- 期刊
有機磷中毒併發呼吸衰竭個案之加護經驗
Experience of Providing Intensive Nursing Care to an Organophosphate Poisoning Patient Complicated with Respiratory Failure
摘要
本文探討有機磷中毒併發呼吸衰竭病患之加護經驗。護理過程自2020年5月15日至23日止，運用Gordon十一項健康功能評估，透過觀察、直接照護、身體評估及筆談等方式收集資料，發現病患有呼吸道清除功能失效、焦慮、睡眠型態紊亂及知識缺失等健康問題。在照護期間，與醫師共同擬定每日肌力訓練計畫，強化呼吸肌群，協助病患順利脫離呼吸器；以關懷同理心與病患建立信任治療性人際關係，引導表達其內心的焦慮與害怕感受；並運用音樂療法、耳塞及眼罩等措施，降低環境干擾，營造舒適睡眠環境，緩解睡眠紊亂之問題。此外，針對此次工作意外，予以正確農藥噴施的安全防護資訊，杜絕再次發生中毒。筆者透過護理專業讓病患身心理舒適，渡過生命危機轉至痊癒。為減少有機磷中毒的發生，建議社區護理師可於鄉公所或農會定期舉辦衛教活動，普及有機磷農藥製劑的使用與安全防護知識，提升社區民眾的防護意識與技能。
並列摘要
This article discusses the intensive care experience of patients with organic phosphorus poisoning complicated by respiratory failure. The nursing process was carried out from May 15th to 23rd, 2020, using Gordon's 11 functional health patterns to observe, provide direct care, conduct physical assessments, and collect data through communication. It was found that the patients had health problems such as ineffective airway clearance, anxiety, disrupted sleep patterns, and lack of knowledge. During the care period, a daily muscle training plan was developed in collaboration with the physician to strengthen the respiratory muscles and successfully wean the patient off the ventilator. Trusting therapeutic interpersonal relationships were established with empathy and care to facilitate the expression of the patient's inner feelings of anxiety and fear. Music therapy and the use of earplugs, eye masks, etc., were employed to reduce environmental disturbances, create a comfortable sleep environment, and alleviate sleep disorders. Furthermore, correct safety precautions regarding pesticide spraying were provided to prevent reoccurrence of poisoning incidents. Through professional nursing care, the author helped the patient achieve psychological comfort and overcome the life-threatening crisis. It is recommended to regularly hold health education sessions on the preparation and prevention of organic phosphorus pesticide poisoning by community nurses in township offices or agricultural associations. This will increase the community's awareness of protective safety measures when handling organic phosphorus pesticides and reduce the incidence of organic phosphorus poisoning.