Assessmentoftheseriouslyillpatient.ppt

Basic Assessment Support in Intensive Care 邢台市第三医院重症医学科 于 强 contents Assessment of the seriously ill patient Acute respiratory failure Airway management airway obstruction Mechanical ventilation一the basics Mechanical ventilation一common modes Mechanical ventilation一settings Mechanical ventilation一monitoring troubleshooting Mechanical ventilation一specific conditions Basic haemodynamic monitoring Shock Cardiopulmonary resuscitation Life threatening arrhythmias Oliguria and acute renal failure Fluids Transport of the critically ill patient Severe sepsis septic shock Severe trauma contents Neurological emergencies Interpretation of arterial blood gases Sedation and analgesia Nutritional support Thromboembolic disease - risks prophylaxis Stress ulcer prophylaxisbleeding Metabolic and electrolyte disturbances Paediatrics Appendix1一Antibiotic regimes. Appendix 2一ARDS ventilation algorithm Appendix 3一Dilational cricothyrotomy Appendix 4一Intercostal catheter insertion management Appenaix 5一Medical Emerqency Response and Crisis Resource Management Assessment of the seriously illpatient The aim of assessment of seriously ill patients identify the physiological abnormalities identify the most appropriate way to correct those abnormalities diagnose the underlying problem The aim of assessment of seriously ill patients 识别生理异常 找出纠正这些生理异常的合适方法 诊断潜在的疾病 Why to assess? The process ultimately involves taking a full history and thoroughly examining and investigating the patient but the order in which this occurs is different in the seriously ill patient. The difference is due to the urgency with which treatment needs to be started. As a result there is rarely time to take a full history or carry out a very detailed examination before initiating treatment. Often it is necessary to restrict oneself to only the information required to guide the next treatment decision and to fill in missing components of History, examination and investigation after treatment has been initiated