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ICU插管患者通過E-Z板進行交流

【?2004-11-19 發布?】 美迪醫訊
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由于氣管插管通過聲帶,許多重癥患者無法表達自己的需求。為改變這種令人沮喪的局面,一個學生發明了一種信息交流板幫助患者告知護理者他們的需求。

使用機械通氣的患者無法表達感情、確認需求以及通過語言交流來面對恐懼、焦慮和壓力。“你不能僅僅通過客觀現象來治療患者”,加州大學洛杉磯分校(the University of California in Los Angeles,UCLA)David Geffen醫學院一位三年級醫學生Lance California說,“聽任處于危險期的患者不能有效地與人交流,不僅僅是一種疏忽大意還是一種不仁慈的行為,并且不能為醫療實踐所接受的。在任何情況下,我們都應該接受來自患者的主觀體驗。”

在過去數年中,在作為前UCLA醫學中心的護士照顧了許許多多這種重癥患者之后,1998年他萌生了這種想法:設計一種便于使用的具有明確含義的交流板,這樣插管患者能夠使用標簽筆做簡單的標記,將他們的需求告知他們的護理者和家庭成員。

使用這種輕便柔軟的E-Z板,患者就可以表達基本的需求,諸如口渴、寒冷和疼痛,或者諸如想坐起來、活動、洗臉的想法,或者是簡單地說“謝謝你”。所有這一切只要使用一種易于擦拭的記號筆在適當的選擇上作個標記即可。

一般情況下,機械通氣患者通過便條來傳遞他們需求。但是這些便條通常字跡模糊,或者拼寫錯誤百出。結果護理者不得不試圖理解患者的非語言交流方式,諸如怪臉、手勢、點頭和書寫,這些對重癥患者是十分困難的。這些非語言交流方法令這些患者十分疲勞的,也是一種感情的宣泄。

英文原文:

Intensive Care: Intubated Patients Communicate via E-Z Board

Many critically ill patients cannot communicate their needs due to the endotracheal tubes that go through their vocal cords. To ease this frustrating situation, a student invented a communication board helping the patient to inform its caregiver of all conceivable needs.

Mechanically ventilated patients are unable to vocalize feelings, verify perceptions and cope with fears, anxiety and stress through verbal communication. "You cannot treat a patient based on objective data alone," says Lance Patak, third-year medical student at the David Geffen School of Medicine at the University of California in Los Angeles (UCLA). "To leave a patient unable to communicate effectively at a critical time is not only negligent, but is unkind and not grounded in medical practice. We have to obtain subjective information from the patient whenever possible."

Over the years, the former UCLA Medical Center nurse cared for many of these critically ill patients. In 1998 he came up with the idea of an easy-to-use augmentative communication board that intubated patients could use to make their needs known to their caregivers and family members with a simple mark of a felt-tipped pen.

With the lightweight, flexible E-Z Board the patient can communicate basic needs like thirst, cold and pain or signal intentions like to sit up, to exercise, to clean his face or simply to say "Thank you". All require no more effort than marking a box next to the appropriate selection with an attached wet-erase marker.

Generally, mechanically ventilated patients relay their needs via notes which are frequently illegible or an alphabet sheet which often ends up with a lot of misspellings. As a result, the caregiver is forced to interpret the patients' non-verbal communication such as mouthing, gesticulating, nodding and writing - which can be difficult for the critically ill patient. Such nonverbal methods are fatiguing and emotionally draining for these patients.

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