Earthquake buried trauma care in patients with experience of 179 h.docVIP

 PAGE \* MERGEFORMAT 12 Earthquake buried trauma care in patients with experience of 179 h [Keywords:] earthquake; buried injury; nursing At 14:28 on May 12, 2008 8 earthquake occurred in Wenchuan County in Sichuan Province, we have successfully rescued was buried in the earthquake were 179 h in 1 case, now nursing are described below. 1 Clinical data Were male, 32 years old, married, people in Mianyang City of Sichuan Province, May 12, 2008 buried after the earthquake, no food water, buried in 179 h was successfully rescued in at 15:00 on May 20, 2008 airlifted arrived in the hospital. admission examination: body temperature 38.5 , pulse 134 / min, breathing 10 times / min, blood pressure 119/74 mm Hg, poor nutrition, suffering face, passive position. auxiliary examination, bedside ECG showed: (1) sinus tachycardia; (2) T wave changes. electrolytes: sodium 154 mmol / L; Cl 118.2 mmol / L; calcium 1.18 mmol / L, serum albumin lt;31.7 g / L. Results of urinalysis: specific gravity 1.010 (reference range 1.015 ~ 1.025). Diagnosis: (1) earthquake buried traumatic shock injury; (2) left forearm crush injury with avascular necrosis (gas gangrene); (3) multiple soft tissue injury with systemic infection of local necrosis; (4) sepsis; (5) traumatic multiple organ injury; (6) severe hypoproteinemia (serum albumin 30 2 Care 2.1 Nursing gas gangrene gas gangrene is Clostridium wound caused by a serious invasion of the specific infection, gas gangrene bacteria multiply in the wound of the muscle, resulting in a variety of enzymes and toxins, causing muscle glycogen fermentation produces gas, break down the protein production of hydrogen sulfide [1]. gas in the tissue space growing, local Splitting the wound like pain, progressive swelling [2]. The destruction of pathogenic bacteria produce toxins outside the organization, and a direct violation of the heart, liver and kidney focal necrosis occurred, leaving wounds, compound fractures, contusion or lacera