 总 分100 精品w o r d 学习资料 可编辑资料-精心整理-欢迎下载-第 6 页，共 6 页文档编码:CP1S2C4K3Y

40、2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I

41、1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y

42、2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I1X7T8文档编码:CP1S2C4K3Y2 HV6U3A1I7N8 ZI4K7I

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