Three basic and three strict skills operation scoring standards are as follows:
Tracheal tube shaping is satisfactory (1 point), adequately lubricated tracheal tube (1 point).
Preparation of dental cushions (no more than 2 minutes, more than 25 points deduction, order reversal deduction of 2.5 points), did not find the sleeve leakage catheter for intubation (10 points deduction). The laryngoscope is used appropriately, the handle is held in the proper position (5 points), and the lens is at the proper depth (2.5 points).
Adequate exposure of the vocal folds (2.5 points), appropriate depth of tracheal tube entry, and no one-lung ventilation in the simulator (10 points). The tracheal tube enters the trachea accurately (20 points), 10 points are deducted for repetitive maneuvers, and 20 points are deducted for accidental entry into the esophagus. Auscultation of both lung cusps to confirm the correct position of the catheter (2.5 points), correct placement of the dental cushion (fixed wings must not compress the lips) and withdrawal of the laryngoscope (2.5 points).
The above is for reference only, and it is recommended that you consult the relevant staff for specific scoring criteria.
Correct connection of the ventilator tubing (5 points) and correct setting of the ventilator mode (5 points). Ventilator parameters are set reasonably (tidal volume 6-8ml/kg, frequency 12-16 times/min, oxygen concentration 33%-50%, positive end-expiratory pressure ventilation 0-5cmH2O) (10 points).
Correctly connect the suction device and properly fix the tracheal tube (5 points). Check the patency of the suction device and test the suction pressure (negative pressure <-40 cmH2O) (5 points).
Master the criteria for deconditioning (ventilator test lung volume blowing, voluntary respiratory rate <30 breaths/min, respiratory muscle strength check without auxiliary respiratory muscle involvement) (10 points).
Master the indication for extubation of tracheal tube (clear consciousness, strong cough, stable spontaneous respiration, gradual decrease of ventilator support, and ability to expel sputum by oneself) (10 points).
Master the observation items after extubation (vital signs, cough reflex, chest rise and fall, and whether there are signs of hypoxia) (10 points).
Overall, the scoring criteria for the "Three Fundamentals and Three Strict Rules" covers tracheal intubation, use of ventilator, use of suction device, extubation criteria, tracheal tube extubation indications and post-extubation observation items, etc. In actual practice, it is necessary to take into account the specific needs of the patient. In the actual operation, it is necessary to comprehensively analyze and judge according to the specific situation to ensure the accuracy and safety of the operation.