《急危重症的监护》ppt课件

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1、急危重症的监护IntensiveCare/CriticalCare方向韶中山大学附属第二医院急诊科1急危重症监护将危重患者、先进设备、掌握设备和技术的优秀医务人员同时集中于一体，充分发挥有经验和专业知识的医务人员的能力，也充分利用有限高级贵重设备，利用仪器、设备和技术方法，更加频繁进行快速有效的生命、器官检查或者连续监测，及必要的功能支持、加强的照料护理。目的是为迅速掌握患者病情及其变化情况，挽救患者生命和器官功能。2HistoryofCriticalCareCriticalcareevolvedfromanhistoricalrecognitiontha

2、ttheneedsofpatientswithacute,life-threateningillnessorinjurycouldbebettertreatediftheyweregroupedintospecificareasofthehospital.Nurseshavelongrecognizedthatverysickpatientsreceivemoreattentioniftheyarelocatednearthenursingstation.3HistoryofCriticalCareFlorenceNightingalewroteabout

3、theadvantagesofestablishingaseparateareaofthehospitalforpatientsrecoveringfromsurgery4In1927,thefirsthospitalpremature-borninfantcarecenterwasestablishedattheSarahMorrisHospitalinChicagoDuringWorldWarII,shockwardswereestablishedtoresuscitateandcareforsoldiersinjuredinbattleorunder

4、goingsurgeryThenursingshortage,whichfollowedWorldWarII,forcedthegroupingofpostoperativepatientsinrecoveryroomstoensureattentivecare5In1947-1948,thepolio(poliomyelitis)epidemicragedthroughEuropeandtheUnitedStates,resultinginabreakthroughinthetreatmentofpatientsdyingfromrespiratoryp

5、aralysis.Patientswithrespiratoryparalysisand/orsufferingfromacutecirculatoryfailurerequiredintensivenursingcareBjornAageIbsen(1915-2007)becameinvolvedinthepoliomyelitisoutbreakinDenmark;Patientsweremanagedin3special35bedareas;Inthisfashion,mortalitydeclinedfrom90%toaround25%.6Duri

6、ngthe1950s,thedevelopmentofmechanicalventilationledtotheorganizationofrespiratoryintensivecareunits(ICUs)inmanyEuropeanandAmericanhospitals.Createdin1958,JohnsHopkinsBayviewMedicalCenter becamethefirstmultidisciplinaryintensivecareunit(ICU)intheUnitedStates.7Bythelate1960s,mostUni

7、tedStateshospitalshadatleastoneICU.In1970,anorganizationcommittedtomeetingtheneedsofcriticalcarepatients:theSocietyofCriticalCareMedicine(SCCM).Between1990andthepresent,criticalcaresignificantlyreducedin-hospitaltimeaswellascostsincurredbypatientswithdiseasessuchascerebrovasculari

8、nsufficiencyandrespiratoryfailure