高壓氧治療與急性一氧化碳中毒

Hyperbaric Oxygen Therapy and Acute Carbon Monoxide Poisoning

郭淑珍(Shu-Chen KUO) ； 徐千剛(Chien-Kang HSU) ； 蔡建宗(Chien-Tsung TSAI) ； 解旻容(Min-Jung CHIEH)

《護理雜誌》 65卷4期 (2018/08) Pp. 11-17

https://doi.org/10.6224/JN.201808_65(4).03

摘要

一氧化碳中毒是急診室最常見的中毒類型急症，因一氧化碳與血紅素具有高親和力與複雜的生物學特性，導致一氧化碳中毒會造成心臟、神經、肌肉、腎臟等組織病變，嚴重者數分鐘內失去知覺或死亡。近年來，高壓氧廣泛應用在急重症病人（如一氧化碳中毒、腦組織缺氧），因為高壓氧可以加速一氧化碳結合血紅素的分解，故這類病人送達急診室，若能盡早接受高壓氧治療，可以改善或降低認知障礙及延遲神經心理學後遺症。急診護理是影響一氧化碳中毒病人能否獲救的關鍵。本文探討高壓氧對一氧化碳中毒的實證分析，提出高壓氧的使用通則；繼而由護理人員角度闡述急性一氧化碳中毒的處置與照護，及高壓氧治療的護理，期能提供給急診照護團隊參考，在救護的黃金時刻給予正確有效的醫護措施，使病人得到完善的護理照顧，減低對病人的傷害，及提高存活率。

關鍵字

急診照護 ； 一氧化碳中毒 ； 高壓氧治療

並列摘要

Carbon monoxide poisoning is the most commonly seen cause of poisoning in the emergency room (ER). The high affinity between carbon monoxide and hemoglobin and their complex biological characteristics greatly increase the risks of cardiac, nervous, muscular, and kidney diseases. In severe cases, patients may lose consciousness or die in just a few minutes. In recent years, hyperbaric oxygen therapy has been applied extensively in patients with severe conditions such as carbon monoxide poisoning and cerebral hypoxia. Hyperbaric oxygen accelerates the decomposition of carbon monoxide in hemoprotein. Therefore, treating patients with similar conditions in the ER with hyperbaric oxygen as soon as possible will improve their cognitive disorder and postpone their neuropsychological sequelae. ER nurses typically play a decisive role in saving patients with carbon monoxide poisoning. This research scrutinizes a case analysis of using hyperbaric oxygen to treat carbon monoxide poisoning and offers general rules for the use of hyperbaric oxygen. Further, the research elaborates from the perspective of ER nursing staffs the management and care of acute carbon monoxide poisoning and hyperbaric oxygen therapy nursing care. The aim of this research is to offer references for members of the ER nursing team and to enable this team to provide accurate and effective medical measures to patients during the ＂golden hours＂ of nursing care. Achieving this will help ensure that patients receive comprehensive nursing and care, thus reducing the harm suffered by patients and increasing the rate of survival.

並列關鍵字

emergency care ； carbon monoxide poisoning ； hyperbaric oxygen therapy

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