RESUMO
Objective To investigate the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) in patients with pre-hospital respiratory and cardiac arrest.Methods Forty-five patients with respiratory and cardiac arrest,and with contraindication of chest compression admitted to Baiyin Central Hospital of Gansu Province from March 2012 to September 2018 were enrolled,and they were divided into two groups according to random number table.AACD-CPR (abdominal compression-decompression group,n =24) and cardiopulmonary resuscitation (CPR) with unarmed abdominal compression (unarmed abdominal pressure group,n =21) were performed respectively.The success rate of rescue was observed in the two groups,and the changes in heart rate (HR),pulse oxygen saturation (SpO2) and blood pressure 30 minutes after CPR in patients with restoration of spontaneous circulation (ROSC) were observed.Results Among the 24 patients in the abdominal compression-decompression group,5 patients (20.83％) had ROSC,and 2 patients (9.52％) had ROSC in 21 patients of the unarmed abdominal pressure group.The success rate of resuscitation in the abdominal compression-decompression group was significantly higher than that in the unarmed abdominal pressure group (P ＜ 0.05).HR of ROSC patients at 30 minutes of CPR in abdominal compression-decompression group was significantly lower than that in unarmed abdominal compression group (bpm:139.45±5.08 vs.147.62±5.24,P ＜ 0.05),and SpO2 and blood pressure were significantly higher than those in unarmed abdominal compression group with significant differences [SpO2:0.92 ± 0.03 vs.0.85 ± 0.03,systolic blood pressure (SBP,mmHg,1 mmHg =0.133 kPa):118.23 ± 3.26 vs.98.51 ± 3.10,diastolic blood pressure (DBP,mmHg):60.10 ± 2.50 vs.56.36 ± 2.45,all P ＜ 0.05].Conclusion The effect of AACD-CPR was superior to that of unarmed abdominal pressure CPR,which had higher application value to rescue patients with respiratory and cardiac arrest with chest pressure contraindication.
RESUMO
Objective To investigate the clinical value of cardiopulmonary resuscitation (CPR) with abdominal lifting and compression on patients with breathing and cardiac arrest induced by severe chest trauma.Methods Sixty-six breathing and cardiac arrest patients induced by severe chest trauma admitted to the General Hospital of Jingyuan Coal Industry Group Company from October 2011 to October 2016 were enrolled,and they were divided into abdominal lifting and compression group (n =32) and unarmed abdominal compression group (n =34) by random number table.The patients in both two groups were given the airway open,respiration support,defibrillation treatment,venous access establishment,vasoactive drugs application and other conventional treatments.On the basis of the routine treatment,the patients in abdominal lifting and compression group were given application of abdominal lifting and compression device with 100 times/min frequency and continuously alternating press down to lift the abdomen,the amplitude of pressing and pulling were 3-5 cm below or above the original level of the abdomen.Those in unarmed abdominal compression group were given abdominal CPR pressing method by hand,the frequency of pressing and depth of subsidence was the same as abdominal lifting and compression group.Heart rate (HR) and arterial blood gas at 30 minutes after CPR as well as the success rate of resuscitation were compared between the two groups.The changes in HR,mean arterial pressure (MAP) and pulse oxygen saturation (SpO2) before and 30 minutes and 60 minutes after CPR were dynamically observed in patients with restoration of spontaneous circulation (ROSC) after abdominal lifting and compression CPR treatment.Results Compared with the unarmed abdominal compression group,HR (bmp:136.13±6.14 vs.148.45±5.16) and arterial partial pressure of carbon dioxide [PaCO2 (mmHg,1 mmHg =0.133 kPa):48.51 ±2.60 vs.62.51 ±2.50] at 30 minutes after CPR in abdominal lifting and compression group were significantly lowered,and arterial partial pressure of oxygen (PaO2) was significantly increased (mmHg:88.07±3.92 vs.74.12±2.12,all P ＜ 0.05).Four patients with ROSC were found in abdominal lifting and compression group,and 2 in unarmed abdominal compression group.The success rate of resuscitation in abdominal lifting and compression group was significantly higher than that of unarmed abdominal compression group (12.50％ vs.5.82％,P ＜ 0.05).In 4 patients with ROSC after abdominal lifting and compression CPR showed a downward trend in HR and an upward trend in MAP and SpO2 with CPR time prolongation.Conclusions The effect of abdominal lifting and compression CPR is better than that of unarmed abdominal compression CPR,which is of great value for the life saving of patients with breathing and cardiac arrest induced bv severe chest trauma.
RESUMO
Objective:To evaluate the safety and efficacy of dosing transdermal fentanyl patch by patient-controlled intravenous anal-gesia (PCIA) with fentanyl to treat opioid-naive patients suffering from cancer-related pain. Methods:In this open non-controlled trial, 30 patients with moderate to severe cancer pain were enrolled in the study. Titration conditions, pain score (NRS), and pain of life im-pact scores were assessed and recorded during four periods of treatment, as follows:before fentanyl-PCIA;during fentanyl-PCIA treat-ment;during Duragesic with fentanyl-PCIA treatment;and during Duragesic treatment. Adverse reactions were assessed and recorded during the two periods of treatment (the period before fentanyl-PCIA and the period after fentanyl-PCIA). Results:A total of 20 cases of titration were a success, whereas 10 cases failed. The general pain score, the most serious pain score, activity pain score, resting pain score, and the pain of life impact scores were all significantly reduced during fentanyl-PCIA treatment, during Duragesic with fen-tanyl-PCIA treatment, and during Duragesic treatment compared with the period before fentanyl-PCIA treatment (P<0.05). Nausea was the only adverse reaction that occurred during treatment. Obvious muscle rigidity, loss of consciousness, cough, respiratory depres-sion, and bradycardia were not observed. Conclusion:Dose titration of transdermal fentanyl patch with fentanyl administrated by PCIA for opioid-naive patients provides an effective and convenient method for pain relief treatment.
RESUMO
Objective To explore the training mode and practical effects of nurse training on oncology nursing. Methods One hundred students were chosen by examination and inspection and then trained in the full-time centralized training mode. In the program, the theory courses focused on the characteristics of specific nursing. Multi-mode teaching was adopted in the clinical practice. Thelearn andteach evaluation was implemented throughout the whole process. Results All of the students were trained in our training base with the pass rate of 98.0%. The rate of satisfaction with teaching and management quality reached 100.0%. Conclusion The scientific and standard training can improve the knowledge and skills of the oncology nursing specialists.
RESUMO
Objective To investigate the establishment and application effect of Evaluation Form for Cancer Pain Nursing Quality Control. Methods Nursing quality control team was founded on account of the leadership of the superintendent of nursing department and the head nurse from department of pain clinic. The team consisted of eight nurses containing the head nurse from model ward of the standardized treatment for cancer pain and nurses from department of pain clinic. According to the criteria and content of on- site assessment of cancer pain standardized treatment demonstration unit, indexes for cancer pain nursing quality was made, combining with the management practice of cancer pain nursing. The quality indexes was divided into five one- class indexes which had a total score of 100 and 20 for each including pain assessment, cancer pain treatment, patient education, nursing ability and others. Each one- class index followed with two - level index. And the table was applied to the cancer pain standardized treatment demonstration unit. Results After application of the Evaluation Form for Cancer Pain Nursing Quality Control, the following items were improved compared with those before application: accuracy of pain assessment [97.22%(70/72)vs.90.28%(65/72)], correctness of nursing record [98.61%(71/72)vs.88.89%(64/72)], satisfactory rate of pain control [97.22%(70/72)vs.84.72%(61/72)], accurate usage rate of cancer drugs [100.00%(72/72)vs.88.89%(64/72)] , understanding rate of health knowledge of patients and their family members[100.00%(72/72)vs.80.56%(58/72)], satisfactory degree of patients and their family members with nurses [100.00%(72/72)vs. 88.89%(64/72)], χ2=4.71, 8.87, 10.86, 8.87, 18.00, 8.87, P<0.05 or 0.01. Conclusions Application of Evaluation Form for Cancer Pain Nursing Quality Control in management of cancer pain can improve the nursing quality of cancer patients.