一位因意外導致多重創傷病人之加護經驗

The Nursing Experience of a Patient with Multiple Traumas caused by Accident

楊雅淳(Ya-Chun Yang) ； 陳姿芳(Tz-Fang Chen) ； 鍾杜珍(Du-Zhen Zhong)

《源遠護理》 15卷2期 (2021/07) Pp. 43-49

https://doi.org/10.6530/YYN.202107_15(2).0006

摘要

本文旨在探討一位青年男性因車禍意外，遭遇多重創傷病情進展快速，面臨生死攸關危機的加護經驗。護理期間為2019年5月7日至5月23日，筆者與個案及家屬建立良好護病關係，藉由直接照護、觀察及會談等方法，運用Gordon 11項健康功能評估個案確認有氣體交換障礙、急性疼痛、焦慮的健康問題。筆者運用護理過程維持呼吸道通暢增加氧氣交換能力，進行呼吸訓練成功移除氣管內管；給予良好的止痛措施，緩解急性疼痛，運用同理心評估焦慮來源及程度，給予個別化的安撫放鬆方式，緩解急性疼痛，使個案能理解焦慮來源及症狀，最後改善個案面對多重創傷的身、心衝擊。建議可運用多媒體影音，讓個案更容易理解病程進展，給日後護理同仁照護類似案例時，能在初期全方位評估生、心理需求照護，提高警覺，注意遭遇多重創傷可能會出現的症狀與護理過程，以提升照護品質。

關鍵字

多重創傷 ； 加護病房 ； 意外

並列摘要

This article explores the experience of a young man admitted to the intensive care unit on account of multiple traumas due to a car accident, recovering from a life and death crisis undergoing a rapid progress. The nursing period was from May 7th to May 23rd, 2019. The nursing assessment was made using Gordon's 11 Functional Health Patterns (FHP). By means of direct care, observation and interviews, FHP was assessed in terms of gas exchange barriers, acute pain, and anxiety. The nursing process maintained the airway patency to increase the oxygen exchange capacity, successful removal of endotracheal tube through breathing training, and give good pain relief measures. The source and degree of anxiety was reduced by empathy, individualized comfort and relaxation methods. Relief from acute pain, enabling to understand the source and symptoms of anxiety, and finally improve the case's physical and mental impact in the face of multiple traumas. Multimedia video and audio can be used to make it easier for the case to understand the progress of the disease. These may be adapted for future cases to comprehensively assess the health and psychological needs of case at the initial stage. An increase in vigilance, attention to the symptoms that occur in multiple trauma and careful nursing process may improve the quality of care.

並列關鍵字

multiple trauma ； intensive care unit ； accident

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