The prevention and treatment of the complications of endotracheal intubation in SICU / 中国基层医药

Objective To discuss the clinical preventation and treatment of the complications induced by endotracheal intubation in SICU.Methods Retrospective analysis was used on 55 cases of intubated patients in our hospital nearly 2 years.Results The incidence of endotracheal intubation was 36.4％,pneumonia 23.6％,accidental extubation 5.5％,endotracheal ulcer 1.8％,tracheoesophageal fistula 1.8％,obstruction of tracheal catheter 1.8％,arytenoid dislocation 1.8％.Conclusion The causeof complications of endotracheal intubation in SICU were overtime intubation,tranma,excessive-pressure of the air cuff and local inflammation.Airway humidification,suitable sedation,accurate and moderate operation,extubation or tracheotomy,suitable cuff pressure and fiberoptic bronchoscopy examination could avoid such complications.

Surveillance to Invasive Fungal Infection in Surgical Intensive care Unit During 6-years / 中华医院感染学杂志

OBJECTIVE To surveillance invasive fungal infection rate in SICU,in order to direct intervention to prevent invasive fungal infection.METHODS The samples collected from SICU patients in our hospital between Jan 2003-Nov 2008 were cultured.RESULTS According to the diagnosis standard of nosocomial infections,75 case of 3699 patients were isolated fungi.During 6-years invasive fungal infection rate is 2.027%,(1.05%-2.63%).Totally 86 fungi strains were isolated,the majority of them being Candida albicans,accounting for 46.51%;Candida glabrata 22.09%;Candida tropicalis 13.95%.CONCLUSIONS During 6-years,invasive fungal infection rate and incidence density do not increase.Candida are the major pathogens of fungal infections in SICU.

Application value of APACHE Ⅲ in surgical iCU / 重庆医科大学学报

Objective:To evaluate and analyze the application value of Acute Physiology and Chronic Health EvaluationⅢ(A- PACHEⅢ)in evaluation of the severity and prognosis of patients in SCIU.Methods:By collecting and sorting out the data of 341 cases of surgical serious patients,the severity and prognosis of patients were evaluated by APACHEⅢ.Results:Making comparison among the different types of diseases,the scores and mortality of cerebral hemorrhage and multiple hurt were high- er than those of the diseases(P

Hospial Infection in Surgical Intensive Care Unit(SICU):Analysis and Countermeasures / 中华医院感染学杂志

OBJECTIVE To analyze the reasons causing hospital infection in surgical intensive care unit(SICU) in order to make the intervention strategy.METHODS The underlying diseases,age,interventional manipulation and medical staff versus hospital infection and the status of pathogens in SICU were analyzed.RESULTS Severe diseases among old patients caused hospital infection easily.More times of interventional manipulation made the occurrence of hospital infection more frequent.The inappropriate use of antibiotics caused resistant pathogens.SICU established incorrectly and the lack of medical staff increased cross-infection possibly.CONCLUSIONS In order to control infection in SICU,the effective measures should be taken,including strengthening the regulations of administration about SICU,enhancing the antiseptic measures for severe patients,anddecreasing interventional manipulation.

Approach on Factors Related to Dead Case in SICU / 重庆医科大学学报

Objective; To discuss the related factors of Surgical Intensive Care Unit in order to further reduce the death rate in SICU. Methods; The clinical data of 112 death cases were analyzed retrospectively. Results; The dead cases in the SICU had certain features. The high MODS incidence and unsolved surgical problems should be paid attention to so as to prevent errors during the treatment process actively. Conclusion; The recognition of surgical critical illness and the special knowledge should be enhanced so as to improve the cure successful rate of SICU.

The Administration Patterns of Analgesics and Sedatives for Patients in SICU / 간호학회지

Major purposes of this study were to investigate the administration patterns of analgesics and sedatives in SICU and to identify the factors influencing the use of prn analgesics and sedatives by ICU nurses. The sample of this descriptive study was 50 adult patients in SICU and 53 ICU nurses. Patient's medical records were reviewed to investigate names, doses, the routes of administration, the interval of administration, and the type of prescription of sedatives and analgesics administered. Study medications were narcotics, hypnotics, and antipsychotics. To identify the factors influencing the use of prn analgesics and sedatives, 53 ICU nurses checked 9 items, and rank them from first to fifth. The selection of items was based on the previous studies and the experience of the investigator. The results of the study are as follows: 1. The mean age of the subjects was 53 years, 24 patients out of 50 subjects had received mechanical ventilation therapy. Most of the patients received neurosurgeries and abdominal surgeries. 2. For 4 days, 13 total study medications and combination of these were administered to the patients. Commonly prescribed drugs were Ketoprofen and Midazolam. Twenty six to fourty two percent of the patients did not receive any drugs for at least one day during the four days. 3. On the average, the study drugs were administerd 1.4 to 2.6 times per day during 4 days. 4. More than 50 percent of the prescription was as-needed (prn) except those of the POD 3. Fourteen percent of the patients did not have any prescription for sedation and pain control after surgery. 5. Examination of the frequency of sedatives and analgesics bolus administration revealed that a greater number of doses were given during daytime (from 7 am. to 7 pm.) than nighttime (from 7 pm. to 7 am.). The difference was significant at Alpha, .05. 6. First factor that most influenced nurses to administer sedatives and analgesics for intubated patients was the evaluation of patient's vital signs (51%). For non- intubated patients, the factors that nurses considered important were the patients' complaints of pain (64%) and evaluations of patients' vital signs (23%). In conclusion, the results of this study indicate that patients in SICU might not receive enough analgesics and sedatives to feel completely free from pain during the post operational period. Future study should be focused on the evaluation of the adequacy of current practice for pain and anxiety control in terms of the SICU patient's response.

Analysis of the Nursing Interventions done by MICU and SICU nurses using NIC / 간호학회지

The purpose of this research was to identify nursing interventions performed by MICU and SICU nurses. For data collection this study used the taxonomy of the Nursing Interventions Classification(NIC: 433 nursing interventions) which was modified by McCloskey and Bulecheck(1996). Each of the 433 interventions were identified as used by MICU and SICU nurses. More than 50% of the ICU nurses performed 280 nursing interventions at least monthly. Rarely used interventions included 26 nursing interventions in the childbearing care class. Overall, both MICU and SICU nurses used interventions in the Physicological : Complex domain most often on a daily basis and the interventions in the Family domain least often. The most frequently reported interventions as being used daily in the MICU were chest physioterapy, airway suctioning and coughing enhancement and, in the SICU, documentation and airway suctioning. There were significant differences between MICU and SICU nurses differences interventions childbearing care, cognitive therapy, communication enhancement, coping assistance, elimination management, lifespan care, health system mediation, immobility management, medication management, neurologic management, patient education psychological comfort promotion, physical comfort program, respiratory management, risk management and information management. The SICU nurses performed there interventions more frequently than the MICU nurses. These findings will help in building of a standardized language for the MICU and SICU and enhance the quality of nursing care.