創(chuàng)傷護理中英文對照版

StandardOperatingProceduresofTraumaCareⅠ.PurposeLetthepatientbacktohealth,toavoiddisfiguringordysfunctionandothersequelae,preventspreadofinfectiontootherpatients.Ⅱ.ScopeDuetomechanicalfactorsonhumanbodycausedbythedestructionoftissuesororgansofpeoplecareⅢ.ContentTocleanthewound,asurgerytotheprimaryhealing.1.Generaltraumacare(1)Onthewound:theplacesuchasbrain,chest,abdominalwoundsteriledressingsorcleanclothbandage,compressionbandagesofteningofthechestwallshouldbepaidattentionto,andprotectionoftheemergenceofinternalorgans.Bythemethodofcompressionbandagehemostasisbodybleeding.Atourniquetshouldonlybeusedasalastresort,andshouldberecordingtime,openeveryhour.(2)theeffectivefixed:limbfractureordislocationavailablesplint(orsubstitute),orinthehealthylimbtoneutralposition(orbody).Afterafixed,shouldtesttheremotepulse,ifthepoorbloodsupplyshouldbeadjustedandrecord.Suspectedcervicalspinefractureswithneckcollar.Seriouspollutionofopenfractures,cankeepthepositionininjurybandagefixation.Properlyandtimelyfixedcanrelievepain,avoidaggravatingtraumaandhemorrhage,adaptabletotransmit.Properpositionandbraking:generalshouldprostrate,bodypositionchangesslowly,preventingorthostatichypotension.Takepositionshouldbeconducivetobreathingandvenousreturn.Thewoundusedplywood,bracketorgypsum.(3)topreventinfection:chooseantibiotics,openwoundshouldbevaccinatedagainsttetanus.(4)bandiet:ifagastricretentionorsuspectedacutegastricdilatation,shouldbuynasogastrictubedecompression.(5)tomaintainfluidbalanceandnutrition:accordingtotheconditionandbloodbiochemicaladjustinfusion,severetraumaaslongastheintestinalfunction,asfaraspossiblebyenteralnutrition,maintainthebasicfunctionoftissuesandorgans,andshouldnotbetoomuch.(6)calmanalgesic:observationperiodshouldbecareful.Confirmedorpreparetheemergencysurgeryundersurveillancefornarcoticanalgesics.Multipletraumaandcircularfunctionisnotstable,generallydonotgivepainkillers,especiallyinhigh-riskpatients.2.Closedtraumacare(1)generalsofttissuecontusion:earlycold,hotcompressorphysicaltherapyafter24h,locallyavailableanti-inflammatoryanalgesicgels.(2)closedfracturesanddislocations:anesthesiamanualreductionandexternalfixation,orsurgery.(3)XiongFuQiangclosedtrauma:mostlyneedemergencysurgery,tostopbleeding,removalorrepairvisceraandimplementdrainage.(4)craniocerebralinjury,suchasheadinjurytreatmentshouldbe.3.OpenwoundcareShouldbeperformeddebridementunderanesthesia.Multipletraumatotheorderofthesurgicaltreatmentisusuallythechest,abdomen,headandneck,andgenitourinarytract,fractureandsofttissue.(1)debridementofcare:①Obtaininglocal:②keepthedressingclean,legdriveup,properlyfixed,remoalofdrainagematerial,treatmentintime.③observethewoundinfectionsymptomssuchaspain,rednessandswellingthermalpain.(3)toguidefunctionexercise.（2）Denominatedinthebody:①observationofvitalsigns,complications.②theuseofantibioticsandTATtopreventinfection.④strengthenthesupporttherapy,suchasdietaryguidance,bloodtransfusion,infusion,albumininfusion,bloodplasma,toprovidehealingcondition.⑤symptomatictreatment,suchascooling,thepain.4.Tonursingcomplications:(1)thewoundbleeding.(2)infection.(3)crushsyndrome.5.PsychologicalcareRelativestothewounded,thespiritualandpsychologicalsupportisveryimportant.Onmayneedsurgeryorpredictthedeathwillhappentheinjured,shouldbetospiritualsupport.TheinjuredintotheoperatingroomorICUguardianship,shouldbeaccompaniedbythewoundedandprovidecompletewrittenrecords,includingtalkingwithfamilymembersandtheyknowtheinformationaboutit.Ifnecessary,thepatient'sclothesandvaluablesforsafekeeping,wanttohavetwoormorepersonstosigncertificatesofdeposit.Itemsmaybeassociatedwithillegalcrimeshouldbeproperlykeptandrecord.6.Healtheducation（1）psychologicalguidancetopatientsafteradmissionshouldbepassiontoserve,tohelpthepatientandfamilytounderstandthehospitalenvironment,personnel,system,andintroducestheillnessandtreatment.Toadapttolifeinthehospitalassoonaspossible,thepatientasenseofsecurityandtrust.Traumaemergencycases,shouldbesimpleandclearintroductiontotheoperationandtreatmentprocedures,methodsandmattersneedingattentionappropriatelysolvethepatientorfamilyproblems,inordertoeliminatethepatient'sanxietyandfear.Reducetheriskofpost-traumatictoleranceability,inordertocooperatewithtreatment.Instagesoftraumacarehealtheducation,understandtheetiology,developmentandtreatmentmeasures,precautionsbeforeandafteroperationandpreventionknowledge,improvethepsychologytobearability,strengthenthebody'sresistanceability,canpromotewoundhealing.（2）preoperativefasting,thewater,postoperativedietarychangesgradually,accordingtotheneedofillnessandrecovery.（3）theemergencysurgerypatientswithpreoperativechurchdeepbreathingexercise,cough,turnovermovement,bodymovement,preventthepostoperativecomplications.（4）introducevariouspostoperativedrainagetubeplacementposition,howtoprotecttopreventslippage,changeintime,andotherconsiderations.Mayreducethewoundpainandpromotewoundhealing.（5）dischargeguidance,strengthenthefunctionalexerciseinjuriesorgan,encouragingpatientstoactivelyparticipateinthefamilyandthesocietyofjie.Especiallyaftertraumadisablepatientsmorespecificguidance,eliminatetheinferioritycomplex,mentalityhealthintoanormallife.Regularfamilyfollow-upwhennecessary,formulatespecificprogramsandfiles.

創(chuàng)傷護理的標準操作規(guī)程一．目的讓病人恢復健康,避免毀容或功能障礙等后遺癥,防止感染擴散給其他病人。二．范圍對因機械因素加于人體所造成的組織或器官的破壞的人的護理三．內容接近清潔傷口，使其達到一期愈合的一種手術。1.一般創(chuàng)傷護理

（1）包扎傷口：顱腦、胸部、腹部等處的傷口應用無菌敷料或干凈布料包扎，應注意加壓包扎軟化的胸壁、保護脫出的腹內臟器等。肢體出血應用加壓包扎法止血。止血帶只能作為最后手段使用，并應記錄時間，每小時開放一次。（2）有效固定：肢體骨折或脫位可用夾板（或代用品），或用健肢（或軀體）以中立位固定。固定后，應測試遠端脈搏，若血運不良應予調整并記錄。疑有頸椎骨折須用頸托固定。嚴重污染的開放性骨折，可保持在受傷位置包扎固定。妥善、及時的固定能減輕疼痛，避免加重創(chuàng)傷和出血，宜于轉送。適當的體位和制動：一般應平臥，體位變化宜緩慢，防止體位性低血壓。采取的體位應利于呼吸和靜脈回流。傷處應用夾板、支架或石膏制動。（3）預防感染：選用抗生素，開放性創(chuàng)傷應予破傷風預防注射。（4）禁飲食者：若有胃潴留或疑有急性胃擴張，應置鼻胃管減壓。（5）維持體液平衡和營養(yǎng)：根據病情和血生化隨時調整輸液，嚴重創(chuàng)傷只要腸道有功能，盡量經腸內營養(yǎng)，維持組織、器官的基本功能，且不宜過量。（6）鎮(zhèn)靜止痛：觀察期應慎用。已確診或準備急癥手術者可在監(jiān)視下給麻醉止痛劑。多發(fā)性創(chuàng)傷和循環(huán)功能不穩(wěn)定時，一般不給止痛劑，特別是高危病人。

2.閉合性創(chuàng)傷護理（1）一般軟組織挫傷：早期冷敷，24h后可熱敷或理療，局部可用消炎止痛劑外敷。（2）閉合性骨折、脫位：麻醉下手法復位并外固定，或施行手術。（3）胸腹腔閉合性創(chuàng)傷：大多需施行急癥手術，以止血、切除或修復臟器并施行引流。（4）顱腦傷、頭面?zhèn)葢邢鄳委煛?.開放性創(chuàng)傷護理應在麻醉下施行清創(chuàng)術。多發(fā)性創(chuàng)傷需手術處理的次序通常是胸部、腹部、頭頸部、泌尿生殖道、骨折及軟組織。清創(chuàng)后的護理：（1）局部：①保持敷料的清潔，傷肢抬高，適當固定，按時拔除引