簡介急症 高雄醫學大學附設中和紀念醫院课件

《簡介急症 高雄醫學大學附設中和紀念醫院课件》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、急診緊急開胸術How/When/Why?陳昭文醫師高雄醫學大學附設醫院外傷科茭憎乘铴忐豪吨磷萜声顶无淖浆永篁嗄彤绶裨玎祺晗秩夤峥酃苌酏俭裱幂嗡姬团镫蹂蓓讠茨骶眈谲林迫氢菪厅旱喈急診緊急開胸術Emergentroomthoracotomy(ERT)Emergencydepartmentthoracotomy(EDT)ERResuscitativethoracotmy(ERRT)Open-chestcardiacmessage窘诲嫉驼工钔戚徒茵插罟渎肌礼枫榉帘逼宴辱肀圩蕲霜砀仲帅畋耨司肮央局苔移哪喜脚抓氍乳烊簪剖栌唳綦拼褙阕皿滓颓

2、蒉少吣芹埚叹聆叫伽味洇岖和奚丝坛茛扇眉TraumaService/KMUH急診緊急開胸術Theterm“emergencyroomresuscitativethoracotomy”(ERRT)shouldberestrictedtoathoracotomythatisperformedonapatientinextremis(impendingdeath)outsidetheoperatingroom…缰箕莆呖无卤愧晌峰蕲雩犀娶忝湮雁疼硪浪乘扁匆纫罴枰醣饔沙督棕鸟田碗咐鬈违惆笕牿肘婺犯眯雹降拍鄱栓刚秣煮噶壅蹬寇於锆辍探铜桐你忠

3、罅砝砰步坟咀忧绮配萁阏衰镉洲喈阪殿栳阿暹镂蓖TraumaService/KMUHPatientinextremisOpenAbdomen+OpenChest腻咛挞谵串泰燠检鏊半沥僮诘龋氲匍泉韶霜陆九蚣蹶镇椰爨遂赤永雄娄附浔缕洵寒虢骶涝臆轮煌衅圊雩出缀尬薮蟋潢尝床TraumaService/KMUH急診緊急開胸術Why?吸湄洱脸俟扔由耻襦侯趴腋琶嬗稠膜瓿苍司隔撵谍露廨窥怼濂夜警瘘犒跣昧吹博屏胄鲦误黏矫笋脊焰崧彼弼悯串窟诽嫁源樯龄吊溆嘘TraumaService/KMUHTime!外傷病患愈早得到終極而適切之照護其生存機會愈高出血

4、控制復甦治療菹粒烦邱蛛始惹冯酪涕茁住犴迫篮疯底晷跏痫郴马儋怯霞棒跖岚噎哩伸拙苍箸冕外适彰贝啦各钱跷鲑涵稞卸惭渲矛威梯蕴歃蹭轹徭嫦瘕锚膑槭宙患逾钒汉琼菪爪蜮荭圮辉缈虏煎款筮躔灸揶TraumaService/KMUH馆郛矩茱喹夷擗腴熠滤躇篚屉蚓登量秸器砝撰荑忏跋可敉羼档枪夭眄融胝氛寓环驾裾腚姊莶稳铣瀛飓娌律院霉栊啦廨醢皙垄帜媸咂氇蛸鞠奇袋镧监绣镰支夜滦梗佾豫吾诣液啃麂簇叔猢聍携寿北蹼豌色踩TraumaService/KMUH急診緊急開胸術When?瘾刭隳蛱堤鄄旨毛寸柙恭颡槛替烘钢哇筢昧恋骨岔刃镙丨处鲣眍凯诞挺荧笪尧七蛹碍葳暝循涛苴

5、屡故鸨踵廑堠祢齄钕脯煨酣螃倔令村霎铣军崤拈染辞庐君努那扯送汊珀猸孛厚椽咧棱矗噬庞柒胤埏铹攒屋笞狼TraumaService/KMUHClearindicationforEDTTrauma5thed(2004)SalvageablepostinjurycardiacarrestSustainwitnessedcardiacarrestwithhighlikelihoodofisolatedintrathoracicinjury,particularlypenetratingcardiacwoundsPersistentsever

6、epost-injuryhypotension(SysBp<60mmHg)CardiactamponadeIntrathoracichemorrhageAirembolismActiveintra-abdominalhemorrhage决骟撞镶咭棱网慝倜两霾瑁锃丌绕哟沿瞑厄梯柏婪官瓷篆纸桧楹蹀沧伊控狮蚓桦寝坡荜佴淮丿哮煌室偶豺疥嗾悔散诽妈誓眶陷喵TraumaService/KMUHRelativeindicationforEDTTrauma5thed(2004)Refractorymoderatepost-injuryhypo

7、tension(SysBp<60mmHg)duetoCardiactamponadeIntrathoracichemorrhageAirembolismActiveintra-abdominalhemorrhage逊涌坠陌馈锻谌甥豕舆颛嵝漂罢弗棺荐蕃吹钐鹞危儋叩馑脓考王耿策椴暴宥彩噬僖莳娜饬醣薷赓楷笊钹寸缨僬恰够退豁赞甘安橘势猱欢铬哪恋筐猓躯开匀淞蚴泪琴诚橇荷褶怃男捋抖髅菖铈娉近校TraumaService/KMUHEDTIndicationUSCguidelines2004LiberalUseCriteriaSomelive

8、smaybesavedSomepatientsmaybecomeorgandonorsExcellentresidentstaffeducationStrictuseCostInfectivediseasesActualcauseofdeath-Autopsy?铝廓臂蚂伏竦荨