Application of standard transport protocol in patients with coronavirus disease 2019

doi:10.3877/cma.j.issn.2096-1537.2021.01.014

Abstract

Abstract:

Transporting critically ill patients for comprehensive examination could be dangerous in the process , which depends on cooperation of medical staff. In this paper, we introduced a standard process of in-hospital transportation for mechanical ventilated patients with corona virus disease in Huanggang, Hubei Province, which had achieved good results in clinical practice and provided experience for other clinical staff.

Key words: Transport, Coronavirus disease 2019, Mechanical ventilation

Weiming Liu, Xiaohong Hou, Min Ding, Jing Yan, Guilian Wang, Min Liu, Yuping Wang, Xia Liu. Application of standard transport protocol in patients with coronavirus disease 2019[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(01): 81-83.

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URL: https://icu.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2096-1537.2021.01.014

https://icu.cma-cmc.com.cn/EN/Y2021/V07/I01/81

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References 10

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流程	要点说明
1.核对	正确识别患者身份
2.检查用物及设备	确保氧气钢瓶内氧气充足及呼吸机、监护仪、微量泵电量满足，急救箱内物品均在有效期，性能良好
3.连接气源	将转运呼吸机与氧气钢瓶相连接
4.安装管路	使用一次性呼吸机管路，正确安装呼吸机管路，呼吸机吸气端和呼气端接病毒细菌过滤器
5.调节模式参数及报警设置	根据患者病情设置转运呼吸机模式、参数及报警限，连接模拟肺试运行
6.连接患者	将患者气道与转运呼吸机管路相连接，连接前按需吸痰
7.转运前观察	观察呼吸机是否正常运行，输液通路通畅，引流管通畅妥善固定无打折，微量泵，心电监护仪运行良好，密切监测患者生命体征，3~5 min后向医师确认是否允许转运
8.联系电梯、目的地科室	确定转运路线，预约电梯，电话通知目的地科室
9.转运过程中	医生1名，在患者头侧观察：患者病情、神志、面色等生命体征变换，掌握转运方向；护士2名，责任护士领队位于患者右侧，负责观察患者和监护仪，评估病情变化、保持输液管路通畅度及微量泵运行，协助护士在患者床尾，保持引流管通畅，负责急救箱和电动吸痰器应急使用，推动转运床；呼吸治疗师1名，位于病床左侧，监测患者呼吸，保证人工气道安全，防止气管插管脱出、移位、打折，监测呼吸机，保证运行正常，防止呼吸机管路脱落等情况，观察有无人机对抗，及时处理报警因素；监测呼吸机电量、氧气钢瓶压力
10.到达目的地	协助医技人员将患者移动到检查设备上，妥善安置患者，患者使用仪器放置妥当，观察检查过程中的机器运行情况，监测患者生命体征
11.转运后终末处理	连接科室呼吸机，关闭转运呼吸机电源及氧源，充电/充气备用，转运监护仪、微量泵充电备用；终末处理：一次性呼吸回路弃去；呼气阀使用75%酒精浸泡；仪器的外壳、屏幕及按键部分使用75%酒精擦拭
12.记录	在电子护理记录单记录转运过程的突发事件和处理，记录时间及患者生命体征

流程	要点说明
1.核对	正确识别患者身份
2.检查用物及设备	确保氧气钢瓶内氧气充足及呼吸机、监护仪、微量泵电量满足，急救箱内物品均在有效期，性能良好
3.连接气源	将转运呼吸机与氧气钢瓶相连接
4.安装管路	使用一次性呼吸机管路，正确安装呼吸机管路，呼吸机吸气端和呼气端接病毒细菌过滤器
5.调节模式参数及报警设置	根据患者病情设置转运呼吸机模式、参数及报警限，连接模拟肺试运行
6.连接患者	将患者气道与转运呼吸机管路相连接，连接前按需吸痰
7.转运前观察	观察呼吸机是否正常运行，输液通路通畅，引流管通畅妥善固定无打折，微量泵，心电监护仪运行良好，密切监测患者生命体征，3~5 min后向医师确认是否允许转运
8.联系电梯、目的地科室	确定转运路线，预约电梯，电话通知目的地科室
9.转运过程中	医生1名，在患者头侧观察：患者病情、神志、面色等生命体征变换，掌握转运方向；护士2名，责任护士领队位于患者右侧，负责观察患者和监护仪，评估病情变化、保持输液管路通畅度及微量泵运行，协助护士在患者床尾，保持引流管通畅，负责急救箱和电动吸痰器应急使用，推动转运床；呼吸治疗师1名，位于病床左侧，监测患者呼吸，保证人工气道安全，防止气管插管脱出、移位、打折，监测呼吸机，保证运行正常，防止呼吸机管路脱落等情况，观察有无人机对抗，及时处理报警因素；监测呼吸机电量、氧气钢瓶压力
10.到达目的地	协助医技人员将患者移动到检查设备上，妥善安置患者，患者使用仪器放置妥当，观察检查过程中的机器运行情况，监测患者生命体征
11.转运后终末处理	连接科室呼吸机，关闭转运呼吸机电源及氧源，充电/充气备用，转运监护仪、微量泵充电备用；终末处理：一次性呼吸回路弃去；呼气阀使用75%酒精浸泡；仪器的外壳、屏幕及按键部分使用75%酒精擦拭
12.记录	在电子护理记录单记录转运过程的突发事件和处理，记录时间及患者生命体征

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