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夜班医生常见问题一般处理原则 !

2016-01-13 佚名 医学之声整理自网络

1.夜班既是白天工作的延续,又有其特殊性:医护人员少,可获得的医疗资源少,危重病人夜间病情容易变化。 2.能在白天解决的诊治关键问题,例如向家属交待病情,决定是否进行有创抢救等,尽量不要留给夜班;能在前半夜解决的问题,包括请会诊、作检查,不要留到后半夜。 3.白班应对重点病人的病情作详细交班,可能出现重大病情变化或需要有创性操作(如内镜、介入、手术)的病人要在交班的同时通知总住

1.夜班既是白天工作的延续,又有其特殊性:医护人员少,可获得的医疗资源少,危重病人夜间病情容易变化。

2.能在白天解决的诊治关键问题,例如向家属交待病情,决定是否进行有创抢救等,尽量不要留给夜班;能在前半夜解决的问题,包括请会诊、作检查,不要留到后半夜。

3.白班应对重点病人的病情作详细交班,可能出现重大病情变化或需要有创性操作(如内镜、介入、手术)的病人要在交班的同时通知总住院医师,便于联系相关人员。

4.及时请示上级医师,及时申请相关科室会诊,汇报病情要简单扼要、重点突出、信息明确。

5.重视病人新出现的和难以解释的症状和体征,生命体征是最需要关注和严密监测的指标。

6.诊断思路:不要求立即获得明确诊断,但必须首先排除致命性和对诊治时机要求高的急症,如急性心梗、肺栓塞、急腹症、脑血管意外、中枢神经系统感染等。

7.尽量不更改长期治疗方案,只处理当晚需要解决的紧急问题,把涉及病人总体诊疗计划的问题留给主管医生。如果对某些医嘱有疑问,首先明确当晚执行这些医嘱是否会对病情有重大影响,如果不是,则最好等到次日早晨向主管医生澄清疑问。

8.病情判断不明时,处理应积极,千万不可存在侥幸心理,消极等待。如果你决定“先看看吧”,一定要有充分的理由。

9.带病人外出检查必须首先评估转运途中的风险,做好充分准备,缩短病人脱离监护、氧气支持和抢救设备的时间,转运途中密切监测生命体征,请总住院医师协助。

10.病情危重,诊断不明,治疗效果不明显时,及时交代病情,争取病人和家属的理解。

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    2016-01-19 Kiste

    责任心呐

    0

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    2016-01-14 jiangxianchen

    夜班医生可怜

    0

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    2016-01-13 老段

    可怜

    0

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    2016-01-13 木醇阳

    0

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    2016-01-13 午夜星河

    可怜

    0

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    2016-01-13 Lynee劲飞扬

    呵呵

    0

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