Plateau Nursing of closed chest trauma.doc

 PAGE \* MERGEFORMAT 7 Plateau Nursing of closed chest trauma [Keywords:] Highland blunt chest trauma care Traffic accidents, falls, squeeze, etc. caused by blunt chest trauma is more common in the thoracic surgery clinic, may be associated with severe pulmonary contusion, induced ARDS, a higher mortality rate [1]. Our department from January 2008 to 3 months were treated within three months, 39 patients with chest trauma, treatment and care by well, except 1 patient died of severe brain trauma, the all cured. To sum up the experience of high altitude chest trauma nursing, nursing now described below. 1 Clinical data 39 cases of this group of patients, 28 males and 11 females, aged 17 to 56 years old. Traffic accident in 27 cases, 11 cases of falling, crush injury in 1 case. Hemopneumothorax multiple rib fracture in 9 cases, 15 combined abdominal organ injuries cases. simple pneumothorax associated lung injury in 12 cases, 7 cases of head injury, complicated by ARDS 6 patients. after active treatment and care, 1 patient died due to severe brain injury, the all cured, the cure rate of 97%. 2 Nursing 2.1 Application of ventilator injury appears serious respiratory dysfunction, causing hypoxemia, the general method can not correct the oxygen should be given to mechanical ventilation [2], the early application of tidal volume ventilator can guarantee to improve the oxygen concentration , flail chest with chest wall motion abnormalities, it can play the role of internal fixation [3]. in the plateau region, because of their low oxygen content, even if the normal oxygen saturation is low, but should actively use the breathing machine. Except under the condition of the respiratory parameters established targets, we used PEEP. proper PEEP can improve lung compliance, increased functional residual capacity, thereby improving arterial oxygen tension. but too much will produce barotrauma PEEP, PEEP Keep 5 ~ 10 cmH2O. Mechanical ventilation should be