一位肝脏撕裂伤患麻醉期间发生恶性高温之护理经验摘要本文描述一.pdfVIP

一位肝臟撕裂傷患 麻醉期間發生惡性高溫 之護理經驗 摘 要：本文描述一位車禍造成肝臟嚴重撕裂傷的青少年，短期內再 次行剖腹探查手術時於 麻醉期間發生惡性高溫 ，術後入住加 護病房之護理經驗 。筆者以麻醉科護理師的角色協同照護個 案，護理期間自民國2008 年11月 13日至 11月 25日 ，透 過病歷記載、身體評估、實際 參與護理及會談等方式收集資 料，發現個案有呼吸道清除功能失效、體溫過高、疼痛 等身 體不適及 生命受 威脅產生焦慮等健康問題。護理過程中運用 同理心透過關懷、傾聽、陪伴與個案建立良好治療性關係 ， 鼓勵個案以正向態度陎對此特異體質 （idiosyncrasy ），並引 導其抒發負向的情緒感受，同時加強病人與家屬對惡性高溫 的了解及提醒其未來必頇注意的事項。 經過近二星期的照 護，個案呼吸、體溫等生理現象均回復正常，疼痛及焦慮獲 得緩解，身、心、社會各方陎逐漸適應。希望藉此文提供護 理同仁瞭解惡性高溫的臨床症狀、治療方式與相關照護經 驗，並冀望能作為日後照顧類似個案時之參考。 關鍵字：惡性高溫、單挫林 、特異體質 1 The Nursing Experience of the Liver Laceration Surgery Patient who is Suffering from Malignant Hyperthermia during General Anesthesia ABSTRACT This case report describes the nursing experience of a teenager who was injured in a car accident. Accepted the second exploratory laparotomy surgery, he suffered from malignant hyperthermia during general anesthesia period and then transferred to the intensive care unit after the operation. The author is an anesthetic nurse and has coordinated with an ICU nurse to look after this case from November 13th to 25th, 2008. After assessing the patient’s condition by medical record, physical examination, practical participation, and interview, the author found that the patient had both physical and psychological problems, such as ineffective airway clearance, hyperthermia, acute pain, and anxiety. Therefore, the author has established therapeutical relationship with the patient through empathy, concern, listen, and accompany with the patient during the nursing process. Furthermore, the author encouraged the patient to face idiosyncrasy, led him to express the negative emotion, offered professional knowledge about malignant hyperthermia to him, and mentioned the notes which he had to pay atte