Papers Category:Medicine Papers
- Clinical Medicine Papers
Post Time:2013/4/16 8:45:00
PRC on Occupational Disease Prevention Law >> purposes on May 1, 2002, which is a major event in China's legal construction.
<< Occupational Disease Prevention Law of the People's Republic of China >> based on prevention, control and elimination of occupational diseases harm as a direct purpose, but its far-reaching significance far greater than the prevention and control of occupational diseases in my mine focus on the performance of the occupational pneumoconiosis prevention and treatment of pneumoconiosis for long-term inhalation of carbon dioxide or other dust due to dust long-term stay in the bronchioles and alveolar , even though the patient from the powder workplace lesions will continue to develop. dust Yue patients with chest tightness, shortness of breath, cough, sputum, easily combined with respiratory and lung infections. incapacitated, even cause pulmonary heart disease due to respiratory failure and endanger Download Life papers. A person can not be normal is what it's like? Dust of our more than 100 million patients and suspected patients are enduring this torment .
2006 11,519 cases of various types of occupational diseases diagnosed, experts estimate that accounts for about 10% of the actual cases, more than 100 million orchid lung disease patients and suspected patients, practitioners accounted for more than 46% of the coal industry. experts said China Disease Prevention and Control Center reported occupational diseases may not fully reflect the actual situation of occupational diseases, because the number of reported cases of occupational disease diagnosis statistics provide occupational health record are patients, while China's current occupational health care coverage to about 10%, experts estimate that the number of years of the total incidence of occupational diseases in the future will continue an upward trend!
The of my hospital silicosis District was established in October 2004, provides a good opportunity for the nearest treatment of mine silicosis silicosis in our hospital per year, nearly 300 people, the average age of the red in 68 years, as people's living raise the level of human life are constantly extend Once the disease like of these elderly silicosis people will be accompanied by a variety of complications, increasing the difficulty of treatment and care, which requires us to be carefully observed in normal work, conscientiously sum up now silicosis care focus, based on the accumulation of work experience in the past few years and access to relevant information in the literature are presented below.
1 silicosis common complications and related care
1.1 chronic bronchitis
Silicosis patients initially come to the hospital with symptoms of chronic bronchitis treatment, chronic cough slightly color foamy sputum, shortness of breath, and every year the weather is cold symptoms get worse, non-low heat without hemoptysis significantly with the progression of asthma, breathing difficulties, X-ray showed silicosis peculiar change: punctate nodular change to the lining of the lungs disorders, rough, bronchial lesions.
To observe the nature of the cough, appear time and rhythm, observed the nature of the sputum, coloring, odor, and amount of, and sacrificing the right sputum samples to send to the laboratory testing. To encourage effective patient breathing and expectoration methods, first 5-6 times take a deep breath, hold one's breath at the end of inspiration followed by cough, mucus discharge, inability expectoration supplemented chest percussion vibration airway to assist mucus discharge from the bronchial wall, viscous sputum Take phlegm drugs or using ultrasonic atomizing inhalation mucus thin and easy to cough up. while to take the postural drainage measures expectoration. Such diseases are the most important infection control, should be in accordance with the doctor's advice category for pathogens and drug sensitivity reasonable use antibiotics and close observation of the patient's body temperature and changes in condition, listen to the patient's chief complaint.
1.2 obstructive emphysema infection
Dust deposited in the alveoli and small bronchi to blocking normal gas exchange, macrophage phagocytosis dust to form a fiber-like changes, emphysema the stoves, airway secretions excretion barrier pathogens series lungs tissue infections, the symptoms worse fever, chest pain, the slightly yellow sputum, X-ray shows: lung lower lobe patchy change was stripes changes. silicosis defense function and low immunity, such as do not pay attention to keep warm, easy caused by a cold lung infections, especially when the seasons change, when the drama cough or excessive force, often due to the occurrence of spontaneous pneumothorax bullae rupture. patients with spontaneous pneumothorax mostly mental stress, anxiety, fear, and therefore of great significance to strengthen psychological care. nurses good patience interpretation should be given to the patient, explain the method and purpose of closed thoracic drainage, to establish the confidence to overcome the disease. Patients were semi-recumbent, minimize activities. continuous low flow oxygen 1-2 liters / min keep the airway open. difficult expectoration of eloquence to pay attention to maintain smooth closed thoracic drainage, to strictly prevent catheter shedding, distortion, compression and obstruction. observe and record the amount of drainage bottle of liquid, coloring, daily replacement of drainage bottles and non- bacteria saline replacement attention to aseptic technique to prevent infection.
1.3 chronic pulmonary heart disease
Silicosis, chronic bronchitis, recurrent obstructive emphysema infection eventually lead to pulmonary congestion and pulmonary circulation hampered involving the cardiovascular system caused by cardiac function and structural changes caused by right ventricular hypertrophy, expanding right heart failure patients with limited indoor activities, sitting breathing, increased liver, lower extremity edema, X-ray showed: cardiac enlargement, ECG showed lung-type P-wave, ST segment changes, arrhythmia.
Pneumoconiosis with pulmonary heart disease, chest tightness, shortness of breath, difficulty breathing, sometimes activities palpitations, cyanosis. Arrangements to pay attention to in nursing patients with rest, activity restriction, to avoid fatigue, heart failure should be absolute bed rest, dyspnea take semi-recumbent or sitting position to keep the airway open, actively participate in the elimination of respiratory secretions. appropriate amount given expectorant agent, timely suction severe coma. records of intake, urine output, water intake, maintain unobstructed urine .
1.4 tuberculosis The growing number of silicosis and tuberculosis This of silicosis unique pathological changes.
Sometimes difficult to discern in the chest on the selenium nodules or lesions of tuberculosis patients with bloody sputum, fever, tuberculosis poisoning symptoms and X-ray showed : pneumonia and pulmonary leaf punctate density enhancements like changes, and some appear tuberculosis ball and hole-like changes, pleural thickening, exudative pleurisy change.
Such patients should pay attention to the nature of the cough and expectoration if patients first have to go to sleep and then suddenly sat up, suddenly feel suffocated in sleep arousal should be alert to whether paroxysmal nocturnal dyspnea. Patient complained: throat itchy mouth with smell, chest rhyme hot, chest tightness or blood stained sputum or blood with cough cough up the color red foamy. should be considered a small amount of hemoptysis Once large hemoptysis in patients with pulmonary coarse blisters, some bleeding can be spread to the contralateral, when both sides can be heard moist rales. should race against time to prevent massive hemoptysis caused suffocation in rescue, correctly placed in the patient position, take the patient semi-recumbent most secure, easy bleeding drainage to keep the airway protect the contralateral lung function. closely observe discover asphyxia early signs, such as sudden hemoptysis hemoptysis process stops, chest tightness, restlessness, cyanosis of lips, difficulty breathing, and even coma, incontinence and other prompts patients suffocation, quickly patients set off the Trendelenburg posture, pat the back in order to facilitate the lungs and blood drainage, such as postural drainage invalid quickly coarse-off to be inserted through the mouth or nose throat, while attracting the edge of the clearing and blood stimulate the throat once leads to reflection spit The prepared block to get rid of suffocation during postural drainage to a large number of high-speed oxygen flow 3-4 liters / min to improve tissue hypoxia. Links to free papers Download Center http://eng.hi138.com
2 careful observation of the patient's condition, good psychological care silicosis more than half take care of the obvious symptoms of daytime condition balance, night shift easily negligence. Nurses to overcome day and night shifts caused by the own biological clock disorders enhance nighttime patrol, careful observation of the disease. 14:00 still can not sleep the patients to be carefully asked, understanding not fall asleep the reasons and what does not apply to the main complaint, found potential care problems, in a timely manner to take measures, good psychological care to eliminate potential psychological barriers. condition gradually worsened and delayed healing of patients may have anxiety, loneliness and even despair emotional, easily stimulated, concerns about the health care workers do not attach importance to the severity of their illnesses. nurses to do the operation fast, accurate, light, speech cordial and calm, gently its Cahan, rubbing the arm to spread the patient's attention, to meet the psychological needs it emotionally stable.
Observe cough, expectoration circumstances, the amount of sputum color, traits to prompt disease outcome as slightly large number of yellow sputum gold creeping fungus infection, slightly yellow-green sputum Pseudomonas aeruginosa infection, bloody sputum or the hemoptysis prompt a serious infection and the presence of fibrocavitary erosion of the capillaries and large blood vessels, while large number of Nongtan suddenly reducing difficult to spit fever and systemic symptoms aggravated prompt disease changes, sputum formed in the small bronchi embolism accumulation endotracheal increased airway resistance. patients indifferent expression, trance, headache, multilingual character abnormal blood gas analysis of oxygen partial pressure is less than 60mmhg carbon dioxide partial pressure greater than 50 mm Hg, and more tips respiratory failure, pulmonary encephalopathy.
3 attentive care, prevention of repeat infection and respiratory tract infection patient contact, to prevent cross-infection and strengthen the management of the ward. Timing windows open for ventilation, ultraviolet disinfection, 1-2 times a week, the surface ground daily with disinfectant exploration wipe. Oxygen the device regularly disinfected, The humidifier bottle changed daily immersion disinfection use disposable oxygen tube, weekly change at least once. shall hypoxia in patients given continuous low flow oxygen patients and their families propaganda taught with oxygen purpose and how security use of oxygen, and timely monitoring of oxygen saturation, hypoxia improve the situation. bedridden patients to strengthen basic care, regular turning massage pressure at the skin, keeping the skin clean and dry, and the prevention of the occurrence of bedsores. giving oral care to maintain oral hygiene prevention of infection. accurate records of intake, close observation of changes in the characteristics of life, and make a record, found unusual and timely reporting physician speedy processing.
When the silicosis people sticky sputum difficult to spit, often given ultrasonic atomizing inhalation therapy, airway used to wet, easy to spit the sputum becomes thin, can also promote inflammation absorption but also has a small part in clinical use poor lung function silicosis, people should not do inhalation therapy, even with a very small amount of fog can also cause oppressed heavier cyanotic lips increased hypoxia in the various treatment and care should be given to observe the efficacy and adverse reaction, and timely feedback to give appropriate treatment.
Diet and daily life care according to the patient's basal metabolic rate and nutritional status nutritional supplement diet based Shaoliangduocan. Pneumoconiosis stomach motor function disorders, spleen appetizer should choose nutritious easily absorbed diet such as lean meat, eggs, milk, soy flour, fresh vegetables and fruits. Jifu cold and greasy food. limit sodium intake in patients with pulmonary heart disease, such as a large number of diuretic to sweating Laojing sharp supplemental salts to maintain water and electrolyte balance.
Pneumoconiosis should pay particular attention to climate change, changes in clothing and exercise tolerance to cold from the beginning of summer, the first face, with cold water soaked towel wrung by hand, rub the head and face, and limbs gradually good physique, tolerance and strong can a large area of the body cold water friction continued until September, after continue to face and neck with cold water friction, minimum winter should wash in cold water nose to improve the ability to cold, to prevent and reduce the onset of this disease should avoid dust and coal smoke on respiratory tract irritation, smoking habits should be to persuade its smoking cessation.
5 rehabilitation silicosis hospitalized longer period, it is necessary to carry out the rehabilitation training how to abdominal breathing, effective coughing exercises to do breathing gymnastics, walking, playing chronic tai chi and other activities. To promote diaphragmatic activity through training, improve lung function improve anti infection.
6 summarizes silicosis as an occupational disease, mainly due to the work environment caused the face of these disease, we should be patient with them, care about their lives, and listen to their life, listen to them, a careful analysis, timely solve the problem. rounds late at night, early detection of potential problems and prevent complications. efforts to create one to make them feel at ease and comfortable hospital environment, and improve quality of life and prolong life.
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