医学ppt孕妇创伤急救

《医学ppt孕妇创伤急救》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、Chapter19TraumainPregnancyTraumainPregnancy孕妇创伤Overview概要Dualgoalsinmanagingpregnanttrauma需要处理两个或以上的病人Physiologicalchangesofpregnancy孕妇生理改变Responsetohypovolemia对血溶积减少的反应Typesofinjuriesmostcommonlyassociated常见伤势Initialassessmentandmanagement初步检查及处理Traumapreventioninpregnancy预防孕妇创伤3T

2、raumainPregnancy-TraumainPregnancy孕妇创伤Uniquechallenges挑战Vulnerabilityofpregnanttraumapatient孕妇于创伤时之弱点Potentialinjuriestounbornchild对胎儿的伤害Dualroles双重角色Providecaretomother照顾母体Providecaretofetus照顾胎儿4TraumainPregnancy-FetalDevelopment7TraumainPregnancy-ViabilityAssessment8TraumainPregn

3、ancy-阴道出血肚脐耻骨联合流产可被见宫高PhysiologicChanges9TraumainPregnancy-肠蠕动血色素心输出量血量血压心率血含二氧化碳量PhysiologicChanges孕妇生理的改变Respiratorysystem呼吸系统Diaphragmelevatedduetouterinesize日渐长大的子宫令横隔膜上升Decreasedthoracicvolume肺容量下降Relativealkalosis血液相对为碱性Predisposedtohyperventilation较易出现呼吸过速10TraumainPregnancy

4、-VitalSignsinPregnancy孕妇生命表征的改变Donotmistakenormalvitalsignsforsignsofshock.切勿把正常的生命表征当作休克Normalpulse:10–15beatsfaster正常脉搏:快10-15次Bloodpressure:10–15mmHglower血压:低10=15mmHg30–35%bloodlossbeforesignificantbloodpressurechange失血量达30-35%才出现休克Bealerttoallsignsofshock.注意出现休克征状FrequentITLSO

5、ngoingExams反复ITLS”复检”捡查11TraumainPregnancy-ResponsetoHypovolemia血溶积减少的反应Vasoconstrictionandtachycardia血管收缩及心跳过速Reductionofuterinebloodflowby20–30%子宫血流量减少20-30%Fetalheartrateandbloodflowdecreases胎儿心跳速率及血流量下降Fetusbecomeshypoxemic胎儿出现血氧过低High-flowoxygenisessential.给予高浓度的氧气Maternalshoc

6、khas80%fetalmortalityrate孕妇出现休克,胎儿死亡率可达80%12TraumainPregnancy-TraumainPregnancyITLSPrimaryandSecondarySurveys初步检查及进一步检查OptimizematernalandfetaloutcomeHigh-flowoxygenrapidlyadministered尽快给予高浓度氧Fetalhypoxiaoccursbeforematernalhypoxia胎儿会比母体早缺氧Fluidadministrationmustbeprompt必需正确输液Fluid

7、volumeneededisgreater输液量较多FrequentOngoingExams反复ITLS”复检”捡查Mortalityoffetusrelatedtomaternaltreatment胎儿死亡率与母体处理有关13TraumainPregnancy-SupineHypotension仰卧血压低Venousreturndecreases30%insupinepositionwith20-weekorlargeruterus.下腔静脉于仰卧时受压引致心脏血液回流受阻,通常20周以后出现Acutehypotension急性血压低Syncope昏厥Fe

8、talbradycardia胎儿心跳过慢14Trau