(1)Critical care monitoring and treatment ward (ICU): focusing on the hospital's medical and nursing technical strength of all relevant specialties, using advanced medical technology and instruments and equipment, the critically ill patients to implement dynamic and effective monitoring of physiological functions and active treatment, in order to help save the lives of critically ill patients, reduce mortality and disability rate.
(2) ICU nurses should have the conditions: good quality and dedication, professional and technical training, understanding and mastery of the physiological and pathological changes of the disease, solid theoretical knowledge, proficiency in a variety of advanced monitoring technology and rescue techniques, familiar with the commonly used rescue medications, strong clinical skills and keen observation, analysis, adaptability, good at thinking independently, and a certain degree of English foundation. Good command of English.
(3) ICIJ nursing points:
Respiratory monitoring:
(1) Continuous monitoring of oxygen saturation, regular blood gas analysis, in order to understand the body's hypoxia and acid-base balance, to guide the treatment.
(2) Keep the airway open, supply oxygen reasonably, pat the back and suction regularly. If necessary, carry out postural drainage. Patients with hypoxia should first increase the flow rate of adequate oxygenation before suctioning, and when the sputum is thick and sticky, it can be used ? -If the sputum is thick and sticky, use chymotrypsin + gentamicin, or 2% sodium bicarbonate 1 ~ 2mL, tracheal drip or ultrasonic nebulization inhalation, so that sputum is diluted and easy to be discharged. The suction tube is changed once used to prevent infection. Patients using the ventilator, should be adjusted according to the results of blood gas analysis of various parameters to maintain normal respiration.
(3) Tracheotomists should regularly sterilize the endotracheal tube, which should be sterilized three times a day, and the skin around the tube should be sterilized with 75% alcohol three times a day. The gauze pads at the incision should be changed regularly to keep the incision clean.
(4) Disinfect and replace the oxygen humidification bottle and oxygen pipeline every day, and replace the liquid in the humidification bottle at the same time.
(5) Measure and listen to the breath sounds of both lungs at regular intervals in order to understand the condition of the lungs.
(6) In case of respiratory failure or cessation of spontaneous respiration, mechanical ventilation should be used immediately to assist respiration or control respiration.
Circulatory system monitoring:
(1) Observe changes in vital signs and peripheral circulation at all times and record.
(2) Closely monitor electrocardiographic changes, hemodynamic indices, and electrolytes and enzymes for cardiac function and circulation.
(3) Actively correct all kinds of arrhythmias, especially ventricular arrhythmias. Prevent the occurrence of Asperger's syndrome.
(4) Accurately record the amount of water in and out of the 24-hour period, and regulate the rate of infusion according to the condition and the performance of the drugs to prevent acute left heart failure and hypovolemia.
Central nervous system monitoring: pay attention to the observation of the patient's consciousness j pupils and nerve reflexes, timely detection of cerebral edema, cranial hypertension and cerebral herniation of the precursor symptoms, close observation of the general body sensation and limb activity.
Renal function monitoring: observe the patient's hourly urine volume, color, relative density. Urine, blood creatinine, urea nitrogen, electrolyte content and changes, such as in the case of a large number of hemoglobin, myoglobin destruction of human blood, to alkaline dilute urine, to prevent acute renal failure, if necessary, to do renal dialysis treatment.
Various in vivo intubation care:
(1) cardiac catheterization: arterial and venous incision tubes, hemofiltration tubes, etc. daily disinfection, clean the planing surface once a day, and change the disinfected dressings.
(2) Various types of chest, abdomen, stomach, bladder and other drainage bottles and drainage bags are changed and sterilized daily.
(3) Replace the fluid in the negative pressure chest bottle daily to maintain negative pressure in the chest.
(4) Replace intravenous tubing daily.
(5)Observe the condition closely and keep detailed nursing records:
①Record changes in condition and treatment measures.
②Record clinical and laboratory test results.
③Record routine treatment, medication and nursing care.
④Nursing summary should be written at the end of each shift, highlighting changes in condition and nursing priorities.
(6) Do a good bedside shift handover. The shift handover focuses on:
①Vital sign changes.
②Special treatment, special medication, medication and doctor's opinion.
③The use of various types of precision instruments.
④Whether all kinds of tubes are smooth and the color and amount of drainage fluid.
⑤Whether the skin is pressurized, red, swollen and broken.