Papers Category:Medicine Papers
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Severe acute respiratory syndrome (Severe Acute Respiratory Syn2drome, SARS, or atypical pneumonia) is a new respiratory disease. By SARS virus infection in the body may trigger a strong immune response, thereby causing damage to the lung tissue.
Cause fever, shortness of breath and other symptoms. In this paper, 219 cases of SARS patients a systematic clinical observation and care, are summarized below.
Clinical course characterized by a course of SARS, characterized by: (1) from the SARS fever symptoms to diagnosis time for 1 ~ 10 d, an average of 4. 8 d. (2) from diagnosis to the peak of 2 ~ 8 d, the average
4. 4 d. (3) peak 2 ~ 4 d, an average of 3 d. (4) improvement in a period of 10 d after the peak period, an average of 6 d. (5) The recovery for the better after the 10 d period, an average of 8 d.
Two main points Care
2.1 to enhance disinfection and isolation
SARS is now considered close droplets. However, coronavirus inanimate objects in the survival time of up to 24 h. This makes the surface of any object could become a mode of transmission. People may inadvertently be infected with environmental exposure. Shows the importance of disinfection and isolation.
2.1. 1 Air Disinfection
(1) must be 24 h ventilation windows to enhance ventilation.
(2) low ozone exposure to UV lamp, reflector reverse, every interval of 1 h exposure to 1 times. (3) The wards of the exhaust fan every 2 h to open 30 min.
2. 1.2 with the ground surface disinfection (1) surfaces containing chlorine 1000 mg * L - 1 cleaning disinfectants, as early as 7 am to 7 pm, every 4 h wipe a time.
(2) ground containing chlorine 1000 mg * L - 1 cleaning disinfectant, as early as 7 am to 7 pm, at intervals of 3 h wipe a time. (3) placed in the ward door mat, containing chlorine 2000 mg * L - 1 wet cleaning disinfectant, and to maintain its moisture.
2.1. 3 patient's requirements (1) the patient's room in disease, all treatment should be completed in the ward. (2) The patients should wear masks.
2. 1.4 patients to disinfect items (1) Where the patients have been in contact with the cloth, containing chlorine 1500 mg * L - 1 cleaning disinfectant soaking 30 min, sending laundry room.
(2) thermometer and blood pressure monitors, stethoscopes should be disinfected after each use, thermometer containing chlorine 1000 mg * L - 1 cleaning disinfectant soaking 30 min, the remaining disinfectant wipe with 75% ethanol.
2.2 Nursing fever
SARS patients in the first symptom of fever, body temperature from 37 ℃ ~ 42 ℃ , ranging from fever onset peak early to the disease duration is longer, intravenous methylprednisolone, and heat-clearing and detoxifying the body temperature can be reduced after treatment, but the some patients after stopping continued fever. In the care of drug at the same time cooling, pay attention to the physical cooling, the patient intravenous infusion at the same time, helping patients in drinking water.
2.3 Nursing shortness of breath
The patient consciously shortness of breath, hold your breath, the disease has entered the peak season. At this point in patients with hypoxia, leading to a series of physiological dysfunction and metabolic abnormalities.
Oxygen is an important means to correct the lack of oxygen. Patients should be encouraged to continue to oxygen, so that the patient's pulmonary hemodynamics and hypoxemia improved to reduce the incidence of respiratory failure, reducing symptoms of breathing difficulties. Increased difficulty in breathing in some patients, blood oxygen partial pressure, oxygen saturation was experiencing declines, you can use non-invasive ventilation ventilator treatment. Without tracheal intubation, only need to connect non-invasive ventilation mask pressurized oxygen, this method can alleviate the suffering of patients with endotracheal intubation, but also to achieve the purpose of raising the blood oxygen partial pressure.
Patients with the initial use of this ventilator may not meet the pressure of a strong airflow, often Zhai mask, got better not obvious. Nurses to patients should be promptly made it clear that the role of this machine, in which patients actively cooperate to reduce the incidence of respiratory failure and improve the cure rate.
2.4 Diet Care
A long period of SARS patients with fever, catabolism increased, its resistance decreased, especially in critically ill patients and disease in patients with more pronounced peak, has a direct impact on patient quality of life. The supply of various nutrients is very important. Patients should be based on the specific situation and to supplement the existing nutritional status. To note that both the patient's living habits and tastes of the demand and to ensure a balanced supply of nutrients.
2.5 to strengthen psychosocial support
SARS surprise attack and threatened human health, when humanity is not yet know and can not control its spread, it creates fear. In anxiety, fear, stress state, will also lead to digestive disorders. Most of the patients under 50 years old human populations. They are the backbone of the work, the family is the mainstay.
Sudden onset, they cause great psychological stress. In nursing, should be aimed at patients with different psychological, different cultural backgrounds, different social situations and different personality qualities, providing different levels of individual psychological care:
⑴ grasp the detailed patient history and current condition, psychological, family, social background and so on.
⑵ take the initiative to communicate with patients, for patients to solve practical problems and establish a good nurse-patient relationship.
⑶ to encourage patients to talk about their own ideas, to give an explanation and comfort.
⑷ to encourage patients to look at television, and from media to master the knowledge of the disease and enhance the confidence to overcome the disease.
⑸ need to get in touch with the patient's family to seek social support. Practice has proved that the media advocacy and social support to patients in times of crisis to re-understand the friendship and trust, understanding of the epidemic, the build up a healthy psychological defense, improve psychological immunity, in disease recovery played set off an important role. SARS is an emerging infectious disease. It is also a lack of a comprehensive human understanding.
Practical work, complete disinfection and isolation measures to cut off an important means of transmission, while the positive and effective patient care is a guarantee of recovery.