普胸外科手術(shù)麻醉課件

DepartmentofThoracicSurgeryShanghaiChestHospital為誰上麻醉？為稻粱謀？為外科醫(yī)生？為麻醉學(xué)？為病人！Aug,201011/20/202411/20/2024麻醉前知難而退知難而進(jìn)知難而退Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024Aug,201011/20/202411/20/2024麻醉前Aug,201011/20/202411/20/2024麻醉中麻醉深度麻醉醫(yī)生？外科醫(yī)生？病人的情況！利己利人Aug,201011/20/202411/20/2024麻醉中麻醉深度指標(biāo)肌松程度神經(jīng)反射循環(huán)參數(shù)靶控Aug,201011/20/202411/20/2024麻醉中Aug,201011/20/202411/20/2024麻醉中Aug,201011/20/202411/20/2024麻醉中呼吸的控制保護(hù)性肺通氣策略：定壓通氣高頻率低容量CPAP（iNOS）氣管插管到位Aug,201011/20/202411/20/2024麻醉中循環(huán)的維持維持生命保護(hù)內(nèi)環(huán)境急性肺損傷！Aug,201011/20/202411/20/2024麻醉中Aug,201011/20/202411/20/2024麻醉中Aug,201011/20/202411/20/2024麻醉中Aug,201011/20/202411/20/2024麻醉中Aug,201011/20/202411/20/2024麻醉中需要多少監(jiān)護(hù)儀器？麻醉意外的最常見原因：人為因素儀器故障BrodskyJB,StanfordUniversity不是Lackofknowledge而是FailuretoapplyexistingknowledgeAug,201011/20/202411/20/2024麻醉中需要多少監(jiān)護(hù)儀器？Themorethebetter?Themoretheworse?分散注意力虛假安全感監(jiān)護(hù)監(jiān)護(hù)儀浪費(fèi)時(shí)間附加風(fēng)險(xiǎn)Aug,201011/20/202411/20/2024麻醉中需要多少監(jiān)護(hù)儀器？TheAustralianIncidentMonitoringStudy2000例麻醉意外監(jiān)護(hù)儀發(fā)現(xiàn)50%---半數(shù)不能依靠監(jiān)護(hù)儀！SpO227%CO224%ECG19%BP12%Circuitpressure8%其它<1%Aug,201011/20/202411/20/2024麻醉中觀察指標(biāo)基本生命體征！心律血壓呼吸體溫Aug,201011/20/202411/20/2024麻醉中觀察指標(biāo)必需的儀器設(shè)備：按順序聽診器血壓計(jì)指脈儀CO2管道壓力報(bào)警心電圖體溫計(jì)Aug,201011/20/202411/20/2024麻醉后復(fù)蘇藥物復(fù)蘇確認(rèn)生命體征喉保護(hù)Aug,201011/20/202411/20/2024ThanksforYour