镇静镇痛谵妄评估教程文件.pptVIP

ICU病人镇痛、镇静和谵妄的评估;Assessment of pain and analgesia;镇静和镇痛治疗潜在的缺陷 ;镇痛和镇静的必要性 ;镇痛评估;疼痛评估—语言评分法（verbal rating scale,VRS）;疼痛评估—数字评分法 (Numeric rating scale, NRS); 疼痛评估—面部表情评分法（Faces Pain Scale，FPS） ;Behavioral Pain Scale（BPS）;BPS ValidationSedated Mechanically Ventilated Patients;Critical Care Pain Observational Tool (CPOT);Critical Care Pain Observational Tool (CPOT);;Directives of use of the CPOT ;Critical Care Pain Observation Tool;CPOT和BPS在ICU中的应用;Correlating Pain Assessment with Analgesic Administration in the ICU ;评估疼痛 减少镇静/催眠药应用;评估疼痛 改善预后;镇静评估;Ramsay 评分;镇静和躁动评分 Sedation-Agitation Scale (SAS);Richmond躁动镇静评分Richmond Agitation-Sedation Scale (RASS) ;RASS实施方法;1;Sedation Scale Reliability;Correlating Sedation Assessment with Sedative Administration in the ICU ;SAT 失败;谵妄评估;Morandi A, et al. Intensive Care Med. 2008;34:1907-1915.;病人因素 年龄增加 嗜酒 男性 独居 吸烟 肾病;Overall definition of delirium: 临床特点 (1) 注意力不集中的意识障碍，伴有 (2) 认知功能急性改变 (i.e., 记忆缺失, 定向力障碍, 语言障碍和知觉紊乱) 而不能用已存在的、确诊或进展的痴呆所解释; (3) 短时间内(数小时或数天)发生障碍并随时间波动; (4) 有引起意识障碍的生理学改变的直接证据 ;Delirium and Clinical Outcomes;Subsyndromal Delirium and Clinical Outcomes;重症监护谵妄筛查检查表( the intensivecare delirium screening checklist，ICDSC (0～8 分));谵妄诊断：ICU病人意识错乱评估方法（CAM-ICU）;;精神状态的急性变化或波动 ● 精神状态较过去有急性变化吗？ OR ● 过去24h中病人有精神状态波动吗？;;CAM-ICU 应用示范;CAM-ICU 应用示范;CAM-ICU 应用示范;CAM-ICU 应用示范;谵妄诊断工具的可靠性;Curr Opin Crit Care 2011;17:000–000;Protocolized Intensive Care Unit Management of Analgesia, Sedation, and Delirium Improves Analgesia and Subsyndromal Delirium Rates ;;Differentiating Delirium from Dementia;小结;