基于体积的内管袖口膨胀技术的实施:质量改进项目
Christopher Brown1, Hannah Jaiven2, Anne Hranchook2
1Oakland University-Beaumont Graduate Program of Nurse Anesthesia, Rochester, MI, USA brown12@oakland.edu hjaiven@oakland.edu hranchoo@oakland.edu.
Journal of doctoral nursing practice
|February 4, 2025
概括
使用5毫升注射器用于内内管 (ETT) 袖口膨胀,显著降低了过度膨胀. 这项质量改进项目强调了一种简单的方法来保持安全的ETT袖口压力,保护患者免受伤害.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 护理实践 护理实践
背景情况:
- 输内管 (ETT) 袖口压力目标为20-30厘米的H2O用于密封和 perfusion.
- 手持式压力计是黄金标准,但很少使用;10毫升注射器经常导致过度膨胀.
- 过度膨胀的袖子可能会损害气道粘膜和影响 perfusion.
研究的目的:
- 评估ETT袖口过度通货膨胀的发生率.
- 确定使用较低数量的教育干预措施是否能降低过度通货膨胀.
- 通过优化ETT袖口压力来提高患者安全.
主要方法:
- 质量改进项目评估ETT袖口压力.
- 评估了50个手首压力干预前和50个干预后.
- 干预涉及教育,倡导使用5毫升注射器进行通胀,而不是10毫升注射器.
主要成果:
- 平均袖口压力从干预前的60厘米H2O降低了50%,到干预后的30厘米H2O.
- 使用5毫升注射器显著降低了ETT袖口压力 (p < .001).
- 教育干预有效地降低了袖口压力.
结论:
- 教育干预建议为ETT袖口膨胀使用5毫升注射器,可显著降低袖口压力.
- 基于数量的通货膨胀方法可以降低ETT袖口过度通货膨胀的发生率.
- 护士和护士麻醉师应采取策略,以防止高袖压力和相关并发症.
相关概念视频
Endotracheal Intubation I: Procedure
622
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
622
Assessment of blood pressure in brachial artery(two-step method)
648
Measuring blood pressure is a fundamental skill in healthcare that aids in diagnosing and monitoring hypertension and other cardiovascular conditions. An aneroid sphygmomanometer, commonly used in clinical settings, offers a manual and precise method for blood pressure measurement. The technique for using this instrument involves specific steps that must be carefully executed to ensure accuracy. The following detailed description outlines a two-step technique for assessing blood pressure using...
648
Endoscopic Studies II: Thoracocentesis
195
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
195
Endotracheal Tube Extubation
349
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
349
Endotracheal Intubation II: Nursing Management
436
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
436


