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1501 2)持续进行治疗的机器每24h擦拭消毒一次,耗材及废液按院感要求处置。 (2) Wipe the CRRT machine every 24 hours if continuous treatment is applied. Consumables and wasted liquid should be disposed in accordance with hospital requirements to avoid nosocomial infection.
1502 六. 一般护理 VI. General Care
1504 监测患者生命体征,特别是意识、呼吸频率、血氧饱和度等变化。 Patient vital signs should be continuously monitored, especially changes in consciousness, respiration rate and the oxygen saturation.
1505 观察患者的咳嗽、咳痰、胸闷、呼吸困难及紫绀情况,动态监测血气分析,及时发现病情变化,改变氧疗策略或实施急救。 Observe symptoms such as cough, sputum, chest tightness, dyspnea, and cyanosis. Monitor arterial blood gas anlysis closely. Timely recognition of any deterioration to adjust strategies of oxygen therapy or to take urgent response measures.
1506 关注高PEEP,高压力支持下气道压力、潮气量和呼吸频率变化,观察有无发生气压伤。 Pay attention to ventilator associated lung injury (VALI) when under high positive end-expiratory pressure (PEEP) and high-pressure support. Closely monitor changes in airway pressure, tidal volume and respiratory rate.
1507 预防误吸 Aspiration Prevention
1508 1)胃潴留的监测与护理:营养泵持续幽门后喂养以减少胃食管反流,有条件时超声评估胃动力和胃潴留情况,胃排空好的患者不建议常规评估。 (1) Gastric retention monitor: perform continuous post-pyloric feeding with a nutrition pump to reduce gastroesophageal reflux. Evaluate gastric motility and gastric retention with ultrasound if possible. Patient with normal gastric emptying are not recommended for routine assessment;
1509 2)q4h评估胃潴留量:<100mL则回输,>100mL则汇报医生后决定。 (2) Evaluate gastric retention every 4 hours. Re-infuse the aspirate if the gastric residual volume is < 100 mL; otherwise, report to the attending physician;
1510 3)转运期间误吸的预防:转运前,停止鼻饲,回抽胃内残余量,胃管接负压袋引流; (3) Aspiration prevention during patient transportation: before transportation, stop nasal feeding, aspirate the gastric residues and connect the gastric tube to a negative pressure bag.
1511 转运中,保持床头抬高30°。 During transportation, raise the patient’s head up to 30°;