ICU life supportThe ICU (intensive care unit) was mainly responsible for the rescue and continuous life support of critically ill patients, the treatment and organ function support of patients with multiple organ malfunction, and the prevention and treatment of multiple organ malfunction syndrome. There were many types of life support technologies. The following were some common life support technologies:
** 1. Breathing Support Technique **
1. ** oxygen therapy **
- This included nasal tube oxygen therapy, mask oxygen therapy, and nasal high flow wet oxygen therapy (HFNAC). With the help of this device, the patient would be able to breathe in a relatively constant oxygen concentration (21% - 100%), temperature (31 - 37 ° C), and humidity with a high flow rate (8 - 80L/min). The patient would also receive oxygen therapy through nasal obstruction, which was very comfortable.
2. ** Mechanical ventilation **
- This was a method of ventilation that used mechanical devices to replace, control, or change spontaneous breathing.
- ** Non-invasive positive pressure ventilation **: A technique that does not require invasive or invasive intubation or incision of the trachea. The patient is only connected to the ventilation machine through a nasal mask, a mouth and nose mask, a full face mask, or a head mask to perform positive pressure assisted ventilation.
- ** Injured mechanical ventilation **: It is suitable for brain trauma, infection, stroke accidents, poisoning, bronchi, lung diseases, respiratory muscle weakness or paralysis; chest trauma, lung, heart surgery; CPR and other acute and critical diseases that involve breathing. Mechanical ventilation was used with the help of a respiratory machine to maintain unobstructed airways, improve ventilation and oxygen exchange, prevent the body from lacking oxygen and carbon dioxide accumulation, and create conditions for the treatment of underlying diseases. It was the most effective method to treat respiratory failure and critically ill patients.
** II. Eccentric Membrane Oxification (Eccentric Membrane Oxification)**
It was suitable for critically ill patients with heart and lung problems, such as respiratory failure and cardiac arrest. It could assist breathing and blood circulation, and was regarded as the "ultimate weapon" in the intensive care unit (ICU). Although it was not a treatment method for the cause of the disease, it could replace the patient's heart and lung function in the short term, prolong the patient's life, and create time for the treatment of the primary disease. It played an irreplaceable role in the rescue of critically ill patients.
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Paediatic life supportPaediatic life support included basic life support and advanced life support.
** 1. Basic Life Support Points **
1. ** Chest Compressions **
- ** Child (<8 years old)**
- ** Pressing location **: The sternum at the middle of the line connecting the papilla.
- ** Pressing strength **: Press the root of the palm, and the sternum will sink to 1/3 - 1/2 of the chest.
- ** Pressing frequency **: 100 times/min; ratio to breathing (single): 30:2,(double): 15:2.
- ** Infant (<1 year old)**
- ** Pressing location **: Below the breast bone below the papilla.
- ** Pressing strength **: The sternum is sunken to 1/3 - 1/2 of the antero-lateral diameter of the chest.
- ** Pressing frequency **: 100 times/min; ratio to breathing (single): 30:2,(double): 15:2.
2. ** Treatment of foreign body obstructing the air passage **
- ** When consciousness exists **
- Continuous coughing and forced breathing are encouraged. For children, the Heimlich maneuver can also be used. Standing behind the patient, embrace the patient's torso from the armpit, aim the thumb of the fist at the patient's abdominal line, below the xiphoid process and above the umbilicus, hold the fist with the other hand, and quickly push up with both hands (do not touch the xiphoid process or costa). For the infant, use the back knock and chest compression method. The head is lower than the torso and lies prone on the forearm of the rescuer (placed on the thigh together, and the hand supports the lower jaw to support the head). Between the shoulder blades, use the palm root to knock forward and downward for five times. Then support the head and neck to change the position to supine, and use the chest compression technique and position to quickly press down.
- ** When I lose consciousness **
- The infant tried artificial ventilation, back knocks, and chest compressions. The child was placed in a supine position with his tongue and jaw raised in an attempt to remove the foreign body.
3. ** Regarding oxygen therapy **: The SpO2 titre of oxygen therapy should be 94 - 98%. Prior to titrating, it is recommended to start with high-flow oxygen for children who show signs of circulatory/respiratory failure and cannot measure SpO2 (or PaO2).
** 2. Advanced Life Support **
At present, there were relevant materials such as the Learning Guide for Advanced Life Support in Paediatics, which described this. Combined with the paeditic emergency treatment before and after admission, the content was comprehensive, concise, and easy to refer to.
In general, the operation, scope of application, and management of life support in pediatrics were different from that of adults. There were also differences in the specific operation of life support for children of different ages. In the implementation process, many factors should be integrated to ensure that children were treated appropriately.
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Neonatal life support includesNeonatal life support included many aspects, such as:
1. ** Neonatal Resuscitate **:
- The preparation work before the recovery.
- Master the basic procedures of resuscitation, including support for the newborn's breathing and circulation.
- The treatment of special circumstances, such as dealing with various complicated situations when a newborn was suffocated.
- After the resuscitation, the patient was monitored to ensure that the newborn's condition was stable.
2. ** Teamwork **: Medical staff (such as newborns, obstetricians, anesthesiologists, and other related medical staff) must work closely together to improve the success rate of newborn resuscitation.
3. ** Skill training and assessment **: Medical staff need to be proficient in relevant clinical operation skills, such as newborn resuscitation skills, PICU placement technology (to provide medium and long-term venous treatment channels for premature infants and critically ill newborns), etc., and continuously improve their skills through training and assessment.
4. ** Construction and improvement of treatment facilities **: For example, building a NICU (Neonatal Critical Care Unit) to provide the necessary medical environment and equipment support for critically ill newborns.
5. ** Treatment and management of diseases **: effective treatment and management for different diseases of newborns, such as respiratory, circulatory, digestive and other system problems commonly seen in premature infants, infectious diseases, etc. It also includes the use of advanced technologies such as ECMO (ECMO) to replace the heart and lung function of critically ill newborns.
6. ** Blood sugar management, prognosis considerations, etc. **: Blood sugar management during resuscitation and assessment of the newborn's prognosis.
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What are the ICU life support technologies?The life support techniques in the ICU included the following:
1. ** Breathing Support Technique **:
- ** oxygen therapy **: The methods include nasal tube oxygen therapy, mask oxygen therapy, and nasal high-flow oxygen therapy. Transnasal high-flow moistened oxygen therapy can provide patients with a relatively constant oxygen concentration (21% - 100%), temperature (31 - 37 ° C), and humidity of high-flow (8 - 80L/min) gas, and oxygen therapy through nasal obstruction. It has good comfort. The connection method is non-invasive through nasal obstruction, which is beneficial to the patient's expectoration and airflow protection.
- ** Mechanical ventilation **: Use a mechanical device to replace, control, or change the ventilation method of spontaneous breathing. With the help of a respiratory machine, it was the most effective method to maintain the unobstructed airflow, improve ventilation and oxygen, prevent the body from lacking oxygen and carbon dioxide accumulation, and create conditions for the treatment of underlying diseases. Mechanical ventilation included non-invasive positive pressure ventilation and invasive mechanical ventilation. Non-invasive positive pressure ventilation did not require invasive or invasive intubation or incision of the trachea. The patient was connected to the ventilation machine through a nasal mask, mouth and nose mask, full face mask, or head mask for positive pressure assisted ventilation. Injured mechanical ventilation was mechanical ventilation through invasive operations. Mechanical ventilation is suitable for brain trauma, infection, cerebral vascular accident, poisoning, bronchi and lung diseases, respiratory muscle weakness or paralysis, chest trauma or lung, cardiac surgery, CPR and other acute and critical situations involving breathing.
2. ** Nutritional support technology **: For example, nutritional therapy with a Jejunal tube. Jejunal tube feeding was safer than gastric tube feeding. It could effectively reduce the occurrence of aspiration accidents and the resulting lung infection. It could also broaden the route of administration, such as convenient administration of traditional Chinese medicine, especially for critically ill patients (such as severe pneumonias, coma after stroke, multiple organ failure, severe epilepsy, severe trauma, and other patients with poor appetite, gastric dysmotility, and even swallowing difficulties).
3. ** Ectopic Membrane Oxification (Ectopic Membrane Oxification)**: It is suitable for critically ill patients with heart and lung function problems, such as respiratory failure and cardiac arrest. Ecimo could assist in breathing and blood circulation. It was regarded as the ultimate weapon in the intensive care unit (ICU). It was equivalent to an artificial heart providing power for blood flow.
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