手术室各种突发意外事件应急预案及程序44页

The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室手术室各种各种突发意外事件突发意外事件应急预案及程序应急预案及程序2012年年5月月6日日手术室手术室The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室突发意外伤害事件手术室突发意外伤害事件应急预案及程序应急预案及程序【应急预案应急预案】1.手术室平时应备有足量的手术器械和敷料，每日手术室平时应备有足量的手术器械和敷料，每日清点补充清点补充,以保证应急使用。以保证应急使用。2.对特殊器械常规准备，同时备有足量的一次性消对特殊器械常规准备，同时备有足量的一次性消耗材料，以保突发抢救的应用。耗材料，以保突发抢救的应用。3.各类抢救药品，仪器固定房间放置性良好，严格各类抢救药品，仪器固定房间放置性良好，严格交接交接,以备应急使用。以备应急使用。4.全体医护人员熟练掌握各种抢救技术，熟悉抢救全体医护人员熟练掌握各种抢救技术，熟悉抢救药品的药物作用和使用方法。药品的药物作用和使用方法。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室突发意外伤害事件手术室突发意外伤害事件应急预案及程序应急预案及程序5.工作人员要有高度的责任心和应急能力，如遇有工作人员要有高度的责任心和应急能力，如遇有意外事件发生后，及时通知相关人员，立即到达意外事件发生后，及时通知相关人员，立即到达手术室进行抢救。手术室进行抢救。6.按通知根据大型伤员抢救的伤情，合理安排手术按通知根据大型伤员抢救的伤情，合理安排手术房间和人员，由护士长和科主任统一指挥。房间和人员，由护士长和科主任统一指挥。7.巡回、洗手护士力求备好一切抢救用品，保证手巡回、洗手护士力求备好一切抢救用品，保证手术顺利进行。术顺利进行。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室突发意外伤害事件手术室突发意外伤害事件应急预案及程序应急预案及程序8.洗手护士密切配合手术医师进行手术。洗手护士密切配合手术医师进行手术。9.根据情况随时与护理部、急诊科联系，做根据情况随时与护理部、急诊科联系，做好一切记录。好一切记录。10.同时安排同时安排12名工人负责专门取血，送标名工人负责专门取血，送标本等外出工作，保证病人在最短时间内得本等外出工作，保证病人在最短时间内得到最有效的抢救。到最有效的抢救。11.各班分工负责，忙而不乱，若遇有大量伤各班分工负责，忙而不乱，若遇有大量伤员要启动第二梯队应急。及时报告协调。员要启动第二梯队应急。及时报告协调。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室突发意外伤害事件手术室突发意外伤害事件应急预案及程序应急预案及程序【程序程序】平时做好准备平时做好准备熟悉抢救技术熟悉抢救技术按伤情按伤情合理安排合理安排尽快手术抢救尽快手术抢救密切配合密切配合做好记录及时报告做好记录及时报告The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术患者发生呼吸心跳骤停手术患者发生呼吸心跳骤停的应急预案及程序的应急预案及程序心搏骤停心搏骤停是由于各种原因导致心跳突然停止正常是由于各种原因导致心跳突然停止正常收缩和供血功能，使全身血液循环中断，收缩和供血功能，使全身血液循环中断，各组织器官严重缺氧和代谢障碍的一系列各组织器官严重缺氧和代谢障碍的一系列表现表现手术病人出现呼吸、心搏骤停可见于多种情手术病人出现呼吸、心搏骤停可见于多种情况，如：冠心病、心肌梗死、脑血管意外、况，如：冠心病、心肌梗死、脑血管意外、严重外伤、麻醉或手术意外、休克等严重外伤、麻醉或手术意外、休克等The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术患者发生呼吸心跳骤停手术患者发生呼吸心跳骤停的应急预案及程序的应急预案及程序心搏骤停的临床表现：心搏骤停的临床表现：1.意识消失意识消失2.大动脉无波动，颈动脉、股动脉搏动消失大动脉无波动，颈动脉、股动脉搏动消失3.无自主呼吸无自主呼吸4.心搏停止、心音消失心搏停止、心音消失5.瞳孔散大、对光反射消失瞳孔散大、对光反射消失6.手术切口不出血、术野血色暗红手术切口不出血、术野血色暗红7.心、脑电图呈一直线心、脑电图呈一直线The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术患者发生呼吸心跳骤停手术患者发生呼吸心跳骤停的应急预案及程序的应急预案及程序【应急预案应急预案】1.手术患者进入手术室，在手术开始前发生呼吸心手术患者进入手术室，在手术开始前发生呼吸心跳骤停时，应立即行胸外心脏按压、人工呼吸、跳骤停时，应立即行胸外心脏按压、人工呼吸、气管插管，快速建立静脉通道，根据医嘱应用抢气管插管，快速建立静脉通道，根据医嘱应用抢救药物。同时呼叫其他医务人员帮助抢救。必要救药物。同时呼叫其他医务人员帮助抢救。必要时准备开胸器械，行胸内心脏按压术，在抢救过时准备开胸器械，行胸内心脏按压术，在抢救过程中应注意心、肺、脑复苏，程中应注意心、肺、脑复苏，必要时开放两条静必要时开放两条静脉通道。脉通道。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术患者发生呼吸心跳骤停手术患者发生呼吸心跳骤停的应急预案及程序的应急预案及程序2.术中患者出现呼吸心跳骤停时，先行胸外术中患者出现呼吸心跳骤停时，先行胸外心脏按压术，未行气管插管的患者，应立心脏按压术，未行气管插管的患者，应立即行气管插管辅助呼吸，必要时再开放一即行气管插管辅助呼吸，必要时再开放一条静脉通道。条静脉通道。3.参加抢救人员应注意互相密切配合，有条参加抢救人员应注意互相密切配合，有条不紊，严格查对，及时做好记录，并保留不紊，严格查对，及时做好记录，并保留各种药物安瓿及药瓶，做到据实准确的记各种药物安瓿及药瓶，做到据实准确的记录抢救过程。录抢救过程。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术患者发生呼吸心跳骤停手术患者发生呼吸心跳骤停的应急预案及程序的应急预案及程序4.护理值班人员严格遵守科室各项规章制度，护理值班人员严格遵守科室各项规章制度，坚守岗位，术中密切观察病情，以便及时坚守岗位，术中密切观察病情，以便及时发生病情变化，尽快采取抢救措施。发生病情变化，尽快采取抢救措施。5.急救物品做到急救物品做到“四固定四固定”，班班清点，完，班班清点，完好率达好率达100%，保证应急使用。，保证应急使用。6.护理人员熟练掌握心肺复苏流程及各种急护理人员熟练掌握心肺复苏流程及各种急救仪器的使用方法和注意事项。救仪器的使用方法和注意事项。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University心肺复苏心肺复苏1 胸外心脏按压：胸外心脏按压：仰卧于硬板床或地面，开放气道，保持呼吸道仰卧于硬板床或地面，开放气道，保持呼吸道通畅；左手掌根部放于病人胸骨体中下通畅；左手掌根部放于病人胸骨体中下1/3交接处，交接处，双手掌根重叠，双臂垂直按压胸骨，使胸骨下陷双手掌根重叠，双臂垂直按压胸骨，使胸骨下陷45cm，按压频率，按压频率100次次/分，按压与放松时间相分，按压与放松时间相等，同时给予人工呼吸，按压与吹气比率为等，同时给予人工呼吸，按压与吹气比率为30：2，人工呼吸时，应暂停按压。，人工呼吸时，应暂停按压。2控制呼吸：正确使用呼吸囊和面罩，气管插管后控制呼吸：正确使用呼吸囊和面罩，气管插管后机械通气机械通气3胸外电除颤胸外电除颤The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University心肺复苏有效指征心肺复苏有效指征1.心电图恢复心电图恢复2.触及大动脉搏动，如肱动脉有搏动，触及大动脉搏动，如肱动脉有搏动，3.收缩压收缩压10.6kpa(80mmHg)4.瞳孔由大变小，对光反射及吞咽反射恢复。瞳孔由大变小，对光反射及吞咽反射恢复。5.自主呼吸恢复。自主呼吸恢复。6.口唇及甲床转红润口唇及甲床转红润The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术患者发生呼吸心跳骤停手术患者发生呼吸心跳骤停的应急预案及程序的应急预案及程序【程序程序】立即抢救立即抢救胸外按压胸外按压气管插管气管插管快速快速输液输液遵医嘱用药遵医嘱用药密切配合密切配合对症处对症处理理及时记录及时记录CPCRThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术病人休克应急预案手术病人休克应急预案休克定义：休克定义：由于组织有效循环血量灌注不足引起的由于组织有效循环血量灌注不足引起的代谢障碍和细胞受损代谢障碍和细胞受损休克分类：休克分类：低血容量性休克、感染性休克、心源性低血容量性休克、感染性休克、心源性休克、神经性休克和过敏性休克休克、神经性休克和过敏性休克5类类外科休克主要是前外科休克主要是前2种种概念概念The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术病人休克应急预案手术病人休克应急预案低血容量性休克包括：低血容量性休克包括：1）出血性休克见于：）出血性休克见于：食管静脉曲张破裂、溃疡出血、肝脾食管静脉曲张破裂、溃疡出血、肝脾破裂、宫外孕或手术中失血过多破裂、宫外孕或手术中失血过多2）创伤性休克见于：）创伤性休克见于：骨折、挤压伤等骨折、挤压伤等The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术病人休克应急预案手术病人休克应急预案休克临床表现：休克临床表现：早期：精神紧张或烦躁，面色苍白，手足早期：精神紧张或烦躁，面色苍白，手足湿冷，心跳加快，血压稍高湿冷，心跳加快，血压稍高晚期：皮肤湿冷，尿量减少，脉搏细速，心晚期：皮肤湿冷，尿量减少，脉搏细速，心率增快，反应迟钝，神志模糊。率增快，反应迟钝，神志模糊。血压下降，收缩压血压下降，收缩压10.7kpa(80mmHg)，脉压差脉压差2.67kpa(20mmHg)The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University 手术病人休克应急预案手术病人休克应急预案应急予案：应急予案：1.当手术病人发生休克时，立即去枕取中当手术病人发生休克时，立即去枕取中凹卧位，吸氧，保持呼吸道通畅。凹卧位，吸氧，保持呼吸道通畅。2.快速建立静脉通道（选择大血管或应用快速建立静脉通道（选择大血管或应用留置针），及时补充血容量。留置针），及时补充血容量。3.迅速准确执行医嘱迅速准确执行医嘱,口头医嘱应重复口头医嘱应重复2遍遍无误后方可用要药无误后方可用要药.严格执行查对制度严格执行查对制度.4.抗休克的原则是：扩容，纠酸，糖皮质抗休克的原则是：扩容，纠酸，糖皮质激素和血管活性药物的应用。激素和血管活性药物的应用。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术休克病人应急预案手术休克病人应急预案4.1感染性休克感染性休克抗感染。抗感染。低血容量性休克低血容量性休克止血、补液、补血。止血、补液、补血。4.3过敏性休克过敏性休克立刻皮下注射立刻皮下注射0.1%的肾上的肾上腺素。腺素。4.4心源性休克心源性休克纠正心衰、抗心律失常。纠正心衰、抗心律失常。4.5神经源性休克神经源性休克立即给予哌替啶或吗啡镇立即给予哌替啶或吗啡镇静止痛。静止痛。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术休克病人应急预案手术休克病人应急预案5.给予心电监护，严密观察给予心电监护，严密观察T、P、R、BP、意识、皮肤色泽和尿量，并做好记录。意识、皮肤色泽和尿量，并做好记录。6.注意保暖，保持室温注意保暖，保持室温22-26。7.保留导尿，记录出入水量和尿量，以判断保留导尿，记录出入水量和尿量，以判断病情。病情。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University 休克病人的应急预案休克体位是中凹卧位吸氧快速建立有效的静脉通道总的治疗原则是扩容，纠酸，糖皮质激素和血管活性药物的应用 感染性休克控制感染低血容量休克止血、补液、补血过敏性休克立刻皮下注射0.1%肾上腺素心源性休克纠正心衰，抗心律失常神经源性休克镇静止痛The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University物品清点误差应急予案物品清点误差应急予案1.手术前后必须认真清点所有物品的数量，手术前后必须认真清点所有物品的数量，并认真记录于手术护理记录单上，作为法并认真记录于手术护理记录单上，作为法律依据。律依据。2.根据记录数字，严格清点各项数字情况，根据记录数字，严格清点各项数字情况，如出现误差时，应立即上报手术者和护士如出现误差时，应立即上报手术者和护士长，并再次仔细检查所有可能发现的地方，长，并再次仔细检查所有可能发现的地方，直到无误。直到无误。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University物品清点误差应急予案物品清点误差应急予案3严格坚持手术中使用过的物品不离开本严格坚持手术中使用过的物品不离开本手术间的基本原则。手术间的基本原则。4如术中物品清点不够时，经反复查找无如术中物品清点不够时，经反复查找无效，与手术医生商讨，需要效，与手术医生商讨，需要C臂机或臂机或x线检线检查和其他检查，仍无效时，为确保患者病查和其他检查，仍无效时，为确保患者病情不受影响，关闭伤口，并请手术者在手情不受影响，关闭伤口，并请手术者在手术通知单上签字，巡回护士在记录单上注术通知单上签字，巡回护士在记录单上注明查找经过。明查找经过。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University物品清点误差应急予案物品清点误差应急予案手术中的使用物品清点出现误差手术中的使用物品清点出现误差立即上报手术者和护士长立即上报手术者和护士长再次仔细检查所有可能发现的地方，直到无误术中物品清点不够，经反复查找无效再次仔细检查所有可能发现的地方，直到无误术中物品清点不够，经反复查找无效与手术医生商讨，使用与手术医生商讨，使用C臂机或臂机或x线检查和其他检查线检查和其他检查仍无效时，确保患者病情不受影响，关闭伤口仍无效时，确保患者病情不受影响，关闭伤口请手术者在手术通知单上签字，巡回护士在记录单上注明查找经过请手术者在手术通知单上签字，巡回护士在记录单上注明查找经过The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University接送病人途中出现意外应急予案接送病人途中出现意外应急予案一、坠床：一、坠床：1.接送手术病人途中不慎坠车，应立即将病接送手术病人途中不慎坠车，应立即将病人抬至手术推车上，同时马上通知主管医人抬至手术推车上，同时马上通知主管医生。生。2.对病人的情况初步判断，观察有无外伤，对病人的情况初步判断，观察有无外伤，到病房测量血压、心率、呼吸判断患者意到病房测量血压、心率、呼吸判断患者意识等。识等。3.医生到场后，协助医生进行检查，为医生医生到场后，协助医生进行检查，为医生提供信息，遵医嘱进行正确处理。提供信息，遵医嘱进行正确处理。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University接送病人途中出现意外应急予案接送病人途中出现意外应急予案一、坠床：一、坠床：4.遵医嘱进行必要的检查（检查有无骨折和遵医嘱进行必要的检查（检查有无骨折和颅内出血）及治疗。颅内出血）及治疗。5.严密观察病情变化，发现问题及时处理。严密观察病情变化，发现问题及时处理。6.向上级领导汇报。向上级领导汇报。7.认真记录患者坠床的经过及抢救过程。认真记录患者坠床的经过及抢救过程。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University接送病人途中出现意外应急予案接送病人途中出现意外应急予案坠床处理程序：坠床处理程序：发现患者坠车发现患者坠车将病人移至手术推车上将病人移至手术推车上立即通知医生，进行病情初步判断及紧急抢救措施立即通知医生，进行病情初步判断及紧急抢救措施进一步检查与治疗及病情观察进一步检查与治疗及病情观察通知有关领导通知有关领导认真记录病人坠床的经过及抢救过程认真记录病人坠床的经过及抢救过程The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University接送病人途中出现意外应急予案接送病人途中出现意外应急予案二、心跳呼吸骤停时的应急预案二、心跳呼吸骤停时的应急预案1.手术室人员严密观察病情变化，以便及早手术室人员严密观察病情变化，以便及早采取急救措施。采取急救措施。2.判断病情：当病人突然抽搐时，立即轻拍判断病情：当病人突然抽搐时，立即轻拍病人并进行呼唤，无反应时，触摸大动脉病人并进行呼唤，无反应时，触摸大动脉无搏动，看胸廓无起伏，即判断病人为呼无搏动，看胸廓无起伏，即判断病人为呼吸心跳骤停。吸心跳骤停。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University接送病人途中出现意外应急予案接送病人途中出现意外应急予案3.立即将病人面朝上平卧头后仰，保持呼吸立即将病人面朝上平卧头后仰，保持呼吸道通畅，并呼求帮助。道通畅，并呼求帮助。4.立即和麻醉师共同进行徒手心肺复苏（人立即和麻醉师共同进行徒手心肺复苏（人工呼吸和心脏按压），并就近到手术室或工呼吸和心脏按压），并就近到手术室或病房进一步抢救，吸氧、心电监护、气管病房进一步抢救，吸氧、心电监护、气管插管、遵医嘱给药。插管、遵医嘱给药。5.同时通知医生和护士长，做好抢救记录同时通知医生和护士长，做好抢救记录The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University接送病人途中出现意外应急予案接送病人途中出现意外应急予案程序：程序：呼吸、心跳骤停呼吸、心跳骤停呼求帮助呼求帮助立即进行徒手心肺复苏立即进行徒手心肺复苏心脏按压、人工呼吸心脏按压、人工呼吸吸氧、心电监护、气管插管、静脉给药吸氧、心电监护、气管插管、静脉给药向有关领导汇报向有关领导汇报The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University术中压疮预防予案1术前探视病人，对有可能出现术中压疮的高危人群术前探视病人，对有可能出现术中压疮的高危人群包括婴幼儿、高龄、糖尿病、低蛋白血症、恶液包括婴幼儿、高龄、糖尿病、低蛋白血症、恶液质、长期卧床患者等做出评估，制订预防措施。质、长期卧床患者等做出评估，制订预防措施。提醒医生术前告知患者。提醒医生术前告知患者。2入手术室后，巡回护士检查其全身皮肤情况，若已入手术室后，巡回护士检查其全身皮肤情况，若已有压疮应及时与病房护士联系，或让手术医生查有压疮应及时与病房护士联系，或让手术医生查看签名。看签名。3术中采取的措施：术中采取的措施：应用应用抗压体位垫（硅胶凝胶体）抗压体位垫（硅胶凝胶体）保持局部皮肤清洁干燥。保持局部皮肤清洁干燥。手术床单平整清洁防止损伤皮肤。手术床单平整清洁防止损伤皮肤。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University术中压疮预防予案有压疮的部位用体位垫保护，避免进一步加重；有压疮的部位用体位垫保护，避免进一步加重；可能出现压疮的部位，也采取保护措施，减轻受压可能出现压疮的部位，也采取保护措施，减轻受压部位压力；部位压力；对时间长的手术，用体位垫保护外，在手术许可情对时间长的手术，用体位垫保护外，在手术许可情况下，每隔况下，每隔2小时托起受压部位按摩。小时托起受压部位按摩。术后巡回护士再次检查全身皮肤情况，与病房交接术后巡回护士再次检查全身皮肤情况，与病房交接并签名。并签名。4术后回访，了解病人是否有术后并发症术后回访，了解病人是否有术后并发症。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University术中压疮预防予案【程序】探视病人探视病人制订措施制订措施检查皮肤检查皮肤体位垫体位垫保护保护托起按摩托起按摩再次检查再次检查交接签名交接签名回访回访The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室意外事件管理手术室意外事件管理手术室意外事件是手术室安全管理的重要内容手术室意外事件是手术室安全管理的重要内容手术室意外事件管理目标：手术室意外事件管理目标：1.防范意外事件发生，防范意外事件发生，2.降低风险，降低风险，3.提高安全性提高安全性The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室意外事件管理手术室意外事件管理手术室意外事件手术室意外事件1.严重灾难性事件伤员的手术抢救；火灾、严重灾难性事件伤员的手术抢救；火灾、水难、空难、重大交通事故等水难、空难、重大交通事故等2.甲类特殊感染病人的手术甲类特殊感染病人的手术3.成批病人发生切口感染、输液反应等成批病人发生切口感染、输液反应等4.发生严重差错或事故或其它突发事件：输发生严重差错或事故或其它突发事件：输错血、标本丢失、压疮等错血、标本丢失、压疮等The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室意外事件管理手术室意外事件管理手术室意外事件手术室意外事件5.损坏或丢失贵重仪器，设备，或毒麻药损坏或丢失贵重仪器，设备，或毒麻药6.发生严重护患、医患纠纷，不能妥善解决发生严重护患、医患纠纷，不能妥善解决7.器械、敷料数目不符器械、敷料数目不符8.火警、泛水火警、泛水9.中心供氧、中心吸引突然停止，突然停电中心供氧、中心吸引突然停止，突然停电The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室意外事件管理手术室意外事件管理意外事件汇报制度意外事件汇报制度1.遇到上述情况，必须及时向护士长、遇到上述情况，必须及时向护士长、2.护理部或医院相关部门请示报告。护理部或医院相关部门请示报告。3.必要时附书面报告必要时附书面报告The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University手术室意外事件管理手术室意外事件管理意外事件处理原则意外事件处理原则立即通知护士长立即通知护士长通知医院行政总值班，或保卫科，或直接通知医院行政总值班，或保卫科，或直接报警（暴力事件）报警（暴力事件）通知家属或病人单位通知家属或病人单位保护好现场保护好现场组织现有人力、物力积极应对。组织现有人力、物力积极应对。The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University 保持幽默感，有几个知心朋友因为我是孩子！因为我是孩子！The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University 学会宽恕别人The First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou UniversityThe First Affiliated Hospital of Zhengzhou University精品资料网（）成立于2004年，专注于企业管理培训。提供60万企业管理资料下载，详情查看：提供5万集管理视频课程下载，详情查看：提供2万GB高清管理视频课程硬盘拷贝，详情查看：2万GB高清管理视频课程目录下载：高清课程可提供免费体验，如有需要请于我们联系。咨询 ：值班 ：网站 在线文档：:/foxdoc