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类型婴儿心肺复苏、抢救台、Apgar评分计时.doc

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    婴儿心肺复苏、抢救台、Apgar评分计时.doc
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    1、FXQ4 型辐射式新生儿抢救台的使用1、接通外接电源,打开控温电源。此时,温度显示窗的温度显示为抢救台面的温度。2、根据临床需要,设定所需温度(一般设为 30-34,年龄越小,设定温度越高) 。左手手指按住设定显示开关,同时右手旋转调节旋钮,观察温度显示窗的温度值,达到所需值,停止调节。若检查设定值,按住显示开关,读取温度显示值即可。3、用手背小心接近加热元件逐一感觉是否有热量发出,以确定加热器工作。4、当温度加热接近设定值时,加热指示灯和恒温指示灯不断翻转,达到恒温时,恒温指示灯(黄灯)亮。超温时,红灯亮。5、达到恒温,将患儿抱到抢救台上,开始护理操作。The Application of

    2、FXQ4 Neonate Rescue Bed1. Connect the power, and then open the machine. The temperature of rescue bed surface will be showed on the screen.2. Based on the clinic need, set the temperature that we need. (Usually, we set the temperature between 30-34. The infant is younger, the temperature is higher.)

    3、 The finger of left hand presses the setting button; the right hand turns the regulating button at the same time. Observe the temperature on the screen. When it reaches the temperature that we need, stop setting. If you would like to read the setting temperature, please press the setting button.3.Ca

    4、refully near the heating light by the back of hand, and feel the heat. Make sure that the heating light works.4. When the temperature is close to the setting temperature, the heating indicator lamp and the constant temperature indicator lamp begin to flash alternatively. When the temperature reaches

    5、 the constant temperature, the constant temperature indicator lamp (yellow lamp) will be on. When the temperature is over the setting number, the red lamp will be on.5. When the temperature reaches the constant temperature, put the ill infant on the rescue bed, begin to do nursing operation.Apgar 评分

    6、计时操作1、打开计时电源开关。2、启动计时按钮,计时窗显示秒数计时。50s 至 1min,4min50s 至 5min 和9min50s 至 10min 有声光提示。3、消除声光按消音键即可。4、计时结束时再次按下计时按钮。The Application of Apgar Timekeeper1. Turn on the switch of Apgar timekeeper.2. Press the time button, and then computer begins to calculate time from 1 second. The time will be showed on

    7、the screen. The sound and light will be out from 50s to 1min, 4min50s to 5min, and 9min50s to 10min respectively.3. If eliminate the sound and light, please press the “stop” button.4. Finished nursing operation, press the time button again.临床上根据出生后 1 分钟的 Apgar 评分将新生儿分为正常儿和窒息儿。窒息儿又分为轻、重两度。Apgar 评分 8-

    8、10 分为正常,4-7 分为轻度(青紫)窒息,0-3 分为重度(苍白)窒息。对窒息儿经即刻处理后必须于出生后 5 分钟给予再评分,如 5 分钟后评分仍低于 6 分者,则影响神经系统可能性大,预后较差。新生儿心肺复苏(KAF/CPR150 型婴儿心肺复苏模拟人)1、连接电源,打开电脑显示器上的电源开关。2、按频率键,选择工作频率 120 次/分。3、按开始键,放下床栏,开始操作。4、将患儿抱到抢救台上,取仰卧位。5、判断意识。拍打或弹足底,观察反应。触肱动脉,听呼吸音,感觉有无气体逸出,观察胸廓起伏,听心音,检查有无头颈外伤。6、呼救。7、 通畅气道。肩部垫高 2-2.5cm,右手食指托起患儿下

    9、颌,左手扶住患儿额头,避免头过度后仰(下颌角与耳垂连线与地面垂直) 。清除口、鼻、咽及气道分泌物。8、放置纱布在患儿口鼻。9、人工呼吸。对准患儿口鼻吹气,直到患儿胸部稍膨隆起,停止吹气(年长儿,捏住鼻孔,口对口吹气;牙关紧闭者采用口对鼻孔吹气) 。吹气与排气的时间比为 1:2。吹入潮量为 30-50 毫升。 (正确吹气量绿灯显示;吹气量过大黄灯显示;错误吹气太快,在 0.27 秒时间内吹入潮气量大于或等于 30 毫升,红灯显示)10、双手环抱婴儿胸部,将第 2-5 指并拢置于背部,双手大拇指置于胸骨体下1/3(婴儿胸部两乳头连线与胸骨正中线交界点下一横指) ,双手大拇指相对或交叠,然后用双手拇

    10、指与其余 4 指同时按压。按压深度为 1.5-2 厘米。 (按压正确绿灯显示;按压位置错误红灯显示;按压深度错误黄灯显示)11、通气:按压=1:3。12、5 个 CPR 周期,以吹气结束,观察呼吸,查大动脉搏动。抢救成功可以摸到肱动脉波动。根据患儿情况转入进一步生命支持。Neonate CPR (Cardiopulmonary resuscitation)1. Connect power. Turn on the switch of the computer.2. Press the rating button, and choose the rate of work: 120 times p

    11、er min.3. Press “on” button. Put down the bed rails, begin to operate.4. Put the ill neonate on a rescue bed. Make supine position.5. Judge consciousness. Beat footplate, and observe response. Touch the beat of arteria brachialis, listen to the sound of breath, feel the air out or not, observe fluct

    12、uation of thoracic cage, listen to the beat of heart, and examine if there are traumas on head and neck.6. Ask for help.7. Open airway. Raise shoulder 2-2.5cm by a big towel. Hold the submaxilla by the index finger of right hand, put the left hand on the ill infants forehead, and make the line betwe

    13、en the angle of submaxilla and ear lobe be vertical with the ground. Eliminate secretion in mouth, nose, throat, and airway.8. Put a piece of a gauze on the mouth and nose.9. Breathing. Blow 1 time to the mouth and nose. Stop blowing until the chest is expanded. 10. Circulation. Compression mode: En

    14、circling the chest of neonate with two hands and compressing with the two apposed thumbs.Compression position: in the lower 1/3 of midsternum (1 fingerwidth below the nipple line).Compression depth: 1.5-2.0cmRate of compression: 120 times per min.11. Breathing : compression=1:312. After every 5 cycl

    15、es, blow air, and then observe breath and the beat of the big artery. If the rescue succeeds, can be touched the beat of arteria brachialis. Based on the situation of neonate, provide advanced life support. 心肺复苏成功的标志:1、扪到颈、肱、股动脉的跳动,测得血压60mmHg(8kPa);2、听到心音、心率失常转为窦性心律;3、瞳孔收缩为组织灌流量和氧供给量足够的最早指征;4、口唇甲床颜色

    16、转红。成年人 儿童 婴儿 新生儿按压位置 乳头连线与胸骨交界处,即胸骨中、 胸骨体下 1/3 下 1/3 处(剑突上 2 横指) (双乳头连线下 1 横指)按压频率 100 次/分 100 次/ 分 100-120 次/分 120 次/ 分 按压深度 3.8-5cm 2.5-3.8cm 1.3-2.5cm 1.5-2.0cm按压方式 双手交叠掌跟 单手掌跟按压 2-3 个手指按压 双手环抱胸部,大按压 拇指相对或交叠按压(或中指和环指按压) 按压与通 单人 30:2 30:2 30:2 3:1气比 双人 30:2 15:2 15:2 3:1心电图成一直线,CPR 抢救要达到 1/2 小时。先按压还是先吹气要根据病情:若是由于呼吸道窒息引起要先开放气道,吹气,若是由于心脏骤停引起要先按压效果好。除颤的应用时机:1、对 1 岁以上小儿推荐使用 AED2、尚未证实 1 岁以下婴儿使用 AED 的利弊 3、目击突发意识丧失的儿童,若现场有 AED,应尽快使用 4、院外发生又未被目击的心脏骤停儿童,应在实施 5 个周期 CPR 后使用 AED

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