分级和麻醉前准备PPT课件.pptVIP

ASA分级和麻醉前准备 ASA 总部网页上有关分级的描述： ASA Physical Status 1 - A normal healthy patient ASA Physical Status 2 - A patient with mild systemic disease ASA Physical Status 3 - A patient with severe systemic disease ASA Physical Status 4 - A patient with severe systemic disease that is a constant threat to life ASA Physical Status 5 - A moribund patient who is not expected to survive without the operation ASA Physical Status 6 - A declared brain-dead patient whose organs are being removed for donor purposes ASA Ⅰ ASA PS 1 Normal healthy patient No organic, physiologic, or psychiatric disturbance; excludes the very young and very old; healthy with good exercise tolerance ASA Ⅰ 正常健康 患者 没有器官的、生理上的病变以及精神障碍；有健康的体格，很好的运动耐受。不包括婴幼儿及高龄病员。 2个月 80岁 婴幼儿及高龄病员的年龄界定？ ASA Ⅱ ASA PS 2 Patients with mild systemic disease No functional limitations; has a well-controlled disease of one body system; controlled hypertension or diabetes without systemic effects, cigarette smoking without chronic obstructive pulmonary disease (COPD); mild obesity, pregnancy ASA 2 患者有轻度系 统疾病 2个月以内，或80岁以上无功能限制；某一系统疾病得到良好控制；高血压、糖尿病控制良好且无系统症状；抽烟但无COPD；轻度肥胖；妊娠 ASA Ⅲ ASA PS 3 Patients with severe systemic disease Some functional limitation; has a controlled disease of more than one body system or one major system; no immediate danger of death; controlled congestive heart failure (CHF), stable angina, old heart attack, poorly controlled hypertension, morbid obesity, chronic renal failure; bronchospastic disease with intermittent symptoms ASA 3 患者有 严重系 统疾病 有某些功能限制；一个以上系统疾病并得以控制；并未面临即时死亡威胁；充血性心衰得以控制，稳定型心绞痛，陈旧性心梗，高血压控制不良，病态肥胖，慢性肾衰，间歇症状的支气管痉挛性疾病 ASA Ⅵ ASA PS 6 A declared brain-dead patient who organs are being removed for donor purposes ASA 6 等着捐赠器官的脑死亡病员 麻醉前准备 麻醉科医师在任何地点实施任何麻醉(包括 局麻镇静监测)，都必须按一定顺序依次完 成所有麻醉前准备工作 。 麻醉机的准备 监护仪的准备 插管用具的准备 药品的准备 特殊耗材和设备的准备 麻醉机的准备 1、根据病人具体情况设定潮气量、每分通气 量、气道压报警上下限。 2、选定通气模式(容量控制或压力控制)，设定 潮气量或限压通气的压力限制(一般先为12- 14cmH2O)。 3、设定呼吸