zh-cn	第三部分 护理经验 
en-us	Part Three Nursing 

zh-cn	一. 高流量吸氧（HFNC）患者护理 
en-us	I. Nursing Care for Patients Receiving High-Flow Nasal Cannula (HFNC) Oxygen Therapy  

zh-cn	注意事项 
en-us	Assessing  

zh-cn	使用前充分宣教，必要时使用小剂量镇静药物。
en-us	Provide detailed information of the HFNC oxygen therapy to get the patient’s cooperation before implementation. Use low dose sedative with close monitoring if necessary. 

zh-cn	根据患者鼻腔直径选择合适的鼻塞导管。
en-us	Choose a proper nasal catheter based on the diameter of the patient's nasal cavity. 

zh-cn	使用时先贴减压敷料，调节好鼻塞固定带松紧，避免引起颜面部皮肤器械相关性压力损伤。
en-us	Adjust the head strap tightness and use decompression plaster to prevent device-related pressure injuries on the facial skin. 

zh-cn	根据患者病情和耐受情况调节氧浓度、流量及温度，及时添加湿化水。 
en-us	Maintain the water level in the humidifier chamber. Titrate the flow rate, the fraction of inspired oxygen (FiO2), and the water temperature based on the patient’s respiratory demands and tolerance.  

zh-cn	病情监测 
en-us	Monitoring  

zh-cn	使用期间若患者出现血流动力学不稳定、辅助呼吸肌运动明显、氧合持续不改善、意识状态恶化、呼吸频率持续>40次/min、大量气道分泌物等表现时，及时报告医生，考虑是否需要中止HFNC氧疗，及时行气管插管机械通气。 
en-us	Report to the attending physician to seek medical decision of replacing HFNC by mechanical ventilation if any of the followings occur: hemodynamic instability, respiratory distress evidenced by obvious contraction of accessory muscles, hypoxemia persists despite oxygen therapy, deterioration of consciousness, the respiratory rate > 40 breaths per minute continuously, significant amount of sputum. 

zh-cn	分泌物处理 
en-us	Treatment of Secretions 

zh-cn	患者自行或在护士的帮助下用纸巾擦拭口水、鼻涕、痰液，包裹后丢入预置含氯2500mg/L消毒水的一次性密闭容器中。
en-us	Patients’ drool, snot, and sputum should be wiped with tissue paper, be disposed in a sealed container with chlorine-containing disinfectant (2500 mg/L). 

zh-cn	或直接用口腔吸引管吸入预置含氯2500mg/L消毒水的收集器。 
en-us	Alternatively, secretions can be removed by oral mucus extractor or suctioning tube and be disposed in a sputum collector with chlorine-containing disinfectant (2500 mg/L). 

zh-cn	二. 机械通气患者护理 
en-us	II. Nursing Care for Patients with Mechanical Ventilation 

zh-cn	气管插管配合 
en-us	Intubation Procedures 

zh-cn	限制保证患者安全所需的最低医护人数，佩戴正压头套。
en-us	The number of the medical staff should be limited to the minimum number that can ensure the patient’s safety. Wear powered air-purifying respirator as PPE. 

zh-cn	插管前，充分镇痛、镇静，必要时肌松，同时做好血流动力学监测。
en-us	Before intubation, perform administration of sufficient analgesia and sedative, and use muscle relaxant if necessary. Closely monitor the hemodynamic response during intubation. 

zh-cn	操作完成后30分钟内，房间里减少人员走动，持续等离子空气净化消毒。 
en-us	Reduce movement of staff in the ward, continuous purify and disinfect the room with plasma air purification technology for 30 min after completion of intubation. 

zh-cn	镇痛镇静、谵妄管理 
en-us	Analgesia, Sedation and Delirium Management 

zh-cn	每日确定镇痛镇静目标，q4h评估镇痛程度（CPOT），q2h评估镇静深度（RASS/BISS），滴定调节镇痛镇静药物。
en-us	Determine the target pain management goal every day. Assess pain with every 4 hours (Critical-Care Pain Observation Tool, CPOT), measure sedation with every 2 hours (RASS/BISS). Titrate the infusion rate of analgesics and sedatives to achieve pain management goals. 

zh-cn	明确引起疼痛的操作前预镇痛。
en-us	For the known painful procedures, preemptive analgesia is administered. 

zh-cn	每班行CAM-ICU谵妄筛查，尽早识别阳性患者。
en-us	Perform CAM-ICU delirium screening in every shift to ensure an early diagnosis of COVID-19 patients. 

zh-cn	落实谵妄预防集束化策略：处理疼痛，最小化镇静，沟通交流，促进睡眠，早期活动等。 
en-us	Apply centralization strategy for delirium prevention, including pain relief, sedation, communication, quality sleep, and early mobilization are used. 

zh-cn	VAP的预防 
en-us	Prevention of Ventilator-Associated Pneumonia (VAP) 

zh-cn	执行VAP预防Bundle。包括：遵循手卫生制度；如无禁忌症，患者床头抬高30～45°；q4h～q6h进行1次口腔护理，采用一次性吸唾牙刷；维持气囊压30～35cmH2O，并q4h监测；经胃管管饲营养液，q4h监测胃残留量；每天评估能否撤机；使用可冲洗的气管导管，进行声门下分泌物持续低负压吸引，加间断q1h～q2h10mL注射器抽吸，根据实际囊上分泌物的量调整抽吸频次。
en-us	The ventilator bundle is used to reduce VAP, which includes hand washing; raising the tilt angle of the patient's bed by 30-45° if no contradiction is presented; oral care every 4 to 6 hours by using a disposable oral mucus extractor; maintain endotracheal tube (ETT) cuff pressure at 30-35 cmH O every 4 hours; enteral nutrition support and monitor gastric residual volume every 4 hours; evaluating daily for ventilator removal; using washable tracheal tubes for continuous subglottic suctioning combined with 10 mL syringe suctioning every 1 to 2 hours, and adjusting the suctioning frequency according to the actual amount of secretions. 

zh-cn	声门下滞留物的处置： 
en-us	Dispose retentate below the glottis: 

zh-cn	用10mL注射器抽吸囊上分泌物后立即抽吸适量含氯2500mg/L的消毒水，连接针帽，放入锐器盒中。 
en-us	the syringe containing the subglottic secretions is immediately used to aspirate an appropriate amount of chlorine-containing disinfectant (2500 mg/L), then be re-capped and disposed of in a sharp container. 

zh-cn	吸痰的护理 
en-us	Sputum Suction 

zh-cn	1）吸痰：使用密闭式吸痰管、密闭式抛弃型集痰袋，减少气溶胶及飞沫。 
en-us	(1) Use a closed sputum suction system, including closed suction catheter and closed disposable collection bag, to reduce the formation of aerosol and droplets. 

zh-cn	2）采集痰液标本：使用密闭式吸痰管配套使用的集痰器，减少飞沫暴露。 
en-us	(2) Collection of sputum specimen: use a closed suction catheter and a matching collection bag to reduce exposure to droplets. 

zh-cn	呼吸机管道冷凝水的处理 
en-us	Disposal of Condensation from Ventilators 

zh-cn	使用一次性双回路自带加热导丝的呼吸机管路，自动加水湿化罐，减少冷凝水的产生。
en-us	Use disposable ventilator tubing with dual-loop heating wire and automatic humidifier to reduce the formation of condensation. 

zh-cn	及时倾倒冷凝水，使用预置含氯2500mg/L消毒水的加盖容器，双人配合将管道积水倒入加盖容器后，直接放入可达90°C的清洗机进行自动清洗消毒。 
en-us	Two nurses should cooperate to dump the condensation promptly into a capped container with chlorine-containing disinfectant (2500 mg/L). The container can then be directly put in a washing machine, which can be heated up to 90 °C, for automatic cleaning and disinfection. 

zh-cn	俯卧位通气护理 
en-us	Nursing Care for the Prone Position Ventilation (PPV) 

zh-cn	翻身前做好充分准备，妥善固定导管，检查所有导管接口，减少脱开的风险。
en-us	Before changing the position, secure the position of tubing and check all the joints to reduce the risk of disconnection. 

zh-cn	翻转后q2h进行体位改变。 
en-us	Change the patient’s position every 2 hours . 

zh-cn	三. ECMO日常管理及监护 
en-us	III. Daily Management and Monitoring of ECMO (Extra Corporeal Membrane Oxygenation) 

zh-cn	ECMO灌注师专人管理，每小时检查并记录：转速、血流量，氧流量、氧浓度，控温仪是否转流、设置及实际温度；膜肺有无血块，管路有无打折、压迫，静脉管路有无抖动；患者尿色有无变红或深棕色；遵医嘱监测膜前/膜后压力。 
en-us	ECMO equipment should be managed by ECMO perfusionists and the following items should be checked and recorded every hour: Pump flow rate/rotation speed; blood flow; oxygen flow; oxygen concentration; ensuring that the temperature controller is flowing; temperature setting and actual temperature; preventing clots in circuit; no pressure to the cannulae and the circuit tubing is not kinked, or no “shaking” of ECMO tubes; patient's urine color with special attention to red or dark brown urine; pre & post membrane pressure as required by the doctor. 

zh-cn	每班检查并记录：置管深度、管路固定情况、各接口是否牢固，控温仪水位线，机器电源、气源连接情况；每班检查穿刺处有无渗血、肿胀，测量双下肢腿围、观察术侧下肢是否肿胀、末梢血运情况如足背动脉搏动、皮温、颜色等。 
en-us	The following items during every shift should be monitored and recorded: Check the depth and fixation of cannula to ensure that the ECMO circuit interfaces are firm, the water level line of the temperature controller, the power supply of the machine and the connection of the oxygen, the cannula site for any bleeding and swelling; measure leg circumference and observe whether the lower limb on the operation side is swollen; observe lower limbs, such as dorsalis pedis artery pulse, skin temperature, color, etc. 

zh-cn	每日监测：膜后血血气分析。 
en-us	Daily monitoring: Post membrane blood gas analysis. 

zh-cn	抗凝管理：ECMO抗凝管理的基本目标是适度抗凝，在避免凝血过度激活的前提下保证一定的凝血活性，即维持抗凝、凝血和纤溶的平衡。
en-us	Anticoagulation management: The basic goal of ECMO anticoagulation management is to achieve a moderate anticoagulation effect, which ensures that certain coagulation activity under the premise of avoiding excessive activation of coagulation. That is to maintain the balance among anticoagulation, coagulation and fibrinolysis. 

zh-cn	置管时给予负荷剂量肝素钠注射（25-50IU/kg），转流期间予肝素钠维持（7.5-20IU/kg/h），根据APTT结果进行调整，APTT目标40-60s；抗凝期间尽量减少皮肤穿刺次数，各项操作动作轻柔，密切观察有无出血情况。 
en-us	The patients should be injected with heparin sodium (25-50 IU/kg) at the time of intubation and maintained with heparin sodium (7.5-20 IU/kg/h) during the pump flow period. The dosage of heparin sodium should be adjusted according to APTT results which should be held between 40-60 seconds. During the anticoagulation period, the number of skin punctures should be reduced as less as possible. Operations should be taken gently. The status of bleeding should be observed carefully. 

zh-cn	实行“超保护性肺通气”策略，最大程度地避免或减少呼吸机相关肺损伤发生，建议初始潮气量＜6mL/kg、保留自主呼吸强度，保持呼吸频率10-20次/min。 
en-us	Implement the "ultra-protective lung ventilation" strategy to avoid or reduce the occurrence of ventilator-related lung injury. It is recommended that the initial tidal volume is < 6 mL/kg and the intensity of spontaneous breathing is retained (breathing frequency should be between 10-20 times/min). 

zh-cn	密切观察患者生命体征变化，维持MAP60-65mmHg、CVP＜8mmHg、SpO2＞90%，监测尿量、电解质情况。 
en-us	Closely observe the vital signs of patients, maintain MAP between 60-65 mmHg, CVP < 8 mmHg, SpO 2 Handbook of COVID-19 Prevention and Treatment > 90%, and monitor the status of urine volume and blood electrolytes. 

zh-cn	输液、输血尽量膜后输注，避免输注脂肪乳、丙泊酚等药物。 
en-us	Transfuse through the post membrane, avoiding infusion of fat emulsion and propofol. 

zh-cn	根据日常监测管理记录，每班评估ECMO氧合器功能。 
en-us	According to the monitoring records, evaluate the ECMO oxygenator function during every shift. 

zh-cn	四. 人工肝护理 
en-us	IV. Nursing Care of ALSS (Artificial Liver Support System) 

zh-cn	人工肝护理主要分为治疗期护理和治疗间歇期护理，护理人员应严密观察病情、规范操作流程、关注重点环节、及时处理并发症，以便顺利完成人工肝治疗。 
en-us	ALSS nursing care is mainly divided into two different periods: nursing care during treatment and intermittent care. Nursing staff should closely observe the conditions of patients, standardize the operating procedures, focus on key points and deal with complications timely in order to successfully complete ALSS treatment. 

zh-cn	治疗期护理 
en-us	Nursing Care during Treatment 

zh-cn	治疗期护理指每次人工肝治疗过程中的护理，整体操作流程可归纳为：操作人员自身准备-患者评估-装机-预冲-上机-参数调节-下机-记录，
en-us	It refers to nursing during each stage of ALSS treatment. The overall operation process can be summarized as follows: operator’s own preparation, patient evaluation, installation, pre-flushing, running, parameter adjustment, weaning and recording. 

zh-cn	以下为各环节护理重点： 
en-us	The following are the key points of nursing care during each stage: 

zh-cn	1）操作人员自身准备：
en-us	(1) Operator's own preparation

zh-cn	全面落实并执行三级及以上防护措施。 
en-us	 Fully adhere to Level III or even more strict protective measures. 

zh-cn	2）患者评估：
en-us	(2) Patient assessment

zh-cn	患者基本情况及病情，尤其过敏史、血糖、凝血功能、氧疗情况及镇静状态，清醒患者关注其心理状态；评估患者导管功能状态。 
en-us	 Assess the patient's basic conditions, especially allergy history, blood glucose, coagulation function, oxygen therapy, sedation (for sober patients, pay attention to their psychological state) and catheter function status. 

zh-cn	3）装机和预冲：
en-us	(3) Installation and pre-flushing

zh-cn	治疗管路及耗材尽量选择闭环，避免患者血液体液暴露；按照拟定治疗模式选择相应仪器、管路及其他耗材，熟悉治疗耗材的基本性能。 
en-us	Use consumables with closed-loop management while avoiding the exposure to patient's blood and body fluids. The corresponding instruments, pipelines and other consumables should be selected according to the planned treatment mode. All basic functions and characteristics of the consumables should be familiarized. 

zh-cn	4）上机：
en-us	(4) Running

zh-cn	建议起始引血速度≤35mL/min，避免速度过快导致低血压；实时监测生命体征。 
en-us	It is recommended that the initial blood draw speed is ≤ 35 mL/min to avoid low blood pressure which might be caused by high speed. Vital signs should be monitored as well. 

zh-cn	5）参数调节：
en-us	(5) Parameter Adjustment

zh-cn	体外循环稳定后，根据治疗模式调节各项治疗参数及报警参数；早期、足量使用抗凝剂，维持量根据各治疗压力随时调整。 
en-us	 When the patient's extracorporeal circulation is stable, all treatment parameters and alarm parameters should be adjusted according to the treatment mode. A sufficient amount of anticoagulant is recommended in the early stage and the anticoagulant dose should be adjusted during the maintenance period according to different treatment pressure. 

zh-cn	6）下机：
en-us	(6) Weaning

zh-cn	采用液体+重力组合回收法；回收速度≤35mL/min；下机后按新冠病毒感染防控要求处理医疗废物，对治疗室及治疗仪器进行清洁消毒。 
en-us	 Adopt "liquid gravity combined recovery method"; the recovery speed ≤ 35 mL/min; after weaning, medical waste should be treated in accordance to the SARS-Cov-2 infection prevention and control requirements and the treatment room and instruments should be cleaned and disinfected as well. 

zh-cn	7）记录：
en-us	(7) Recording 

zh-cn	患者生命体征、人工肝用药情况、人工肝治疗参数以及特殊情况备注等。 
en-us	Make accurate records of the patient's vital signs, medication and treatment parameters for ALSS and take notes on special conditions. 

zh-cn	间歇期护理 
en-us	Intermittent Care 

zh-cn	1）迟发型并发症的观察和处理：过敏反应、失衡综合征等。 
en-us	(1) Observation and treatment of delayed complications: Allergic reactions, imbalance syndromes, etc.; 

zh-cn	2）人工肝置管护理：每班观察局部情况并记录；预防导管相关性血栓护理；每48小时进行导管专业维护。 
en-us	(2) ALSS Intubation Care: Medical staff during each shift should observe the patient's conditions and make records; prevent catheter-related thrombosis; carry out professional maintenance of the catheter every 48 hours; 

zh-cn	3）人工肝置管拔管护理：拔管前血管超声检查；拔管后置管侧下肢制动6小时，24小时内卧床休息，观察局部创面情况。 
en-us	(3) ALSS Intubation and Extubation Care: Vascular ultrasonography should be performed before extubation. After extubation, the lower limb with the intubation side of patients should not be moved in 6 hours and the patient should rest in bed for 24 hours. After extubation, the surface of the would to be observed. 

zh-cn	五. CRRT护理 
en-us	V. Continuous Renal Replacement Treatment (CRRT) Care 

zh-cn	治疗前准备患者的准备：
en-us	Preparation before CRRT 

zh-cn	建立有效血管通路，一般行中心静脉置管，首选颈内静脉。
en-us	Preparation for patient: establish effective vascular access. Generally, central vein catheterization is performed for CRRT, with the internal jugular vein preferred. 

zh-cn	如同时有ECMO治疗，可将CRRT治疗整合入ECMO系统；设备、耗材、超滤用药准备。 
en-us	A CRRT device can be integrated into the ECMO circuit if the two are applied at the same time. Prepare equipment, consumables, and ultrafiltration medication before CRRT. 

zh-cn	治疗中护理 
en-us	In-treatment Care 

zh-cn	1）血管通路的护理：
en-us	(1) Vascular Access Care: 

zh-cn	中心静脉置管的患者每24小时进行专业导管护理一次，妥善固定通路，避免扭曲、受压。
en-us	Perform professional catheter care every 24 hours for patients with central venous catheterization to properly fix access to avoid distortion and compression. 

zh-cn	CRRT整入ECMO治疗时需双人核对连接方法及连接的紧密性。
en-us	When CRRT is integrated into ECMO treatment, the sequence and the tightness of the catheter connection should be confirmed by two nurses. 

zh-cn	建议CRRT的引出端及回输端均在氧合器后。 
en-us	Both the outflow and the inflow CRRT lines are suggested to be connected behind the oxygenator. 

zh-cn	2）严密监测患者神志及生命体征变化，准确计算液体出入量；严密观察体外循环凝血情况，有效处理报警，确保机器顺畅运转；q4h监测血气分析，评估内环境电解质酸碱平衡；置换液的配置应严格遵守无菌操作原则，现配现用，标示清晰。 
en-us	(2) Closely monitor consciousness and the vital signs of patients; accurately calculate the fluid inflow and outflow. Closely observe blood clotting within the cardiopulmonary bypass circuit, respond effectively to any alarms, and ensure that the machine is operating properly. Assess the electrolyte and acid-base balance in the internal environment through blood gas analysis every 4 hours. The replacement liquid should be prepared freshly and labeled clearly under strict sterile conditions. 

zh-cn	治疗后护理 
en-us	Postoperative Care 

zh-cn	1）监测患者血常规、肝肾功能、凝血功能。 
en-us	(1) Monitor blood routine, liver and kidney function and coagulation function. 

zh-cn	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。 
en-us	(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. 

zh-cn	六. 一般护理 
en-us	VI. General Care 

zh-cn	严密监测患者病情 
en-us	Monitoring 

zh-cn	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。
en-us	Patient vital signs should be continuously monitored, especially changes in consciousness, respiration rate and the oxygen saturation. 

zh-cn	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。
en-us	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. 

zh-cn	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。 
en-us	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. 

zh-cn	预防误吸 
en-us	Aspiration Prevention 

zh-cn	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。 
en-us	(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; 

zh-cn	2）q4h评估胃潴留量：＜100mL则回输，＞100mL则汇报医生后决定。 
en-us	(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; 

zh-cn	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； 
en-us	(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. 

zh-cn	转运中，保持床头抬高30°。 
en-us	During transportation, raise the patient’s head up to 30°; 

zh-cn	4）经鼻高流量吸氧治疗患者误吸的预防：q4h巡查避免湿化过度或湿化不足管路积水现象并及时处理，警惕误入气道引起呛咳和误吸，保持鼻塞位置高度高于机器和管路水平，及时处理管路冷凝水。 
en-us	(4) Aspiration prevention during HFNC: Check the humidifier every 4 hours to avoid excessive or insufficient humidification. Remove any water accumulated in the tubing promptly to prevent cough and aspiration caused by the accidental entry of condensation into the airway. Keep the position of the nasal cannula higher than the machine and tubes. Promptly remove condensation in the system. 

zh-cn	实施导管相关性血流感染、导尿管相关尿路感染策略。 
en-us	Implement strategies to prevent catheter-related bloodstream infection and catheter- related urinary tract infection. 

zh-cn	预防皮肤压力性损伤（包括器械相关压力性损伤）、失禁性皮炎、医用黏胶相关性皮肤损伤，使用风险评估量表筛选高危患者，实施预防策略。 
en-us	Prevent pressure-induced skin injuries, including device-related pressure-induced injuries, incontinence-associated dermatitis and medical adhesive-related skin injuries. Identify patients at a high risk with the Risk Assessment Scale and implement preventive strategies. 

zh-cn	患者入院、病情变化时进行VTE风险评估，筛查高危患者，落实预防策略。
en-us	Assess all patients upon admission and when their clinical conditions change with the VTE risk assessment model to identify those who are at a high risk and implement preventive strategies. 

zh-cn	监测凝血功能及D-二聚体变化，关注VTE相关临床表现。 
en-us	Monitor coagulation function, D-dimer levels and VTE-related clinical manifes- tations. 

zh-cn	体弱、呼吸急促、氧合波动明显者协助进食，进食期间加强氧合监测。
en-us	Assist eating for patients who are weak, short of breath or those with an obvious fluc- tuating oxygenation index. Intensify oxygenation index monitoring on these patients during meals. 

zh-cn	不能经口进食者，早期开通肠内营养，每班评估患者肠内营养耐受情况，根据评估结果调整肠内营养速度和量。 
en-us	Provide enteral nutrition at early stages for those who are unable to eat by mouth. During each shift, adjust the enteral nutrition rate and quantity according to the tolerance of enteral nutrition. 

zh-cn	附录 
en-us	Appendix 

zh-cn	一. COVID-19患者医嘱范例 
en-us	I. Medical Advice Example for COVID-19 Patients 

zh-cn	COVID-19轻型患者医嘱范例 
en-us	Medical Advice of Mild COVID-19 Cases 

zh-cn	1.1诊疗医嘱 
en-us	1.1 Ordinary 

zh-cn	空气隔离、血氧饱和度监测、鼻导管吸氧 
en-us	Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula 

zh-cn	1.2检查医嘱 
en-us	1.2 Examinations 

zh-cn	2019新型冠状病毒RNA测定（三位点）（痰） qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd 

zh-cn	2019新型冠状病毒RNA测定（三位点）（粪便）qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd 

zh-cn	血常规、生化、尿常规、粪便常规+OB、凝血功能+D二聚体、血气分析+乳酸、ASO+RF+CPR+CCP、ESR、PCT、ABO+RH血型、甲状腺功能、心肌酶+血清肌钙蛋白定量、常规四项、呼吸道病毒、细胞因子、G/GM试验、血管紧张素转化酶测定 
en-us	Blood routine, biochemical profile, urine routine, stool routine + OB, coagulation function + D dimer, blood gas analysis + lactic acid, ASO + RF + CPR + CCP, ESR, PCT, ABO + RH blood type, thyroid function, cardiac enzymes + quantitative assay of serum troponin, four routine items, respiratory virus test, cytokines, G/GM test, angiotensin converting enzyme 

zh-cn	肝胆胰脾超声、心脏超声、肺部CT 
en-us	Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan 

zh-cn	1.3药物医嘱 
en-us	1.3 Medication 

zh-cn	阿比多尔片 200mg po tid 
en-us	Arbidol tablets 200 mg po tid 

zh-cn	洛匹那韦利托那韦片 2片 po q12h 
en-us	Lopinavir/Ritonavir 2 tablets po q12h 

zh-cn	干扰素喷雾剂 1喷 pr.nar tid 
en-us	Interferon spray 1 spray pr. tid 

zh-cn	COVID-19普通型患者医嘱范例 
en-us	Medical Advice of Moderate COVID-19 Cases 

zh-cn	2.1诊疗医嘱 
en-us	2.1 Ordinary 

zh-cn	空气隔离、血氧饱和度监测、鼻导管吸氧 
en-us	Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula 

zh-cn	2.2检查医嘱 
en-us	2.2 Examinations 

zh-cn	2019新型冠状病毒RNA测定（三位点）（痰） qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd 

zh-cn	2019新型冠状病毒RNA测定（三位点）（粪便）qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd 

zh-cn	血常规、生化、尿常规、粪便常规+OB、凝血功能+D二聚体、血气分析+乳酸、 ASO+RF+CPR+CCP、ESR、PCT、ABO+RH血型、甲状腺功能、心肌酶+血清肌钙蛋白定量、常规四项、呼吸道病毒、细胞因子、G/GM试验、血管紧张素转化酶测定 
en-us	Blood routine, biochemical profile, urine routine, stool routine + OB, coagulation function + D dimer, blood gas analysis + lactic acid, ASO + RF + CPR + CCP, ESR, PCT, ABO + RH blood type, thyroid function, cardiac enzymes + quantitative assay of serum troponin, four routine items, respiratory virus test, cytokines, G/GM test, angiotensin converting enzyme 

zh-cn	肝胆胰脾超声、心脏超声、肺部CT 
en-us	Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan 

zh-cn	2.3药物医嘱 
en-us	2.3 Medication 

zh-cn	阿比多尔片 200mg po tid 
en-us	Arbidol tablets 200 mg po tid 

zh-cn	洛匹那韦利托那韦片 2片 po q12h 
en-us	Lopinavir/Ritonavir 2 tablets po q12h 

zh-cn	干扰素喷雾剂 1喷 pr.nar tid 
en-us	Interferon spray 1 spray pr.nar tid 

zh-cn	NS100ML+氨溴索30mg ivgtt bid 
en-us	NS 100 mL + Ambroxol 30mg ivgtt bid 

zh-cn	COVID-19重型患者医嘱范例 
en-us	Medical Advice of Severe COVID-19 Cases 

zh-cn	3.1诊疗医嘱 
en-us	3.1 Ordinary 

zh-cn	空气隔离、血氧饱和度监测、鼻导管吸氧 
en-us	Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula 

zh-cn	3.2检查医嘱 
en-us	3.2 Examinations 

zh-cn	2019新型冠状病毒RNA测定（三位点）（痰） qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd 

zh-cn	2019新型冠状病毒RNA测定（三位点）（粪便）qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd 

zh-cn	血常规、生化、尿常规、粪便常规+OB、凝血功能+D二聚体、血气分析+乳酸、ASO+RF+CPR+CCP、ESR、PCT、ABO+RH血型、甲状腺功能、心肌酶+血清肌钙蛋白定量、常规四项、呼吸道病毒、免疫球蛋白+补体、细胞因子、G/GM试验、血管紧张素转化酶测定 
en-us	Blood routine, biochemical profile, urine routine, stool routine + OB, coagulation function + D dimer, blood gas analysis + lactic acid, ASO + RF + CPR + CCP, ESR, PCT, ABO + RH blood type, thyroid function, cardiac enzymes + quantitative assay of serum troponin, four routine items, respiratory virus test, cytokines, G/GM test, angiotensin converting enzyme 

zh-cn	肝胆胰脾超声、心脏超声、肺部CT 
en-us	Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan 

zh-cn	3.3药物医嘱 
en-us	3.3 Medication 

zh-cn	阿比多尔片 200mg po tid 
en-us	Arbidol tablets 200 mg tid 

zh-cn	洛匹那韦利托那韦片 2片 po q12h 
en-us	Lopinavir/Ritonavir 2 tablets po q12h 

zh-cn	干扰素喷雾剂 1喷 pr.nar tid 
en-us	Interferon spray 1 spray pr.nar tid 

zh-cn	NS 100 mL+甲强龙40mg ivgtt qd 
en-us	NS 100 mL + methylprednisolone 40 mg ivgtt qd 

zh-cn	NS100mL+泮托拉唑针40mg ivgtt qd 
en-us	NS 100 mL + pantoprazole 40 mg ivgtt qd 

zh-cn	钙尔奇 D 1片 po qd 
en-us	Caltrate 1 tablet qd 

zh-cn	免疫球蛋白针 20g ivgtt qd 
en-us	Immunoglobulin 20 g ivgtt qd 

zh-cn	NS100mL+氨溴索30mg ivgtt bid 
en-us	NS 100 mL + Ambroxol 30 mg ivgtt bid 

zh-cn	COVID-19危重型患者医嘱范例 
en-us	Medical Advice of Critical COVID-19 Cases 

zh-cn	4.1诊疗医嘱 
en-us	4.1 Ordinary 

zh-cn	空气隔离、血氧饱和度监测、鼻导管吸氧 
en-us	Air isolation, blood oxygen saturation monitoring, oxygen therapy with nasal cannula 

zh-cn	4.2检查医嘱 
en-us	4.2 Examinations 

zh-cn	2019新型冠状病毒RNA测定（三位点）（痰） qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Sputum) qd 

zh-cn	2019新型冠状病毒RNA测定（三位点）（粪便）qd 
en-us	2019 Novel Coronavirus RNA Detection (Three Sites) (Feces) qd 

zh-cn	血常规、ABO+RH血型、尿常规、粪便常规+OB、常规四项、呼吸道病毒、甲状腺功能、 常规心电图、血气分析+电解质+乳酸+GS、 G/GM试验、血培养 ONCE
en-us	Blood routine, ABO + RH blood type, urine routine, stool routine + OB, four routine items, respiratory virus test, thyroid function, electrocardiogram, blood gas analysis + electrolyte + lactic acid + GS, G/GM test, blood culture ONCE 

zh-cn	血常规、生化、凝血功能+D二聚体、血气分析+乳酸、纳尿肽、心肌酶、血清肌钙蛋白定量、免疫球蛋白+补体、细胞因子、痰培养、CRP、PCT qd 
en-us	Blood routine, biochemical profile, coagulation function + D dimer, blood gas analysis + lactic acid, natriuretic peptide, cardiac enzyme, quantitative assay of serum troponin, immunoglobulin + complement, cytokine, sputum culture, CRP, PCT qd 

zh-cn	葡萄糖测定 q6h 
en-us	Blood glucose measurement q6h 

zh-cn	肝胆胰脾超声、心脏超声、胸部床边摄片、肺部CT 
en-us	Liver, gallbladder, pancreas and spleen ultrasound, echocardiography and lung CT scan 

zh-cn	4.3药物医嘱 
en-us	4.3 Medication 

zh-cn	阿比多尔片 200mg po tid 
en-us	Arbidol tablets 200 mg po. tid 

zh-cn	洛匹那韦利托那韦片 2片 po q12h（或达芦那韦 1片 po qd） 
en-us	Lopinavir/Ritonavir 2 tablets q12h (or darunavir 1 tablet qd) 

zh-cn	NS 10mL+甲强龙40mg iv q12h 
en-us	NS 10 mL + methylprednisolone 40 mg iv q12h 

zh-cn	NS100mL+泮托拉针40mg ivgtt qd 
en-us	NS 100 mL + pantoprazole 40 mg ivgtt qd 

zh-cn	免疫球蛋白针 20g ivgtt qd 
en-us	Immunoglobulin 20 g ivgtt qd 

zh-cn	胸腺肽针1.6mg ih biw 
en-us	Thymic peptides 1.6 mg ih biw 

zh-cn	Ns10mL+氨溴索30mg iv bid 
en-us	NS 10 mL + Ambroxol 30 mg iv bid 

zh-cn	Ns 50mL+异丙肾上腺素2mg iv-vp once 
en-us	NS 50 mL + isoproterenol 2 mg iv-vp once 

zh-cn	人血白蛋白 10g ivgtt qd 
en-us	Human serum albumin 10 g ivgtt qd 

zh-cn	NS100mL+哌拉西林他唑巴坦 4.5g ivgtt q8h 
en-us	NS100 mL + piperacillin/tazobactam 4.5 ivgtt q8h 

zh-cn	肠内营养混悬液（白普力）500mL 鼻饲法 bid 
en-us	Enteral nutrition suspension (Peptisorb liquid) 500 mL nasogastric feeding bid  

zh-cn	国家卫生健康委国家中医药管理局《新型冠状病毒肺炎诊疗方案（试行第七版）》 
en-us	National Health Commission and National Administration of Traditional Chinese Medicine of the People's Republic of China. Protocols for Diagnosis and Treatment of COVID-19 (7th Trial Version) 

zh-cn	国家卫生健康委《新型冠状病毒肺炎防控方案（第六版）》 
en-us	National Health Commission of the People's Republic of China. Protocols for Prevention and Control of COVID-19 (6th Version) 

zh-cn	中国疾病预防控制中心《新型冠状病毒肺炎流行病学调查指南》 
en-us	Chinese Center for Disease Control and Prevention. Guidelines for Epidemiological Investigation of COVID-19 

zh-cn	中国疾病预防控制中心《新型冠状病毒肺炎病例密切接触者调查与管理指南》 
en-us	Chinese Center for Disease Control and Prevention. Guidelines for Investigation and Management of Close Contacts of COVID-19 Patients 

zh-cn	中国疾病预防控制中心《新型冠状病毒肺炎实验室检测技术指南》 
en-us	Chinese Center for Disease Control and Prevention. Technical Guidelines for COVID-19 Laboratory Testing 

zh-cn	中国疾病预防控制中心《特定场所消毒技术指南》 
en-us	Chinese Center for Disease Control and Prevention. Technical Guidelines for Disinfection of Special Sites 

zh-cn	中国疾病预防控制中心《特定人群个人防护指南》 
en-us	Chinese Center for Disease Control and Prevention. Guidelines for Personal Protection of Specific Groups 

zh-cn	浙江省市场监督管理局.新冠肺炎疫情防控技术指南第3部分：医疗机构：DB33/T 2241.1—2020 
en-us	Technical Guidelines for Prevention and Control of COVID-19, Part3: Medical Institutions, Local Standards of Zhejiang Province DB33/T 2241.3—2020 

zh-cn	中国疾病预防控制中心.新型冠状病毒肺炎疫情分布 
en-us	Chinese Center for Disease Control and Prevention. Distribution of Novel Coronavirus Pneumonia 

zh-cn	中国疾控中心在武汉华南海鲜市场检出大量新型冠状病毒 
en-us	China CDC has Detected Novel Coronavirus in Southern China Seafood Market of Wuhan 

zh-cn	国家卫生健康委关于新型冠状病毒肺炎暂命名事宜的通知 中华人民共和国国家卫生健康委员会疾病预防控制局.
en-us	Notification of Novel Coronavirus Pneumonia Temporarily Named by the National Health Commission of the People’s Republic of China Bureau of Disease Control and Prevention, National Health Commission of the People’s Republic of China. 

zh-cn	新型冠状病毒感染的肺炎纳入法定传染病管理 
en-us	Novel coronavirus infection pneumonia is included in the management of notifiable infectious diseases 

zh-cn	国家感染性疾病临床医学研究中心，传染病诊治国家重点实验室.
en-us	National Clinical Research Center for Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases. 

zh-cn	人工肝血液净化系统应用于重型、危重型新型冠状病毒肺炎治疗的专家共识[J]. 中华临床感染病杂志，2020,13.DOI:10.3760/cma.j.issn.1674-2397.2020.0003. 
en-us	Expert Consensus on Novel Coronavirus Pneumonia Treated with Artificial Liver Blood Purification System 

zh-cn	医院简介 
en-us	Overview of FAHZU 

zh-cn	医院拥有庆春、余杭、之江等6大院区，浙江大学医学院附属第一医院是集医疗、教学、科研、预防、保健为一体的“国家队”医院，首批委省共建国家医学中心、国家区域医疗中心。
en-us	 With six campuses, it has now evolved into a medical center integrating health care, medical education, scientific research and preventative care. 

zh-cn	医院综合排名全国第14，连续10年保持浙江第一，其中传染病学连续六年蝉联全国第一。 
en-us	In terms of overall strength, FAHZU is ranked 14 th in China. 

zh-cn	浙江大学医学院附属第一医院建院于1947年，是浙江大学创建的首家附属医院。
en-us	Founded in 1947, The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU), is the earliest affiliated hospital of Zhejiang University.

zh-cn	床位数4000余张，2019年门急诊量达500万人次，出院21.43万人次。
en-us	There is a total of 4,000 beds available to patients in FAHZU.Its main campus handled 5 million emergency and outpatient visits in 2019.

zh-cn	医院现有职工6500余人，正高职称364人，副高职称545人，拥有中国工程院院士、国家杰青、“长江学者”特聘教授等顶尖人才。 
en-us	As a large-size general hospital, it currently has over 6,500 employees, including academicians of the Chinese Academy of Engineering, National Distinguished Young Scholars and other outstanding talents. 

zh-cn	医院以综合实力雄厚、医疗质量过硬、学科特色鲜明享誉海内外。多年来，医院在器官移植、胰腺疾病、传染病、血液病、肾脏病、泌尿系疾病、临床药学等学科领域享有盛名，建立了现代化胰腺癌规范诊治创新技术体系，成功开展肝脏、胰腺、肺、肾、小肠和心脏等多器官移植手术。
en-us	Over the years, FAHZU has successfully developed a number of renowned programs in organ transplantation, pancreatic diseases, infectious diseases, hematology, nephrology, urology, clinical pharmacy, etc. FAHZU helps many realize the radical resection of cancer and enjoy long-term survival. FAHZU is also an integrated provider of liver, pancreas, lung, kidney, intestine and heart transplantation. 

zh-cn	自2003年以来，医院在抗击SARS，H7N9禽流感和新冠肺炎过程中获得了丰富的经验，先后在NEJM、Lancet、Nature、SCIENCE等主刊均有论著发表，授权专利300余项，出版专著200余部。 
en-us	In the fight against SARS, H7N9 avian flu and COVID-19, it has gained rich experience and fruitful results. As a result, its medical professionals have published many articles in journals such as New England Journal of Medicine, the Lancet, Nature and Science. 

zh-cn	医院长期以来持续推动全球范围内的交流合作，与美国斯坦福大学、美国约翰霍普金斯医院等30余家世界顶尖高校和医疗机构建立了深厚的合作关系。
en-us	FAHZU has been extensively engaged into overseas exchanges and collaboration. It has established partnerships with over 30 prestigious universities around the world. 

zh-cn	此外，同时医院将先进技术和优秀人才向匈牙利、印度尼西亚、马来西亚等中东欧和东南亚国家辐射，取得了丰硕的医学外交成果。 
en-us	Productive achievements have also been accomplished through exchange of our medical experts and technologies with Indonesia, Malaysia and other countries. 

zh-cn	医院牢记“以卓越的医疗品质促进人类健康”的使命，坚持“科技引领，创新发展，科学管理，优质服务”的发展思路，秉承“严谨求实”的核心价值观，致力于为患者提供高品质的医疗服务，早日成为国际一流的医学中心。 
en-us	Adhering to the core value of seeking truth with prudence, FAHZU is here to offer quality health care to everyone in need. 

zh-cn	马云公益基金会 
en-us	Jack Ma Foundation 

zh-cn	浙江大学 
en-us	Zhejiang University 

zh-cn	阿里云 
en-us	Alibaba Cloud 

zh-cn	阿里健康  
en-us	Alihealth  