重症医学资质培训知识-镇静镇痛.ppt

* * * * The Fine Balance in Patient Comfort: Undersedation When patients are undersedated, they will experience anxiety. Left untreated, anxiety may progress to agitation, which may lead to wound disruption and patient injury. In this state, patients are also at risk for a number of potential complications, including hypertension, tachycardia, arrhythmias, and myocardial ischemia. Shelly MP, Wang DY. The assessment of sedation: a look at current methods and possible techniques for the future. Br J Intensive Care. May/June 1992:195-203. * * Achieving Optimal Patient Comfort in the ICU One of the primary goals of caring for patients in the ICU is to achieve optimal patient comfort. The basis for patient comfort is adequate analgesia and adequate sedation. Sedation is divided into 3 primary components: anxiolysis, hypnosis, and amnesia. * * * The Fine Balance in Patient Comfort: Oversedation If a patient is oversedated, depersonalization may occur, wherein the patient is treated more like an object than a person. Oversedation may culminate in delayed emergence from the effects of medication and delayed weaning from the mechanical ventilator. These possibilities could expose the patient to pressure injury, venous stasis, and muscle atrophy. All of these factors have tremendous cost implications. Ultimately, the goal is to achieve a balance between undersedation and oversedation through regular assessment. ? Shelly MP, Wang DY. The assessment of sedation: a look at current methods and possible techniques for the future. Br J Intensive Care. May/June 1992:195-203. * The Fine Balance in Patient Comfort The challenge in achieving patient comfort is to find the right balance between undersedation and oversedation. * * * * * * * 重症医学专科资质培训·标准教材·2009 重症医学专科资质培训·标准教材·2009 * ICU中病人的镇静与镇痛 * 本章重点 基本概念简介（Slides 3 – 6) ICU中病人镇静与镇痛的必要性（Slides 7 – 12) ICU中病人与接受麻醉病人的区别(目的 环境 时间 合并治疗 PK/PD) （Slides 13 – 16) ICU中病人镇静程度的判断（Slides 17 – 19) ICU中病人镇静与镇痛的实施及不同药物的简单比较（Slides 20 – 24) 每日