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1、气管切开患者意外脱管应急预案1. 患者意外脱管，重在预防，护理人员应注意：1) 对于颈部短粗的患者，应使用加长型气管套管，并牢固固定。2) 对于烦躁不安的患者，给予必要的肢体约束，或根据医嘱给予镇静药物。3) 为患者实施各种治疗如翻身，拍背，吸痰等时应专人固定套管，在病情允许的情况下尽量别离呼吸机管道，以防套管受呼吸机管道重力作用而至脱管。4) 更换固定系带时，应两人操作，一人固定套管，一人更换。2. 发生气管切开导管意外滑脱，应立即通知医师，根据患者情况进行处理。3. 有自主呼吸的病人，抚慰病人，保持呼吸道通畅，面罩给氧。立即通知医生，做好抢救准备。密切观察病情变化，协助医生更换套管重新置入
2、。4. 无自主呼吸的病人，当患者气管切开时间超过一周窦道形成时，立即人工通气，改善缺氧，立即汇报医生协助更换套管重新置入。5. 如切开时间在一周以内未形成窦道，保持呼吸道通畅，用纱布盖住气切口处，呼吸皮囊辅助呼吸，立即汇报医生，协助医生重新置管，操作时间不宜过长，一旦不成功，立即气管插管，然后设法重新置管。6. 同时应迅速准备好抢救药品和物品，如患者出现心跳骤停时立即给予心脏按压。7. 查动脉血气，根据结果调整呼吸机参数。8. 严密观察生命体征及神志、瞳孔、血氧饱和度的变化及时通知医生进行处理。9. 做好护理记录，分析意外拔管原因，提出改良措施，按护理不良事件程序上报。气管切开患者意外脱管急救
3、流程气管切开导管意外滑脱有自主呼吸的病人无自主呼吸的病人抚慰病人，保持呼吸道通畅，面罩给氧已形成窦道未形成窦道 立即通知医生，做好抢救准备。 密切观察病情变化，协助医生更换套管重新置入。 立即挤压胸部，做人工通气，改善缺氧。 立即汇报医生协助更换套管重新置入。 保持呼吸道通畅，用纱布盖住气切口处，呼吸皮囊辅助呼吸。 立即汇报医生，协助医生重新置管，操作时间不宜过长，一旦不成功，立即气管插管，然后设法重新置管。做好护理记录，分析意外拔管原因，提出改良措施按护理不良事件程序上报MdPgSkVnYq$t*x-A1D5G8JbNeQhTlWo#r%u(y+B2E6H9LcOfRjUmXp!s&w)z0
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