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 Wysłany: Wto 0:06, 08 Mar 2011 Temat postu: Nasal surgery and treatment, prevention and care _ |
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Nasal surgery and treatment of syncope in the prevention and care in
9 cases of epistaxis, nasal microwave coagulation therapy in 7 cases, 7 cases of maxillary sinus puncture, dressing change after sinus in 5 cases, 4 cases of nasal septum surgery, inferior turbinate injection in 3 cases, the other 3 cases. Where there were 45 cases of precursor symptoms, syncope in 11 cases. 2. Precursor before the onset of symptoms of syncope are often dizziness, blurred vision, pale, abdominal discomfort, nausea, cold sweats, general weakness and numbness and other symptoms. 3. Cause of syncope occurred. (1) psychological factors. Surgery or treatment because patients do not understand the tension,[link widoczny dla zalogowanych], fear. In addition, some patients worry about postoperative healing and so on. (2) environmental factors. Indoor ventilation, heat, hot, there is oppression. (3) physical factors. Physical weakness, low blood pressure, history of anemia and a halo of blood and so on. (4) lack of sleep before surgery, lasting seating, fatigue. (5) preoperative fasting, fasting, hunger. (6) inadequate intraoperative anesthesia, position inaccuracies caused by pain stimulation, surgery or other treatment time is too long. 4. Results. 56 cases of syncope and syncope in patients with symptoms before the pioneers were rescued without sequelae. Prevention and Care 1. Environment settings. Keep the environment clean and tidy, fresh air, suitable temperature, to seek the views of patients, appropriate to put some melodious soothing music to distract the attention of patients, doctors and patients to shorten the distance to improve the physician-patient relationship,[link widoczny dla zalogowanych], reduce the patient's fear, anxiety, psychological stress, to The purpose of emotional stability. 2. Psychological care. Warm reception of patients, understand the patient's condition and psychological reactions, details of surgery or treatment steps, analysis of the patient state of mind. To patients about the importance of co-ordination, citing past successful cases, and enhance patient confidence. Caring, patient, whether asked in detail about the history of drug allergy, non-fasting patients required to avoid hunger when fasting nasal surgery or treatment. 3. Materials preparation. Prepare emergency supplies and drugs, such as oxygen, suction apparatus, stethoscope, sphygmomanometer, epinephrine, or ephedrine, dexamethasone, and so on. Author: 511,316 by the city of Guangdong Province People's Hospital ENT Care 4. Nasal surgery or treatment care. (1) surgery patient was sitting or supine position to minimize bleeding and equipment to stimulate the patient, if necessary, with sterile towel over my eyes. Tension, preoperative anxiety can be a small amount of sedatives. (2) surgery or treatment, action should be gentle, precise, accurate, anesthesia should be in place to avoid the pain to operate. Should be closely observed during the operation state of consciousness of patients, a pioneer in the early detection of symptoms of syncope, to avoid falls. (3) If the symptoms of patients with syncope or syncope pioneers, we should immediately stop operation, whichever is lower supine or supine position first, in order to facilitate the return of venous blood, leaving the cardiac output, resulting in increased cerebral perfusion, and reduce the brain The insufficiency uJ. Patients also unlock the collar, to keep the airway clear and give people acupressure or acupuncture points necessary to give oxygen inhalation, close observation of patients with consciousness, blood pressure,[link widoczny dla zalogowanych], pulse and looking, timely dry sweat, keep warm, the general to wake up. If the slow recovery of patients, excluding the heart, brain syncope, according to doctor's advice, 50% glucose solution intravenous injection, subcutaneous injection of epinephrine or ephedrine can. Discussion of syncope is due to extensive cerebral insufficiency temporary short-term loss of consciousness due to state, attacks disappear when the patient can not maintain muscle tension due to the normal position and fell to the ground. The general sense of recovery within a few minutes, no significant sequelae. Nasal surgery or treatment, the spirit of high tension, fear, hunger or pain causes such as syncope is reflex syncope, the main cause of nerve. By reflex,[link widoczny dla zalogowanych], causing vasomotor dysfunction, causing systemic vasodilation, blood pressure dropped dramatically, cardiac depression, reduced cardiac output, can not maintain normal cerebral perfusion Erzhi cerebral insufficiency 3. Although generally not life-threatening, but to the surgery, causing difficulties in treatment, to increase the suffering of patients and delay treatment. Therefore, we should be prepared prior to surgery and treatment appropriate psychological care, reduce their stress and fear. Avoid fasting during operation, the patient must be fasting after intravenous infusion in surgical or medical treatment. Operation should be closely observed changes in condition, timely detection of prodromal symptoms of syncope,[link widoczny dla zalogowanych], in time, to minimize the incidence of syncope, in order to ensure the smooth progress of surgery or treatment.
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