1、应急预案+流程图 应急预案 流程图第三军医大学新桥医院 血液净化中心应急预案 1.低血压 . 2 2.肌肉痉挛 . 3 3.恶心呕吐 . 4 4.头痛 . 5 5.失衡综合症 . 6 6.空气栓塞 . 透析器反7 .应 . 8 7 8.透析器破膜 . 9 9.体外循环凝血 .10 10. 火灾 .11 11.意外停水 .12 12.意外停电 .13 13.地震 .14 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance
2、of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and
3、the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system h
4、ours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication
5、 component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital p
6、rogram-controlled switchboards. Operators providing communications . If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 1.低血压 透析中低血压 采取头低脚高位 立即采取措施 停止超滤减慢血流速度 补充生理盐水100ml 报告医生 查看病人，分析原因，对症处理好转 无好转 密切观察血压，逐 步恢复超滤 继续补充生理盐准确记录病情 水扩容，根据情况
7、 使用升压药 必要时停止透析 下次转换透析模 式:序贯超滤， CRRT等 透析中常见低血压原因分析: (1)容量相关性因素:包括超滤速度过快(0.35ml?Kg-1?min-1)、设定的干体重过低、透 析机超滤故障或透析液钠浓度偏低等。 (2)血管收缩功能障碍:包括透析液温度较高、透前应用降压药物、透析中进食、中重度贫 血、自主神经功能障碍(如糖尿病神经病变患者)及采用醋酸盐透析者。 (3)心脏因素:如心脏舒张功能障碍、心律失常(如房颤)、心脏缺血、心包填塞、心肌梗 死等。 (4) 其它少见原因:如出血、溶血、空气栓塞、透析器反应、脓毒血症等。 for computer software en
8、gineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring sy
9、stem (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitoring system out entrance control s
10、ystem car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Kok intelligent integrated system
11、 of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system using a local telecommunications
12、 operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications . If any compatibility requirements, by way of increased access to the Communications Board within the chassis to meet 2.肌肉痉挛 透析器反应 报告上级医师 准确记录
13、病情 肌肉痉挛 A型透析器反应 B型透析器反应 透析开始后5分钟内发生 透析开始后20,60min 出现 监测血压 发生 立即采取措施外力挤压痉挛肌肉 立即停止血泵，夹闭血路报告医生 吸氧，心电监护 报告医生 管，丢弃管路和透析器中 血液，予吸氧，心电监护 查看病人，分析原因，对症处理 报告医生 予抗组胺、激素或肾上 腺素药物治疗 必要时心肺支持治疗 超滤过多过快 低钙血症 补充10%葡萄糖酸钙 快速输注生理盐水， 采用高钠透析，或设 置超滤曲线 准确记录病情 采取预防措施 :病人体重增长不超过干体重的5, 透析中肌肉痉挛原因分析 透析中低血压、低血容量、超滤速度过快及应用低钠透析液治疗等导致
14、肌肉 血流灌注降低是引起透析中肌肉痉挛最常见的原因;血电解质紊乱和酸碱失衡也 可引起肌肉痉挛，如低镁血症、低钙血症、低钾血症等。 3 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engine
15、ering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast pa
16、rt) security technology prevention system security monitoring system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and t
17、raining system call intercom system hours, five hours Kok Kok intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer r
18、oom located in the engine room. Voice communication system using a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications . If any compatibility requirements, by way of incre
19、ased access to the Communications Board within the chassis to meet 3.恶心呕吐 恶心呕吐 头偏向一侧防误吸 保护穿刺侧肢体，防止针滑脱，A-V管受压 清除口腔分泌物，床旁备吸引器及相关物品 立即采取措施 监测血压 查看病人，分析原因，对症处理 报告医生 失衡综合征按失衡低血压者按低血高血压脑病或脑 综合征处理 压处理 血管意外结束透 析治疗抢救 准确记录病情 透析中恶心呕吐原因分析: 常见原因有透析低血压、透析失衡综合征、透析器反应、 糖尿病导致的胃轻瘫、透析液受污染或电解质成份异常(如 高钠、高钙)、 高血压导致高血压脑病或
20、脑血管意外等。for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent building weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilit
21、ies system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (containing public broadcast part) security technology prevention system security monitorin
22、g system out entrance control system car library management system hours three Kok building equipment monitoring system hours four Kok information application system queued station ICU visitation system operation the system monitoring and training system call intercom system hours, five hours Kok Ko
23、k intelligent integrated system of information system (1) cabling systems (including computer room network, communication component) computer network systems and voice communications systems Center of information on medical floor computer room located in the engine room. Voice communication system u
24、sing a local telecommunications operator providing voice service, configuration-independent integrated services digital program-controlled switchboards. Operators providing communications . If any compatibility requirements, by way of increased access to the Communications Board within the chassis t
25、o meet 4.头痛 透析中头痛监测血压 立即采取措施 降低血流量 查看病人，分析原因，对症处理 报告医生 失衡综合征按失衡高血压者按高血 综合征处理 压处理 准确记录病情 透析中常见原因 透析失衡综合征、严重高血压和脑血管意外等。对于长期饮用咖啡者， 由于透析中咖啡血浓度降低，也可出现头痛表现。 5 for computer software engineering GB/T50314-2000 of electrical installations code for construction and acceptance of GBJ232- 92 intelligent buildin
26、g weak design construction figure set GJBT-471 2. system description this times engineering weak design including: hours a Kok information facilities system integrated wiring system (containing room network, communications part) wired TV system information guide and the released system hours II Kok public security system fire automatically alarm system (
