总结1例院外心搏骤停患者经公众互救—院前急救—院内救治成功出院的急救护理体会。针对患者猝死原因不明、病情危重、第一目击者无救援经验、需快速恢复生命体征、避免脑损伤和神经功能障碍等问题,采取成立远程救援小组,通过远程把控、统一指挥、分工协作,早期快速识别病情,最小化急救空白期,自主循环恢复后提供血流动力学监测与容量管理、多维度最佳目标体温管理、预防微循环障碍等措施。经过2 h的积极抢救和精细化护理,患者转急诊重症监护室继续治疗,16 d后顺利出院。出院后随访6个月,状态良好。
To summarize the emergency nursing experience of a patient with cardiac arrest who was successfully discharged from hospital after public aid-prehospital first aid-in-hospital treatment. Aiming at the problems of unknown causes of sudden death,critical condition,no rescue experience of the first witness,needs of rapid recovery of vital signs,avoidance of brain injury and neurological dysfunction,a remote rescue team was established and early and rapid identification of the disease was performed to minimize the first aid blank period through remote control,unified command,division of labor and cooperation. Hemodynamic monitoring and volume management,multi-dimensional optimal target body temperature management,prevention of microcirculation disorders and other measures were implemented after spontaneous circulation recovery. After 2 hours of active rescue and meticulous nursing,the patient was transferred to EICU for further treatment,and was discharged smoothly 16 days later. After 6 months of follow-up,the patient was in good condition.
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