第八章常用急救技術(shù)3

1、廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo1第八章第八章 常用急救技常用急救技術(shù)與護(hù)術(shù)與護(hù)理理廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo第五第五節(jié)節(jié) 心心臟電臟電除除顫顫及及護(hù)護(hù)理理一一、概概述：述： 心心臟電臟電除除顫顫通

2、通過較過較強(qiáng)的強(qiáng)的電電流流刺激，在短刺激，在短時(shí)間內(nèi)時(shí)間內(nèi)使全部心肌使全部心肌纖維纖維瞬瞬間間同同時(shí)時(shí)除除極極，消除，消除異異位心律位心律轉(zhuǎn)轉(zhuǎn) 復(fù)為竇復(fù)為竇性性心律的方法。心律的方法。廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo適適應(yīng)應(yīng)癥：癥： 1.1.心室心室顫動(dòng)顫動(dòng)第五第五節(jié)節(jié) 心心臟電臟電除除顫顫及及護(hù)護(hù)理理廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL

3、COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo 第五第五節(jié)節(jié) 心心臟電臟電除除顫顫及及護(hù)護(hù)理理2.心室撲動(dòng)：心室撲動(dòng)：廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo2 2、禁忌癥、禁忌癥：心室心室靜靜止：止：電電- -機(jī)械分離：機(jī)械分離：心功能不全：心功能不全：嚴(yán)嚴(yán)重重電電解解質(zhì)質(zhì)紊紊亂亂：尤其是低：尤其是低鉀鉀血癥血癥最近最近

4、發(fā)發(fā)生栓塞等：生栓塞等：第五第五節(jié)節(jié) 心心臟電臟電除除顫顫及及護(hù)護(hù)理理廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo終止室顫最快速、有效的方法終止室顫最快速、有效的方法除顫除顫常見的除顫儀：常見的除顫儀： （單相、雙相）（單相、雙相）廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights r

5、eserved.Company LogoLogo第五第五節(jié)節(jié) 心心臟電臟電除除顫顫及及護(hù)護(hù)理理三、操作方法及三、操作方法及護(hù)護(hù)理：理：（一）操作方法：（一）操作方法： 1 1、明確、明確診斷診斷 2 2、連連接除接除顫儀電顫儀電源、源、選擇選擇非同步非同步并并充充電電： 3 3、電極電極板準(zhǔn)板準(zhǔn)備備及放置：及放置： 4 4、能量的、能量的選擇選擇： 5 5、除、除顫顫操作：操作：廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company Lo

6、goLogo第五第五節(jié)節(jié) 心心臟電臟電除除顫顫及及護(hù)護(hù)理理（二）二）護(hù)護(hù)理措施：理措施： 1 1、注意體位：、注意體位： 2 2、防止、防止觸電觸電： 3 3、密切注意生命體征的、密切注意生命體征的變變化：特化：特別別心心電圖電圖 4 4、檢查檢查是否有皮是否有皮膚膚的的損傷損傷。 5 5、在除、在除顫顫的同的同時(shí)時(shí)注意注意糾糾正正電電解解質(zhì)質(zhì)紊紊亂亂。 廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo9 第六節(jié)節(jié)

7、 外傷傷止血、包扎、固定、搬運(yùn)運(yùn) 在在現(xiàn)實(shí)現(xiàn)實(shí)生活中，生活中，創(chuàng)傷創(chuàng)傷很多很多見見，為為了了防止防止創(chuàng)創(chuàng)口口繼續(xù)繼續(xù)出血、出血、污污染、再染、再損傷損傷，保，保護(hù)創(chuàng)護(hù)創(chuàng)面，面，讓讓病人迅速病人迅速脫脫離離現(xiàn)場(chǎng)現(xiàn)場(chǎng)，需立即，需立即進(jìn)進(jìn)行行現(xiàn)場(chǎng)現(xiàn)場(chǎng)救救護(hù)護(hù)。廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo現(xiàn)場(chǎng)現(xiàn)場(chǎng)急救原急救原則則：先先搶搶后救，先重后后救，先重后輕輕，先急后先急后緩緩，先近后，先近后遠(yuǎn)遠(yuǎn)，先止血后包扎，

8、再固定后搬先止血后包扎，再固定后搬運(yùn)運(yùn)10廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo用物用物 11廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo止血方法的止血方法的選擇選擇出血部位的不同，出血性出血部位的不同，出血性質(zhì)質(zhì)的不同，

9、危的不同，危險(xiǎn)險(xiǎn)同止血方法同止血方法也有所也有所區(qū)別區(qū)別。1 1、指、指壓壓止血法止血法 2 2、加、加壓壓包扎法包扎法3 3、填填塞止血法塞止血法 4 4、屈曲肢體加、屈曲肢體加墊墊止血法止血法5 5、止血、止血帶帶止血法止血法原原則則：根據(jù)出血部位及：根據(jù)出血部位及現(xiàn)場(chǎng)現(xiàn)場(chǎng)具體具體條條件件選擇選擇最佳方法最佳方法12廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo一、止血一、止血（一）指（一）指壓壓止血止血：概

10、概念：用手指、手掌或拳念：用手指、手掌或拳頭壓頭壓迫迫傷傷口近心端口近心端動(dòng)動(dòng)脈脈經(jīng)過經(jīng)過骨骼表面的部位，阻骨骼表面的部位，阻斷斷血液流血液流動(dòng)動(dòng)，達(dá)達(dá)到到臨時(shí)臨時(shí)止血的目的。止血的目的。指征：中等或指征：中等或較較大大動(dòng)動(dòng)脈以及脈以及較較大范大范圍圍的的靜靜脈和脈和毛毛細(xì)細(xì)血管的出血。血管的出血。13廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo1.1.顳動(dòng)顳動(dòng)脈止血法脈止血法14要領(lǐng)：壓迫同側(cè)耳屏前方顴弓根部

11、的博動(dòng)點(diǎn)（顳淺動(dòng)脈）廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo2.2.面面動(dòng)動(dòng)脈脈15要領(lǐng)：壓迫下頜角前上方1.5cm處（顏面部及頸部出血）廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo3.3.頸動(dòng)頸動(dòng)脈止血法脈止血法16注意：

12、對(duì)頸總動(dòng)脈壓迫止血應(yīng)慎重，絕對(duì)禁止壓迫雙側(cè)頸總動(dòng)脈，以免引起腦缺氧要領(lǐng)：用拇指或其他四指壓迫同側(cè)與胸鎖乳突肌前沿中點(diǎn)之間的強(qiáng)搏動(dòng)點(diǎn) 頭、頸、面部出血廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo4 4、鎖鎖骨下骨下動(dòng)動(dòng)脈脈17要要領(lǐng)領(lǐng)：壓壓迫同迫同側(cè)銷側(cè)銷骨上骨上窩窩中中部的搏部的搏動(dòng)動(dòng)點(diǎn)，點(diǎn)，將動(dòng)將動(dòng)脈脈壓壓向第向第一肋骨一肋骨 肩部、肩部、腋部、上臂出腋部、上臂出血血廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HO

13、SPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo5 5、肱肱動(dòng)動(dòng)脈止血法脈止血法18要領(lǐng)：壓迫肱二頭肌內(nèi)側(cè)溝中部的搏動(dòng)點(diǎn)（前臂出血前臂出血）廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo6 6、尺、尺、橈動(dòng)橈動(dòng)脈止血法脈止血法19要領(lǐng)：壓迫手腕橫紋稍上方的內(nèi)、外側(cè)搏動(dòng)點(diǎn)（手部

14、出血）廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo7 7、股、股動(dòng)動(dòng)脈止血法脈止血法20要領(lǐng)：壓迫腹股溝中點(diǎn)稍下部的強(qiáng)搏動(dòng)點(diǎn)（大腿出血）廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo8 8、腘動(dòng)脈止血法21要領(lǐng)：拇指垂直壓迫腘窩橫

15、紋中點(diǎn)處（小腿出血）廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo9 9、脛脛前前動(dòng)動(dòng)脈脈與脛與脛后后動(dòng)動(dòng)脈止血法脈止血法22要領(lǐng)：壓迫足背中部近足腕處搏動(dòng)點(diǎn)（脛前動(dòng)脈）和足踝內(nèi)側(cè)與內(nèi)踝之間的搏動(dòng)點(diǎn)（脛后動(dòng)脈）足部出血廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.

16、Company LogoLogo1010、指、指動(dòng)動(dòng)脈止血法脈止血法23要領(lǐng)：一手拇指與示指分別壓迫指根兩側(cè) 手指出血廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（二）加（二）加壓壓包扎止血包扎止血 是急救中最常用的止血方法之一是急救中最常用的止血方法之一 適用于小適用于小動(dòng)動(dòng)脈、脈、靜靜脈及毛脈及毛細(xì)細(xì)血管出血血管出血24廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MED

17、ICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（二）加（二）加壓壓包扎止血包扎止血 方法：用消毒方法：用消毒紗紗布或干布或干凈凈的手帕、毛巾、衣物等的手帕、毛巾、衣物等 敷于敷于傷傷口上，然后用三角巾或口上，然后用三角巾或繃帶繃帶加加壓壓包扎，其包扎，其松松緊緊度以能度以能達(dá)達(dá)到止血目的到止血目的為為宜。宜。 注意：若注意：若傷處傷處有骨折有骨折時(shí)時(shí)，須須加加夾夾板固定。板固定。關(guān)節(jié)脫關(guān)節(jié)脫 位及位及內(nèi)內(nèi)有碎骨存在禁用。有碎骨存在禁用。25廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF

18、 GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（三）止血（三）止血帶帶止血：止血： 只適用于不能用加只適用于不能用加壓壓止血的四肢大止血的四肢大動(dòng)動(dòng)脈出血。脈出血。 方法：抬高患肢，方法：抬高患肢，將襯墊將襯墊置于置于傷傷口近心端的皮口近心端的皮膚膚上，上，其上用橡皮其上用橡皮帶緊纏繞帶緊纏繞肢體肢體2-32-3圈后固定，借助橡皮管圈后固定，借助橡皮管的的彈彈性性壓壓迫血管而迫血管而達(dá)達(dá)到止血的目的。到止血的目的。 26廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITA

19、L OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo3、止血帶止血27廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo3、止血帶止血28廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT

20、 All rights reserved.Company LogoLogo2 2、止血、止血帶帶止血注意事止血注意事項(xiàng)項(xiàng)（1）上止血帶部位要準(zhǔn)確）上止血帶部位要準(zhǔn)確:前臂和小腿不宜前臂和小腿不宜扎止血帶，上臂避免扎在中扎止血帶，上臂避免扎在中1/3處，以防損處，以防損傷橈神經(jīng)。傷橈神經(jīng)。 （2）止血帶不能直接纏在皮膚上，必須用）止血帶不能直接纏在皮膚上，必須用三角巾、毛巾、衣服等做成襯墊墊上。三角巾、毛巾、衣服等做成襯墊墊上。 （3）松緊適宜，以能止住血為度。）松緊適宜，以能止住血為度。 29廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL CO

21、LLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo2、止血帶止血注意事項(xiàng)（4 4）記錄記錄上止血上止血帶帶的的時(shí)間時(shí)間，不宜超，不宜超過過3 3小小時(shí)時(shí)，每隔每隔1-2H1-2H放松一次，每次放松一次，每次2-32-3分分鐘鐘。放松。放松時(shí)時(shí)改用指改用指壓壓法。法。 （5 5）嚴(yán)嚴(yán)禁用禁用電線電線、鐵絲鐵絲、繩繩索代替止血索代替止血帶帶。 （6 6）上止血）上止血帶處帶處要有明要有明顯標(biāo)顯標(biāo)志，志，并并用用標(biāo)簽標(biāo)簽注明注明上止血上止血帶帶的的時(shí)間時(shí)間和放松止血和放松止血帶帶的的時(shí)間時(shí)間。（7 7）解除止血）解除止血帶

22、應(yīng)帶應(yīng)在在輸輸血、血、輸輸液及有效止血后液及有效止血后30廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo二、包扎二、包扎 適適應(yīng)應(yīng)癥癥 創(chuàng)傷經(jīng)創(chuàng)傷經(jīng)止血止血處處理后，理后，傷傷口均需作口均需作現(xiàn)場(chǎng)現(xiàn)場(chǎng)包扎。包扎。31廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.C

23、ompany LogoLogo二、包 扎 包扎材料包扎材料: :繃帶繃帶和三角巾和三角巾、四四頭頭巾巾 就地取材。就地取材。 包扎目的包扎目的: : 保保護(hù)傷護(hù)傷口、口、幫幫助止血、固定下敷助止血、固定下敷料、料、減輕減輕痛苦。痛苦。 包扎要求包扎要求: :快快、準(zhǔn)、準(zhǔn)、輕輕、牢。、牢。 暴露暴露傷傷口口 包扎前包扎前處處理理: : 特殊特殊傷傷包扎包扎: : 開開放性放性氣氣胸、腹部胸、腹部?jī)?nèi)臟脫內(nèi)臟脫出、出、腦腦膨出、膨出、異異物刺入、物刺入、開開放性骨折放性骨折32廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyri

24、ght by ARTCOM PT All rights reserved.Company LogoLogo包扎方法包扎方法1.1.繃帶繃帶包扎法包扎法（1 1）環(huán)環(huán)形包扎法形包扎法33包扎原則：環(huán)形纏繞，下周將上周繃帶完全覆蓋.適用于：四肢、適用于：四肢、額額部、胸腹部部、胸腹部廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（2 2）螺旋形包扎法）螺旋形包扎法 34包扎原則是遠(yuǎn)心端到近心端，始、終環(huán)形繞兩圈，螺旋

25、向上，每周覆蓋上周1/2-2/3適用于：上臂、大腿適用于：上臂、大腿廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（3 3）螺旋反折形）螺旋反折形繃帶繃帶包扎法包扎法35適用于：適用于：前臂、前臂、小腿小腿廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Compan

26、y LogoLogo（4 4）“ “8”8”字形包扎法字形包扎法 36適用于：適用于：關(guān)節(jié)關(guān)節(jié)部位部位廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（5 5）蛇形包扎法）蛇形包扎法 37適用于：適用于：臨時(shí)臨時(shí)固定固定廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.

27、Company LogoLogo（6 6）回返形）回返形繃帶繃帶包扎法包扎法 38適用于：適用于：頭頭部或部或殘殘端端廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo2.三角巾包扎法 （1）頭部包扎法39廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company

28、LogoLogo（2 2）單單肩包扎法肩包扎法 40廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（3）雙肩包扎法41廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（4 4）單單胸包扎法胸包扎法 42廣東醫(yī)學(xué)院附屬醫(yī)院AFFILAT

29、ED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（4）胸背部包扎法）胸背部包扎法 43廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（5）腹部包扎法）腹部包扎法 44廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL C

30、OLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（6 6）臀包扎法）臀包扎法 45廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo（7）上肢包扎法）上肢包扎法 46廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rig

31、hts reserved.Company LogoLogo（8 8）手、足部包扎法）手、足部包扎法 47廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo包扎注意事包扎注意事項(xiàng)項(xiàng) 1.1.包扎前包扎前應(yīng)應(yīng)先作先作簡(jiǎn)單簡(jiǎn)單的的清創(chuàng)清創(chuàng)及蓋敷料，及蓋敷料，2.2.包扎包扎時(shí)時(shí)被包扎肢體被包扎肢體應(yīng)應(yīng)保持功能位。保持功能位。3.3.包扎包扎時(shí)時(shí)根據(jù)受根據(jù)受傷傷部位部位選擇選擇合適的合適的繃帶繃帶或三角巾。或三角巾。4.4.

32、包扎方向包扎方向應(yīng)應(yīng)自上而下，自左向右，由自上而下，自左向右，由遠(yuǎn)遠(yuǎn)心端向近心心端向近心端包扎。端包扎。5.5.包扎包扎時(shí)時(shí)松松緊緊適宜，打適宜，打結(jié)應(yīng)結(jié)應(yīng)在前面或外在前面或外側(cè)側(cè)。6.6.四肢包扎四肢包扎時(shí)應(yīng)時(shí)應(yīng)暴露指（趾）端，便于暴露指（趾）端，便于觀觀察末梢血液察末梢血液循循環(huán)環(huán)。48廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo三、固 定 固定術(shù)是針對(duì)骨折的急救措施。固定術(shù)是針對(duì)骨折的急救措施。 目的目的

33、: 限制受傷部位的活動(dòng)，減輕疼痛，避免限制受傷部位的活動(dòng)，減輕疼痛，避免骨折端骨折端因移位而損傷血管、神經(jīng)等。也可防因移位而損傷血管、神經(jīng)等。也可防治休克、便于傷員的搬運(yùn)。治休克、便于傷員的搬運(yùn)。 固定范圍要包括上下關(guān)節(jié)固定范圍要包括上下關(guān)節(jié). 適應(yīng)癥適應(yīng)癥: 適用于四肢的骨折、脊柱的骨折、骨盆骨折適用于四肢的骨折、脊柱的骨折、骨盆骨折 49廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo三、固 定 固定材料: 木

34、制夾板 、鋼絲夾板 、充氣夾板、負(fù)壓氣墊、塑料夾板、其他材料，如特制的頸部固定器、股骨骨折的托馬固定架，緊要時(shí)就地取材:竹棒、木棍、樹枝等。 在缺乏外固定材料時(shí)也可以進(jìn)行臨時(shí)性的自體固定，如將受傷的上肢縛于上身軀干，或?qū)⑹軅南轮≈`于一起。50廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo物品準(zhǔn)備51廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLA

35、GECopyright by ARTCOM PT All rights reserved.Company LogoLogo操作方法操作方法521、鎖鎖骨骨折固定法骨骨折固定法 廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo2、肱骨骨折固定法、肱骨骨折固定法 53廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM P

36、T All rights reserved.Company LogoLogo3 3、前臂骨折固定法、前臂骨折固定法 54廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo4 4、股骨干骨折固定法、股骨干骨折固定法 55廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Co

37、mpany LogoLogo5 5、小腿骨折固定法、小腿骨折固定法 56廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo6 6、頸頸椎骨折椎骨折 、胸腰椎骨折57廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo固定注意事項(xiàng)1.固定前如有

38、固定前如有傷傷口和出血，口和出血，應(yīng)應(yīng)先止血、包扎，如有先止血、包扎，如有休克，休克，應(yīng)應(yīng)先抗休克。先抗休克。2.2.開開放性骨折，原放性骨折，原則則上上現(xiàn)場(chǎng)現(xiàn)場(chǎng)不不復(fù)復(fù)位，位，懷懷疑脊柱、大疑脊柱、大腿、小腿骨折腿、小腿骨折應(yīng)應(yīng)就地固定。就地固定。3.3.夾夾板板長(zhǎng)長(zhǎng)度和度和寬寬度要適宜。度要適宜。4.4.固定固定時(shí)時(shí)患肢患肢應(yīng)應(yīng)保持功能位。保持功能位。5.5.夾夾板不板不應(yīng)與應(yīng)與皮皮膚膚直接接直接接觸觸，其，其間應(yīng)襯墊間應(yīng)襯墊敷料。敷料。6.6.綁綁扎扎繃帶繃帶或三角巾或三角巾時(shí)時(shí)，松，松緊緊要適宜。要適宜。7.7.固定中避免不必要的活固定中避免不必要的活動(dòng)動(dòng)。58廣東醫(yī)學(xué)院附屬醫(yī)院AFF

39、ILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company LogoLogo四、搬四、搬 運(yùn)運(yùn)搬搬運(yùn)運(yùn)方法方法: : 徒手搬運(yùn)法用于傷勢(shì)較輕且運(yùn)送距離較近者。 擔(dān)架搬運(yùn)適用于傷勢(shì)較重，不宜徒手搬運(yùn)，且需轉(zhuǎn)運(yùn)距離較遠(yuǎn)的傷者。 基本原則: 及時(shí)、迅速、安全地將傷員搬至安全地帶，防止再次負(fù)傷。59廣東醫(yī)學(xué)院附屬醫(yī)院AFFILATED HOSPITAL OF GUANGDONG MEDICAL COLLAGECopyright by ARTCOM PT All rights reserved.Company Lo