照護一位青少年經歷燒傷併急性壓力症候群之加護經驗

Nursing Experience in a Young Adult Case with burns and acute stress syndrome

楊慧文(Hui-Wen Yang) ； 吳昭瑩(Chao-Ying Wu) ； 林采蓉(Tsai-Rung Lin)

《高雄護理雜誌》 36卷1期 (2019/04) Pp. 44-54

https://doi.org/10.6692/KJN.201904_36(1).0005

摘要

本文敘述青少年經歷燒傷併急性壓力症候群之加護經驗，病人因烹飪時不慎發生意外造成雙下肢及軀幹二度至三度TBSA21％嚴重燙傷，歷經意外事件衝擊及燒傷治療，心中感到恐懼與焦慮，照護期間為2015年10月14日至11月2日，運用整體性護理評估收集資料，發現有急性疼痛、組織完整性受損及急性壓力症候群之健康問題，為減輕傷口疼痛更換傷口時，動作輕柔並運用含銀敷料，提供實證依據之營養措施，以促進傷口癒合，對於創傷所造成的反應，以同理心主動關懷引導抒發內心的衝擊與壓力及改變的想法，持續給予正向鼓勵與心理支持，使病人能面對創傷事件，積極配合治療及復健，勇敢面對，期望藉此分享此照護經驗於類似個案之參考。

關鍵字

燒燙傷 ； 急性壓力症候群 ； 青少年

並列摘要

In this report, we describe our nursing experience caring for a teenager with traumatic burns and acute stress syndrome. In this case of severe accidental burns due to a cooking fire incident, the patient incurred skin wounds to the lower limbs and trunk with two to three degrees TBSA 21% serious burns. After the shock and burn event, with the patient and family experiencing fear and anxiety, ongoing treatment from October 14^(th), 2015 to November 2^(nd) was provided, Holistic nursing assessment was used to collect information and found that acute pain, tissue integrity damage and acute stress syndrome health problems were most significant, and replacement of wound dressings with gentle action was introduced along with the use of silver-containing dressings to reduce wound pain and provide empirical evidence based on nutritional measures to promote wound healing. Measures to promote such wound healing in response to trauma were guided by empathy and intuition by taking the initiative in guiding the feelings and inner impact of the idea of change. Psychological support enabled the patient to face this traumatic event by giving positive encouragement, allowing him to actively cooperate with the treatment and rehabilitation, and courageously face it. It is hoped that this case experience can be shared for reference in similar care cases.

並列關鍵字

burns ； acute stress syndrome ； adolescents

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