人工气道内吸引与安全

气道高压报警Р⑥患者主诉有痰РAmer ican Assaciati an for Resai ratory Care. AARC cl inical practice guide ines: endatracheaРtioni ng of mechanical ly venti lated patients with arti ficial airways 2010. RespiratorРcare,201.5562):75-764РРР令吸痰途径Р经气管插管吸痰法Р经口腔、鼻腔吸痰法Р经气管切开吸痰法、纤维支气管镜下吸痰РРР令吸痰方式分类Р开放式吸疲Р密闭式吸疲Р分类方Р式Р按照吸痰管插入深度分Р吸痰笞的插Р入深度以有抵抗时停止再往上回提lcm为准Р2、度吸痰( Shallow suciton):吸瘐笞插Р入一定预设深度,通常为人工气道长皮加Р上辅助裝置的长度。Рy Care. AhRc cl inical practice guicel ines: endotracheal suct ioning of mechanical ly vent i lated patientsРal airways 2010, Resp iratory Care, 2010, 55( 6: 758-764РРР令痰液的分度Р痰液粘稠度区别I度(稀痰)Ⅱ度(中度粘痰)Ⅲ度(重度粘痰)Р痰液性状Р稀痰Р较I度粘稠Р明显粘稠Р痰液颜色Р米汤或白色白色或黄白色Р黄色伴血丝痰、血痰Р能否咳出Р易咳Р力咳Р不易咳出Р吸痰后玻璃头内Р大量滞留,不易冲净Р壁痰液滞留情况Р易被冲净Р及痰管常因负压过大Р而塌陷Р补加湿化液时间及量ml/2-3h4ml/1hР4-8ml/0.5hР湿化不足:痰痂形成Р备注(湿化程度)2湿化过度:呼吸急促、痰液呈水样、sO2下降3%以上РРРPart2Р≌临床操作Р气道内吸痰