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1、1Acute carbon monoxide poisoning in pre-hospital emergency care1 Materials and Methods 1.1 General Information January 2008 to December 2010, I treated 72 cases of acute carbon monoxide poisoning, 25 cases were male and female 47 cases; age from 4 to 76 years, an average of 32.4 years. Coal stove fo
2、r heating in 46 cases (63.9%, gas water heater shower poisoning in 10 cases (13.9%, gas stove improper use of poisoning in five cases (6.9%, suicide in four cases (5.6%, the scene of death in 7 cases (9.7% according to the degree of intoxication classification Standard: 17 cases of mild to moderate
3、in 28 cases, 27 cases, severe. 1.2-site first aid and care Immediately from the first aid environment, as soon as possible so that the poisoning scene with the outside ambient air circulation, poisoning patients quickly go to the fresh air and well-ventilated place, unlock the collar, to keep warm,
4、supine, head to side side to maintain airway patency, timely and clear vomit and secretions in the respiratory tract, to 2prevent the occasional lead to suffocation of the heart, respiratory arrest patients, immediate cardiopulmonary resuscitation. quickly to correct hypoxia, coma or irritability im
5、mediately unlock the collar, to clear the respiratory secretions in a timely manner to ensure that the airway Meanwhile, according to the condition of mild poisoning were given high-flow nasal cannula oxygen, severe poisoning, give oxygen mask, critically ill patients with tracheal intubation easy b
6、reathing bag or ventilator-assisted breathing. the rapid establishment of intravenous access, rescue medication in order to facilitate the intravenous injection, to gain time for successful treatment. effective drug treatment is the prevention and treatment of brain edema and improved cerebral tissu
7、e hypoxia, and effective measures to restore the function of brain cells. 2 to 4 hours after acute poisoning, cerebral edema, 24 to 48 is the development of brain edema peak hours, as soon as possible to protect brain function, active dewatering to reduce intracranial pressure is essential. should q
8、uickly enter the 20% mannitol 125ml + dexamethasone 10mg losers within 15 minutes, in order to reduce the intracranial 3pressure to reduce brain tissue damage. carbon monoxide poisoning, coma patients, naloxone drug to promote brain cell function recovery. irritability, convulsions by intravenous in
9、jection of diazepam 10mg, patient sedation, oxygen consumption in order to avoid too much to aggravate the condition. 1.3 transferred to the predictability of the way of complications nursing To prevent cerebral edema, and close observation of patients with or without vomiting, and early detection o
10、f the precursor of cerebral edema, close observation of patients with consciousness, vital signs, skin and mucous membrane and pupillary changes, recovery time and whether the convulsions and other symptoms, such as found twitching symptoms report to a doctor, and given the appropriate treatment pre
11、scribed by a doctor, such as injection stability, place wrapped around gauze spatula or openings between two molars, so calm and prevent bites in a timely manner to give 20% mannitol and dexamethasone and other drugs to prevent lung edema observed to ask patients with or without chest tightness, suf
12、focation, coughing and other 4symptoms, such as tracheal secretions are more oral and nasal secretions should be promptly removed to prevent choking and aspiration pneumonia, and to assist in turning shot back, conscious patients to encourage their cough, take a deep breath, keep the airway open. my
13、ocardial damage, to ask patients with or without chest tightness, heart palpitations and other symptoms, pay attention to controlling the infusion rate (especially elderly or other diseases the infirm, giving the ECG to observe whether the tachycardia or bradycardia, such as found ECG abnormalities
14、should be promptly reported to the doctor to do the appropriate treatment of respiratory failure, the application of multifunctional monitor to monitor vital signs and close observation of the pupil, consciousness, oxygen saturation, such as patients with respiratory failure, aspiration asphyxia and
15、 other symptoms immediately tracheal intubation, mechanical ventilation for respiratory support, and timely removal of foreign bodies and secretions in the mouth and respiratory tract, at any time to do the preparation of cardiopulmonary resuscitation. 52 Discussion Acute carbon monoxide poisoning,
16、high morbidity, and death due to carbon monoxide poisoning each year, ranking the first in a variety of accidental poisoning deaths. Rescue of acute carbon monoxide poisoning, time is critical, fully reflects the time is life, so to try to make early, immediate early away from as early as early as oxygen poisoning in patients with treatment time to waste and found that the shorter the period, namely, carbon monoxide poisoning to the emergency doctor arrived at the
