- 期刊
照護一位燒炭自殺導致一氧化碳中毒之憂鬱症患者急診護理經驗
Emergency Nursing Experience of Caring for a Depressed Patient who Committed Suicide by Burning Charcoal and Caused Carbon Monoxide Poisoning
摘要
本文為描述一位34歲憂鬱症女性，因與家人發生口角後選擇燒炭自殺導致一氧化碳中毒之急診護理經驗。2022年2月21日於急診護理期間以直接護理、觀察及會談方式收集資料，以Gordon十一項健康功能型態進行整體性評估，確立個案主要健康問題為：一、氣體交換障礙／與一氧化碳中毒COHb：39%有關；二、個人因應能力失調／與存在不當調適技巧，如燒炭自殺、美工刀自傷行為有關；三、無望感／與情傷後失去生活重心及自我價值存在意義，對未來不明確感有關。透過一氧化碳中毒相關實證處理原則，安排高壓氧治療，降低遲發性神經系統病變風險。另外，透過跨領域團隊模式，依照個別性擬定照護計畫，與個案簽訂「不自殺契約」，提供心理支持、宗教文化介入措施等，使個案於急診短暫停留時間，除了生理層面得到安全舒適外，更獲得心靈上的安適。透過此急診照護經驗分享，啟發護理人員認識自我角色功能，於急診照護過程中，立即提供自殺未遂個案跨領域團隊全面性照護，陪伴個案渡過自殺危機，滿足其第一時間的生理舒適及心理安適。
並列摘要
This study describes an acute nursing experience of a 34-year-old woman with depression and carbon monoxide (CO) poison resulting from charcoal burning suicide after she quarreled with her family. On February 21, 2022, direct nursing care, observation, and interview methods were used to collect data during the acute care period. Gordon's 11Functional Health Patterns were applied to conduct overall evaluations. The main health concerns of the patient were as follows: (1) impaired gas exchange, which was related to CO poisoning (carboxyhemoglobin: 39%); (2) Dysregulation of personal coping skills, which was related to inappropriate adjustment abilities (such as charcoal burning suicide and self-harm with a utility knife); and (3) a sense of hopelessness, which was related to the loss of the focus in life, purpose of life after ending a romantic relationship, and also feeling of uncertainty to the future. According to relevant principles for handling CO poisoning, hyperbaric oxygen therapy was arranged to reduce the risk of delayed neuropsychiatric syndrome through an interprofessional team model, formulate care plans based on individual characteristics; sign a "No-Suicide Contract" with the case; providing psychological support, religious and cultural intervention measures and so on. During the short stay in the intensive care unit, the patient was comforted beyond physical level to also comprise psychological extent. Through this emergency care experience sharing, nursing staff are inspired to perceive their own role and function and hence provide immediate and comprehensive cross-disciplinary team care for suicide attempt cases during the emergency care process. They also accompany the case through the suicidal dilemma and fulfilling their immediate physiological comfort as well as psychological condolence.