严重创伤病人的麻醉_.pptxVIP

严重创伤病人的麻醉;overview;Treatment principle to critically ill patients;Preoperative Assessment;1.ASA physical status classification system It is divided into 5 levels According to medical history, Physical examination and laboratory examination Level 1 and Level 2 :normal organ function Level 3: compensation, need sufficient preoperative preparation Level 4 decompensation, High mortality Level 5 dying ;2. Glasgow coma score scale（GCS） Indicators: Eye opening Spontaneous 4 To voice 3 To pain 2 None 1 Verbal response Oriented 5 Confused 4 Inappropriate words 3 Incomprehensible words 2 None 1 ; Motor responses Obeys Command 6 Localizes pain 5 Withdraws（pain） 4 Flexion（pain） 3 Extension（pain） 2 None 1 ; Injury classification Light : 13~15 Consciousness obstacle in 20min Medium: 9~12 Consciousness obstacle between 20min and 6h Severe: 3~8 Coma more than 6 hours or the second coma in 24h;3. Revised Trauma Score（RTS） Indicators：Systolic blood pressure ≥89mmHg 4 76～89mmHg 3 50～75mmHg 2 1～49mmHg 1 No pulse 0 Weight 0.7326 Respiratory rate 10～29/min 4 ＞29/min 3 6～9/min 2 1～5/min 1 None 0 Weight 0.2908; Glasgow Coma Scale 13～15 4 9～12 3 6～8 2 4～5 1 3 0 Weight 0.9368 Numeric range 0～7.84 SBP×wgt+RR×wgt+GCS×wgt=TS Lower Score m