美国医师协会压疮指南课件.ppt

Pressure Ulcers CPG Treatment压疮治疗 Preventive Measures预防措施 Assuring adequate Nutrition and Hydration 保证营养和水分 Watch for anorexia in patients with a sudden change in intake对于食欲缺乏的病人要改变营养摄入方式 Undernourished patients – caloric/protein/hydration targets:营养不足的病人——热量、蛋白质、补水作用的目标： 30-35 calories/kg/day 1-1.5 g/kg/day protein 30 ml/kg/day fluid Except for a daily multivitamin, other vitamin and mineral supplements are not needed unless deficiencies are confirmed 除了日常补充多种维生素之外，其他的维生素和矿物质是不需要额外补充的，除非是临床证实需要补充的。 Pressure Ulcers CPG Treatment压疮治疗 Preventive Measures – A Step Wise Approach to Nutritional Intervention in Patients with Wounds预防措施——对于有压疮伤口的病人选用营养干预是一个明智的方法 Level 1 – Approximately within first week after wound onset第一阶段——大约在伤口开始后的第一周内 Level 2 – Following completion of Level 1 assessment第一阶段治疗后进行第二阶段治疗 Level 3 – Approximately within 2 weeks of implementing Level 2第二阶段治疗后两周内进行第三阶段的治疗. Source: AMDA Pressure Ulcer Therapy Companion – Clinical Practice Guideline Pressure Ulcers CPG Treatment压疮治疗 Wound Care伤口护理 Principles of wound dressings:伤口敷裹的原则： Protect wound bed from further trauma, contamination or drying避免伤口创面进一步的受到创伤或者污染或者过于干燥 Promote removal of necrotic tissue and exudate加速坏死组织和渗出物的移除 Provide a moist healing environment supportive of regeneration and growth of granulation tissue. 提供湿润的愈合环境来利于恢复和肉芽组织生长 Wound characteristics change as the wound evolves.随着伤口的发展，伤口的特性不断发生改变。 Tailor dressings primarily to wound characteristics, not wound stage选择适应伤口特性的敷料，而不是适应伤口的阶段。 Pressure Ulcers CPG Treatment压疮治疗 Wound Care Teams – Possible Roles合理的角色——伤口护理团队 Help guide care by staying abreast of developments in the field利用该领域的发展结果来帮助指导护理工作 Evaluate new products for formulary评估规定的新产品 Provide consultation for difficult wounds提供不同类型伤口的咨询 Help select appropriate support surfaces for complex patients帮助病人选择适当的支撑装置 Train new staff训练新的医护人员 Provide continuing education for existing staff提供目前医护人员的持续教育 Perform wound care执行伤口护理 Pressure Ulcers CPG Treatment压疮治疗 Wound C