小儿麻醉安全和术前评估左云霞 ppt课件.ppt

麻醉安全几小点 * 人性化一点 * 准备好一点 * 多监测一点 监测多一点 * 固定牢一点 监测仔细一点 * 麻醉技术要多掌握一点 * 转运病人小心一点 * 可视化技术多学一点 * 可视化技术多学一点 * 1.45Kg 早产儿 可视化技术多学一点 * 床旁超声引导术中穿刺活检 可视化技术多学一点 * 祝大家运气好一点！！！ * * 小儿麻醉相关死亡的主要原因37%与麻醉药物使用有关，32%是心血管方面的原因，仅有20%与呼吸道的并发症有关。而死亡患儿中，全身情况很好，ASA 1-2级的患儿占33%。这些患儿的死亡多与麻醉药物相关。麻醉药物中氟烷和阿片类药物为罪魁。 This study includes cases submitted by enrolled institutions in 1998–2004. During this time, an average of 68 9 (range, 58–79) institutions was enrolled each year in the POCA registry. Seventy-two percent of these institutions were university-affiliated hospitals, 16% community hospitals, 4% government or military hospitals, and 9% other. cardiac arrest (defined as the administration of chest compressions or as death) that occurred in children 18 yr or younger during administration of, or immediate recovery from, anesthesia. Neonatal resuscitations and resuscitations in the pediatric intensive care unit or on the ward were excluded. * Nearly 80 North American institutions that provide anesthesia for children voluntarily enrolled in the Pediatric Perioperative Cardiac Arrest Registry. A standardized data form for each perioperative cardiac arrest in children 18 yr of age was submitted anonymously. We analyzed causes of anesthesia-related cardiac arrests and related factors in 1998–2004. From 1998 to 2004, 193 arrests (49%) were related to anesthesia. Medication-related arrests accounted for 18% of all arrests, compared with 37% from 1994 to 1997 (P 0.05). Cardiovascular causes of cardiac arrest were the most common (41% of all arrests), with hypovolemia from blood loss and hyperkalemia from transfusion of stored blood the most common identifiable cardiovascular causes. Among respiratory causes of arrest (27%), airway obstruction from laryngospasm was the most common cause. Vascular injury incurred during placement of central venous catheters was the most common equipment-related cause of arrest. The cause of arrest varied by phase of anesthesia care (P 0.01). Cardiovascular and resp