Care before use

First of all within 10 s to complete the condition determination, and then immediately with the physician with the start of the rotation without hand chest compressions, and according to C-A-B order to open and clean the airway, ready stretcher recovery machine. This group of patients without cardiac arrest caused by suffocation of the case, so no need to first tracheal intubation. Followed by a doctor prescribed pre-attached defibrillation electrode films. Because the recovery machine will take up the defibrillator electrode strap position, once the defibrillator will delay the use of a lot of time, which is particularly important for cardiovascular patients. In addition to this group of patients with open chest and back injury in 7 cases, the rest are preset defibrillation electrode films.

Handling

Patients were transferred to a stretcher resuscitation machine according to a standard procedure for training. Our department will carry the patient's procedure is divided into 6 steps, by 3 people (respectively called A, B, C) completed, each step by one of the senior health care personnel to issue instructions. The first step: A and B stations on both sides of the patient (a right, B left), hand care in patients with hip and subscapular, C lift leg. Step 2: 3 people lift the patient placed on the stretcher recovery machine, try to make the patient in the stretcher center. Step 3: adjust the position of the patient from the B, so that the head is located in the head of the stretcher head depression, shoulders and stretchers resurrection device parallel to the upper edge. Position appropriate, A, B continue to turn by hand to press, while the mechanical ready to press from the C instrument, and connect the pipeline, open the airway, wearing a mask and so on. The fourth step: When the implementation of a press, by the B side of the band will be a bundle of fixed (both sides of the arm must be fixed in the binding band or are tied to the band, not one outside). Step 5: A suspension of the press, the pressure quickly by the B placed in patients with sternal double nipple to the middle of the skin, by the rapid side of the other bundled with a fixed, the B hold down the press to make it close Patients with chest skin and maintain a certain pressure. Step Six: C fast deduction by the top of the two binding band after the press, from the rapid opening of a resuscitator switch, according to the above requirements set the parameters. For this group of 47 patients with pre-hospital patients also use this method of handling. But more emphasis on the recovery of the stretcher and the patient lying position close to the flush, and do not do a good job in the recovery machine before the preparation, more emphasis on uninterrupted manual pressure.

In-use care

Once the resuscitation machine began to press the work, nurses to close observation of the disease, to confirm the effectiveness of the press recovery. Mainly including the location of the resuscitator, check the neck, the Ministry of large vascular fluctuations; observe the pupil and the state of consciousness, changes in vital signs, ECG waveform changes; observed end-tidal CO2 value changes. Especially after the two indicators, when the emergence of autonomic rhythm, end-expiratory CO2 value of a sudden increase of 35 ~ 40 mmHg, indicating that the patient showed signs of ROSC, the need to promptly inform the physician for timely and further processing. In this group of 29 patients with ROSC, 25 patients with rapid changes in end-tidal CO2 more than 35 mmHg, the other four cases were relatively slow, but still reached 29 ~ 32 mmHg. On the other hand, when found to be weak or even can not touch the big blood vessels; systolic blood pressure below 40 mmHg or even can not be measured; ECG waveform low and messy and even inconsistent with the press rhythm; end-tidal CO2 value has been lower than 20 mmHg or even lower than 10 MmHg, then cardiopulmonary resuscitation is ineffective or ineffective, you must immediately inform the physician. In this group, 9 cases of the use of half-way push-button position shift affect the recovery effect, of which 7 cases of pre-hospital patients, mainly moving the stretcher when the patient shift caused by adjustment can be re-achieved the minimum effective standard. At the same time, nurses strictly prescribed medication, timely, accurate and complete rescue records.

Treatment after use

Discontinued R-301 stretcher cardiopulmonary resuscitation machine, pay attention to cleaning, disinfection and maintenance, to ensure that each button is turned off, disconnect the oxygen connector. Ventilated pipe immersed in 2% alkaline solution of glutaraldehyde, 30 min after washing with saline or distilled water, dry spare; stretcher with 2% alkaline glutaraldehyde solution of a soft cloth scrub clean, l0-30min And then wipe clean with a soft cloth to keep clean, pay attention to the protection of the floor to support the opening to prevent salt water, blood and other dirt into; for special oxygen cylinders check pressure to ensure that at any time enabled. At the same time record the use, check disinfection, to ensure instrument performance.