一位因石化氣爆燙傷病人之加護護理經驗

Intensive Care Nursing Experience for a Patient with Burn Injury Caused by a Petrochemical Explosion

許華真(Hua-Jen Shiu) ； 陳淑芳(Shu-Fang Chen) ； 徐琬茵(Wan-Yin Hsu) ； 謝生蘭(Sheng-Lan shieh)

《高雄護理雜誌》 34卷1期 (2017/04) Pp. 61-71

https://doi.org/10.6692/KJN-2017-34-1-6

摘要

本文敘述一位歷經高雄石化氣爆事件燙傷病人之加護經驗，災難造成個案四肢及軀幹二度至三度TBSA 54%嚴重燙傷，其男友一同遭遇氣爆被送至加護病房治療，除身體傷痛外，歷經生命威脅衝擊，心中害怕與恐懼是無法抹滅的。護理期間2014/8/1～8/20，運用整體性護理評估收集資料，發現有急性疼痛、身體心像紊亂及創傷後反應健康問題。護理過程以真誠正向態度相待，提供減輕傷口疼痛照護技巧，引導抒發身心改變的想法，持續給予正向鼓勵與心理支持，促進自我整體感受，降低面臨傷口的害怕，運用創傷後成長理論照護模式，使個案減少負面情緒，領悟珍惜生命當下美好，順利轉出加護病房，希望藉此能提供相關照護之參考。

關鍵字

燒燙傷 ； 急性疼痛 ； 身體心像紊亂 ； 創傷後反應

並列摘要

The paper described the intensive care nursing experience for a patient with burn injuries caused by a petrochemical explosion accident that occurred in Kaohsiung. The disaster made the patient suffer from secondary to tertiary severe burn injuries on her four limbs and body, with a 54% TBSA (total body surface area) severe burn. Her boyfriend was also injured in the same explosion, and brought to the intensive care unit (ICU) to receive treatment. They both not only suffered from physical pain in their bodies, but also experienced the threats and impacts on their lives. The fear and terror in their hearts could not be easily eliminated. During my nursing period of the patient from Aug. 1 to Aug. 20, 2014, I employed overall nursing evaluation to collect information, and found that my patient had health problems of acute pain, body image disturbance, and posttraumatic responses. During the nursing process, I treated her sincerely and took a positive attitude, provided her with special nursing techniques to reduce the pain of her wounds, led her to express her physical and mental distress, changed her pessimistic mindset, gave her positive encouragement and psychological support continuously, increased her optimistic feeling towards the suffering, and reduced her fear when facing the wounds. I applied a nursing model based on posttraumatic growth theory, making the patient have less negative emotion, treasure her life, and realize the goodliness of living in the world at the moment. Finally, she was transferred out of the ICU smoothly. It is hoped that the nursing experience can be provided as a reference for other nursing staff in offering intensive care nursing to patients with burn injuries.

並列關鍵字

burn injury ； acute pain ； body image disturbance ； posttraumatic responses