Precautions after surgery
September 23, 2005 20:22 Sina Life
Postoperative care should be carried out after surgery, and postoperative care is a A specialized medical discipline. No matter how beautiful the operation is, if postoperative care is ignored, the patient will suffer postoperative accidents, which will make all the efforts of the operation in vain. Experienced surgeons attach great importance to the postoperative management of patients. Postoperative precautions can be summarized as follows:
(1) Carefully monitor and observe changes in the condition after surgery. In order to strengthen the observation and strict care of postoperative patients, patients who have undergone major operations should be sent to the intensive observation room or postoperative recovery room, special care in the intensive care unit, or first-level postoperative care. Ensure that personnel, equipment, emergency medicines, and hospital beds are fixed. Before the postoperative patient leaves the operating room and after being transferred to the intensive care unit, the operator must conduct a comprehensive examination. In particular, it is important to check blood pressure, respiration, pulse, heartbeat, etc. It is necessary to confirm that the patient's respiratory tract and various drainage tubes are unobstructed, that intravenous infusion and blood transfusion are normal, and that the patient must be handed over to the personnel in the intensive care unit before leaving.
Under normal circumstances, after a major operation, the physician in charge and the surgeon will pay attention to the prevention of oral complications, the occurrence of bedsores, phlebitis, wound infection and other diseases and surgical procedures. Prevention of postoperative complications is very important. Specific measures should be taken for the "six preventions", such as regular cleaning and dressing change, quantitative cleaning of the mouth, regular turning of the patient's body, changing positions, trying to protect the veins and blood vessels during blood transfusion, hot compresses, etc. These are all routine treatments for postoperative patients. , is also a practical measure for nursing care. Strengthening the scientific management of postoperative patients requires a strict inspection system and a serious work attitude, so that patients can survive the postoperative period, reduce complications, prevent and reduce the occurrence of medical accidents or errors, and enable postoperative patients to recover as soon as possible.
(2) Medical records of cases of postoperative death, especially those showing signs of medical disputes, should be sealed by the medical administration department. Convene emergency death case discussion meetings and cause-of-death identification meetings, and report the situation to the health authorities in a timely manner. In cases of unexplained death, the body should be temporarily preserved, and forensic doctors should be invited for forensic identification if necessary. Actively mobilize patients to conduct autopsies as soon as possible and make cause-of-death identification to determine whether the patient's death is related to medical negligence.
The first assistant should leave one person in the hospital to observe changes in the condition for 24 hours, and the patient can only leave the hospital after the patient is out of danger. When encountering critically ill patients with postoperative changes, Qing will make overall arrangements within the department and take turns on duty to monitor the patients. If the person on duty leaves the patient without authorization and serious consequences occur, the doctor on duty must be held accountable for his dereliction of duty.
(3) Carefully provide postoperative care to prevent complications. The use of analgesics for postoperative patients should not only consider the needs of the patient, but also prevent the side effects of narcotic drugs. For example, in patients after thoracic surgery, excessive use of analgesics will affect the patient's expectoration and cause sequelae such as atelectasis. Or if the medication is taken for too long, the patient becomes overly dependent on analgesics and becomes addicted. Therefore, medical staff are required to use analgesics appropriately. Medical staff also need to master the essentials of helping patients recover after surgery, such as instructing patients after abdominal surgery to get out of bed as soon as possible to restore intestinal peristalsis and prevent intestinal adhesions. For patients after thoracic surgery, medical staff should teach them to do deep and long breathing exercises, blow up balloons, self-suppress coughs from wounds, and expel sputum. Medical staff are responsible for observing and handling various surgical drainage tubes.
For various postoperative drainage tubes, it is necessary to master the technical operations of placement and removal to prevent the drainage tube from slipping out or falling into the body cavity. The quality and quantity of drainage fluid should be observed and recorded at any time. If the body cavity drainage fluid is dark in color and the volume is large, a sample should be taken for testing. If the concentration of hemoglobin and red blood cells is close to that of blood, it can prove the tendency of internal bleeding, so emergency measures can be taken.
Contradictory breathing of postoperative patients, treatment of acute respiratory insufficiency, rational use of antibiotics, adjustment of water and salt electrolytes, avoiding cross-infection of postoperative patients, etc. are all ways to prevent postoperative complications. key.
(4) Specific measures should be taken for the "six preventions" after surgery.
Post-operative patients, due to surgical trauma, blood loss, anesthesia and other reasons, the body's defense function is temporarily in a passive state with reduced levels, and most need careful observation and timely care by medical staff. Therefore, the "six defenses" are to prevent lung complications and respiratory infections.