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相关概念视频

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...

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相关实验视频

Updated: Jul 9, 2026

Functional and Morphological Assessment of Diaphragm Innervation by Phrenic Motor Neurons
09:43

Functional and Morphological Assessment of Diaphragm Innervation by Phrenic Motor Neurons

Published on: May 25, 2015

在外科手术过程中DNAR命令状态变化:意图与实践对比.

Lily Johnson, Neil Manago, Michelle Cantillo

    The Journal of clinical ethics
    |May 21, 2025
    PubMed
    概括

    虽然在手术前讨论不要尝试复苏 (DNAR) 命令是常见的,但电子健康记录往往无法更新这些命令. 这种监督可能会导致护理缺口,无法在麻醉期间尊重患者的愿望.

    科学领域:

    • 医学伦理 医学伦理
    • 麻醉学 麻醉学
    • 医疗信息学 医疗信息学

    背景情况:

    • 在手术期间自动暂停"不要尝试复苏" (DNAR) 命令的做法已经转向了更个性化的讨论.
    • 确保在医疗程序期间尊重患者关于复苏的愿望是一个关键的伦理和临床考虑.

    研究的目的:

    • 评估在特定机构接受手术的患者的DNAR订单的实施和电子健康记录 (EHR) 更新.
    • 在术前期间,识别患者记录的愿望与EHR中实际订单之间的潜在差异.

    主要方法:

    • 在手术前对100名随机患者进行了回顾性审查,这些患者在手术前已经有DNAR订单.
    • 收集的数据包括与手术有关的DNAR状态讨论的文档和后续更新的EHR.

    主要成果:

    • 在需要全身麻醉的外科手术之前,在85%的病例中,DNAR状态被重新讨论.
    • 然而,在这些案例中88%的情况下,EHR没有更新DNAR状态,这表明顺序准确性存在重大差距.
    • 这表明,如果需要在麻醉下进行复苏,护理可能会偏离患者的偏好.

    结论:

    • 在麻醉和手术方面,DNAR愿望的变化经常被记录在案,但EHR中的相应代码状态命令并未始终更新.

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  • 这种不一致性会在护理中造成潜在的差距,冒着未能遵守患者声明的愿望的风险.
  • 在订单集中更新DNAR状态的标准化流程对于确保在手术干预期间和之后准确反映患者偏好至关重要.