严重创伤病人的麻醉是.pptVIP

严重创伤病人的麻醉;几个概念;Why should we learn trauma anesthesia?;In 1993, approximately 90,000 individuals in the U.S died of accidental injuries , for a rate of 34.9 deaths per 100, 000 population, the second lowest accidental death rate on record;In the same year there were an estimated 18,200,000 disabling accidental injuries, or about 2,080 injuries every hour, and the 90,000 accidental deaths amounted to 1 every 6 minutes---and these numbers excluded the rising level of intentional injuries caused by attempted or successful suicides and homicides; ;Potential roles of the anesthesiologist in this area;Pain relief physician Prohospital care physician Critical care transport physician or director Disaster planning consultant;病情评估;病情评估;Scoring system;ASA分级;GCS（Glasgow coma score);Eye opening;Verbal reponses;Motor response;创伤机制;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;严重创伤病人的病情特点;严重创伤病人的麻醉处理特点;术前准备;原则;程序（sequence of management of trauma patients);Primary survey(ascertain “ABCDEs”) Breathing (give supplemental oxygen) Determine whether ventilation is adequate Inspect chest to exclude open pneumothorax Auscultate for bilateral breath sounds Provide assisted ventilation for ventilatory failure Circulation (establish venous access) Check peripheral pulses, capillary refill, and blood pressure Obtain electrocardiogram Grade shock according to vital signs Correct hypovolemia and obtain blood samples;Primary survey(ascertain “ABCDEs”) Disability (determine neurologic status) Evaluate central function A: alert V: responds to vocal stimulus P: responds to painful stimulus U: unresponsive Evaluate pupil response to light Expose patient for complete examination Resuscitation phase Secondary survey Definitive care phase;气管插管术; 插管时应注意以下问题 ;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;插管时应注意以下问题;插管时应注意以下问题;插管时应注意以下问题;休克复苏——液体通道;休克复苏——液体通道;休