協助到院前呼吸心跳停止個案脫離呼吸器之照護經驗

Experience in Weaning an Out-of- Hospital Cardiopulmonary Arrest Patient off A Ventilator Support System in Hospice Care

陳婉君(Wan-Chun Chen) ； 許蕊(Jui Hsu) ； 陳冠珊(Kuan-Shan Chen) ； 劉淑皎(Shu-Chiao Liu) ； 葉人華(Ren-Hua Ye) ； 陳錫洲(Shyi-Jou Chen) ； 陳佳宏(Jia-Hong Chen)

《安寧療護雜誌》 20卷1期 (2015/03) Pp. 67-78

https://doi.org/10.6537/TJHPC.2015.20(1).6

摘要

本文探討一位到院前呼吸心跳停止個案脫離呼吸器之照護經驗。於2013年6月01日至6月14日照護期間，透過身體評估、家屬會談及召開家庭會議等方式收集資料，進行身體、心理、社會及靈性評估，發現病人因處於無意識狀態造成生活無法自理、無生活品質與生命尊嚴，家屬堅持撤除個案呼吸器，經醫療團隊運用「臨床倫理議題思辨四象限評估」及召開家庭會議取得共識，積極給予漸進性呼吸訓練後，順利脫離呼吸器，並提供安寧四全之照護模式，提升個案照護品質。期望藉此經驗分享，提供醫療人員照護相關個案之參考。

關鍵字

脫離呼吸器 ； 安寧療護 ； 到院前呼吸心跳停止

並列摘要

This article aims to explore the method of weaning an out-of-hospital cardiopulmonary arrest patient off a ventilator support system in hospice care. Nursing care was provided during the 1st to 14th of June, 2014. The data was collected through a physical assessment which was focused on the patient's physical, psychological, and social aspects via a family interview and conference. There was argument about poor quality of life and dignity for a persistent unconscious patient with ventilator. The family insisted to withdraw the ventilator support system. After giving respiratory training to the patient and success of weaning was achieved. Four methods of clinical care and hospice palliative care were suggested by medical team, which could improve the physical comfort, well-being and quality of life.Respiratory training is very important not only for the family but most importantly for the patient. This article can be used as a reference for future care of similar cases.

並列關鍵字

weaning off ventilator ； hospice care ； out-of-hospital cardiopulmonary arrest

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