Design and application of wrist restraint gloves suitable for patients with agitation / 中华危重病急救医学

Patients in the intensive care unit (ICU) often need to have various catheters placed on their bodies due to their severe condition. In order to prevent the occurrence of unplanned extubation, patients' hands should be restrained appropriately. The current restraint gloves used in clinical practice have problems such as improper restraint, easy falling off of oxygen saturation monitoring probes, and pressure injury of hands. Therefore, department of critical care medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a wrist restraint glove suitable for restless patients, and obtained the national utility model patent (ZL 2020 2 1612453.7). The device is composed of restraint gloves and restraint rings, which can not only restrain patients, but also continuously monitor the changes of blood oxygen saturation in patients with restfulness. This device is convenient to use, low cost, comfortable to wear, and can prevent the occurrence of device-related pressure injuries, which is suitable for clinical application.

Design and application of flushing device of a totally enclosed sputum suction tube for reducing the incidence of ventilator-associated pneumonia / 中华危重病急救医学

Ventilator-associated pneumonia (VAP) is one of the most common infectious diseases in patients undergoing mechanical ventilation in intensive care unit (ICU). Although the use of closed sputum suction tube for sputum suction is the most common nursing measure for patients with tracheal intubation in ICU, and it is also an important measure to reduce the occurrence of VAP, the existing clinical technology still needs to use external flushing solution for humidification and flushing. In the process of use, the flushing operation has the risk that the amount of flushing fluid cannot be controlled, resulting in a large amount of flushing fluid entering the patient's airway, causing the patient to suffocate. The sputum attached to the wall of the sputum suction tube cannot be completely flushed, and the prolonged retention of the sputum leads to the proliferation of colonized bacteria, aggravating the infection of patients. Repeated pipe flushing not only increases consumables, but also increases the workload of medical staff. For this reason, the author has designed a fully enclosed sputum suction tube flushing device, which has obtained the National Utility Model Patent of China (patent number: CN 2019 2 1198740.5). This device is an integrated design, and the materials used for sputum suction, humidification and flushing are fully enclosed, without air exposure, and can be operated strictly without bacteria. Pulse flushing with syringe can clean the sputum attached to the inner wall and reduce the incidence of VAP. The volume of flushing fluid can be effectively controlled during use to ensure patient safety and reduce waste. It is worth popularizing and applying in clinical practice to optimize the operation steps and reduce the workload of medical staff.

Design and application of a rapid positioning and measuring device for leg circumference / 中国实用护理杂志

Objective:To investigate the application effect of rapid leg circumference positioning measuring device in critical ill patients.Methods:From August 2021 to November 2021, selected 50 patients in ICU of Hangzhou First People′s Hospital. Two methods to measure the leg circumference of the same patient at the same time were used. The traditional method used a tape measure to measure the leg circumference, while the improved method used the rapid positioning and measuring device of leg circumference to measure the leg circumference. the average total positioning time, average total measurement time, average measurement difference and nurses′ satisfaction were compared.Results:The total positioning time and total measurement time of the improved method were respectively (15.2 ± 3.3) s and (34.0 ± 3.9) s, which were shorter than the traditional method (29.0 ± 3.1) s, (79.1 ± 4.9) s, the differences were statistically significant ( t=50.93, 21.43, P<0.05). The measured data difference between 15 cm above patella and 10 cm below patella of the improved method was (1.27 ± 0.67) mm, (0.93 ± 0.31) mm, which were less than the traditional method (8.82 ± 3.28) mm and (7.94 ± 2.11) mm, the differences were statistically significant ( t=28.66, 23.42, P<0.05). Nurses′satisfaction in the improved method was 96.0% (48/50), which was higher than 36% (18/50) in the traditional method, and the difference was statistically significant ( Z=5.78, P<0.05). Conclusions:The leg circumference measurement device designed in this study can effectively save the leg circumference measurement time, quickly and accurately, increase the comfort of patients and improve the satisfaction of patients and nursing staff. It is worthy of clinical application.