胸腹聯(lián)合傷現(xiàn)場急救Onsiteemergencyt課件講解

OnsiteemergencytreatmentforcombinedchestandabdominalinjuriesSpeaker:HuangLing胸腹聯(lián)合傷現(xiàn)場急救主講人：黃靈《應(yīng)急救護(hù)技術(shù)》EmergencyrescuetechniqueLearningObjectivesMastertheclinicalmanifestationsandon-siteemergencytreatmentofcombinedchestandabdominalinjuriesFamiliarwiththeconceptofthoracoabdominalcombinedinjuryUnderstandtheclassificationofthoracoabdominalcombinedinjuries學(xué)習(xí)目標(biāo)掌握胸腹聯(lián)合傷的臨床表現(xiàn)與現(xiàn)場急救熟悉胸腹聯(lián)合傷的概念了解胸腹聯(lián)合傷的分類TheconceptofthoracoabdominalcombinedinjuryChestandabdominalcombinedinjury:mainlycausedbyexternalforcedirectlyorindirectlyactingonthehead.胸腹聯(lián)合傷的概念胸腹聯(lián)合傷：主要是外力直接或者間接作用于頭部所造成的損傷。ClinicalmanifestationsofthoracoabdominalcombinedinjuryThemainmanifestationsofcombinedchestandabdominalpainarechestpain,cough,hemoptysis,shortnessofbreath,cyanosis,abdominalpain,vomiting,increasedpulse,dizziness,palecomplexion,andweakness.Thethoracoabdominaljointinjuryissevereandcomplex,withahighrisk.Theincidenceofshockisashighas60%,andthemortalityrateis25%to35%.ChestpaincoughhemoptysisShortnessofbreathbecomepurplePalecomplexionvomitabdominalpainPulserateincreasesdizzyunable胸腹聯(lián)合傷的臨床表現(xiàn)窒胸腹聯(lián)合傷主要表現(xiàn)為胸痛、咳嗽、咯血、呼吸急促、發(fā)紫、腹痛、嘔吐、脈搏加快、頭暈、面色蒼白、無力等表現(xiàn)。胸腹聯(lián)合傷情嚴(yán)重而復(fù)雜，危險性較大，其休克發(fā)生率高達(dá)60%，死亡率25%～35%。EmergencytreatmentforcombinedchestandabdominalinjuriesStep1:GetoutofthedangerousenvironmentIfthepatientisfoundtohaveobviouschestandabdominalinjuries,immediatelycalltheemergencynumber,Seekhelpfromthesurroundingpopulationwhileconductinganenvironmentalassessment.ThencheckfirstPatient'sspontaneousbreathingandarterialpulsation,whiledialing120,Seekhelpfromthepeoplearoundyou.胸腹聯(lián)合傷的急救第一步:脫離危險環(huán)境發(fā)現(xiàn)患者有明顯的胸腹受傷，馬上撥打急救電話，尋求周圍人群的幫助，同時進(jìn)行環(huán)境評估。之后先檢查患者的自主呼吸以及大動脈的搏動情況，同時撥打120，尋求周圍人群的幫助。EmergencytreatmentforcombinedchestandabdominalinjuriesStep2:CheckforsurfaceinjuriesUsebandagestoeffectivelyfixthepatient'schest,covertheabdominalwoundwithsterilegauze,andapplypressuretobandageandstopbleeding.Checkifthereareanyinjuriestothecervicalspine.Ifthereareinjuriestothecervicalspine,useaneckbracetofixittopreventfurtherinjuryduringneckmovement;胸腹聯(lián)合傷的急救第二步:檢查體表損傷情況

使用繃帶將患者胸部進(jìn)行有效的固定，使用無菌紗布覆蓋腹部傷口，并加壓包扎止血，檢查頸椎是否合并有損傷，如合并有頸椎損傷，應(yīng)用頸托固定避免患者頸部活動發(fā)生再損傷；EmergencytreatmentforcombinedchestandabdominalinjuriesStep3:InitialRecoveryABCDCheckforcombinedinjuriestootherorgans:Traumapatientsmayhavecombinedinjuriestoorgansinthechestandabdominalcavityandwaitforemergencypersonneltoarriveatthescene胸腹聯(lián)合傷的急救第三步:初期復(fù)蘇ABCD

檢查是否有合并其它臟器的損傷：外傷患者可合并有胸腹腔內(nèi)器官的損傷并等待急救人員抵達(dá)現(xiàn)場LearningSummaryChestabdominaljointinjurycanoccurinanylocationwithdirectorindirectimpactforce.Learningfirstaidforcombinedchestandabdominalinjuriescanimprovethesurvivalrateoftheinjuredinthefirstplace.