一位高壓氧耐壓測試導致多重氣壓傷病人之急診護理經驗

The Emergency Nursing Experience of a Patient with Hyperbaric Oxygen Therapy Test Leading to Multiple Barotraumas

10.6692/KJN.201812_35(3).0007

林育如(Yu-Ju Lin)；黃麗娟(Li-Chun Hung)

急診照護 ； 組織灌流改變 ； 氣體交換障礙 ； 身體活動功能障礙 ； 焦慮 ； Emergency nursing experience ； ineffective tissue perfusion ； impaired gas exchange ； impaired physical mobility ； anxiety

高雄護理雜誌

35卷3期（2018 / 12 / 01）

70 - 82

繁體中文

本文為照護一位預至艦艇單位服役之青年，因高壓氧耐壓測試導致多重氣壓傷之急診護理經驗，筆者於個案在急診照護期間，2016年12月09日09：47至2016年12月09日11：30，經由直接護理、身體評估、會談等方式收集資料，組織灌流失效/腦、氣體交換障礙、身體活動功能障礙、焦慮、急性疼痛等健康問題，藉由護理處置：監測意識狀態與瞳孔反應、維持床頭抬高、協助肢體維持功能位置、關懷照護建立良好護病關係，運用ISBAR原則並持續追縱會診復健科，加上潛醫科及胸腔外科等跨領域團隊的共同照護、讓個案參與決策，促使個案面對疾病的態度轉為正向與積極；期盼藉由本次護理經驗，提供臨床護理師不同專業領域的照護經驗，儲備多面向且紮實的專業照護。

This article describes the emergency nursing experience of a patient with hyperbaric oxygen therapy test leading to multiple barotraumas, including diffuse pneumocephalus, spontaneous pneumothorax and seizures. The emergency treatment period was from 09：47 to 11：30 of December 9, 2016. According to physiological, psychological, social, and spiritual assessments, the author collected data through physical assessment, conversations, and observation. The major health problems included ineffective tissue perfusion/brain, impaired gas exchange, impaired physical mobility, anxiety, and acute pain. The author took care of these barotraumatic complications via nursing care including monitoring the patient's consciousness, checking the patient's pupil size reflex, maintaining the patient's head position and raising the bed, assessing limbs muscle power, listening to the patient and establishing a good relationship during the nursing process, reducing anxiety, and using the ISBAR principles to pass messages to the intensive care unit nurse. Combining interprofessional practices such as hyperbaric oxygen, internal medicine medical and thoracic surgery allowed the case to be involved in decision-making, prompting individual endeavor to develop positive attitudes towards the disease. It is expected that by sharing this one-time nursing experience, it will provide information to clinical nurses in different fields in reserving multifaceted and substantial professional care, not only to promote the ability to enhance clinical care of recovering patients but to promote health in a timely fashion.