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學(xué)習(xí)啦 > 學(xué)習(xí)英語 > 專業(yè)英語 > 醫(yī)學(xué)英語 > 醫(yī)藥類英語翻譯

醫(yī)藥類英語翻譯

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醫(yī)藥類英語翻譯

  醫(yī)藥類英語翻譯有哪些你知道嗎?下面是小編收集整理的醫(yī)藥類英語翻譯希望對你們有用。

  醫(yī)藥類英語翻譯如下

  A Guide to Intensive Care Unit  ICU指南

  This introductory guide to the critical care environment describes the ICU and the caregivers who staff it; the patients and how they are admitted, monitored, and treated; and some of the common life-support equipment. It includes a strategy for presenting your patient to your team and prepares you for the ethical issues that might confront you in the ICU. The guide also describes some of the career paths that culminate in leadership positions in critical care medicine.  危重病護(hù)理環(huán)境指南介紹了重癥監(jiān)護(hù)室及室內(nèi)護(hù)理人員,病人與病人入院、監(jiān)護(hù)和治療方式,及一些常用的生命支持設(shè)備等內(nèi)容。指南還包括如何向ICU小組介紹病人和如何作好應(yīng)對ICU可能遇到的職業(yè)道德問題的心理準(zhǔn)備,并對危重病人護(hù)理醫(yī)學(xué)中提升領(lǐng)導(dǎo)職位的職業(yè)發(fā)展途徑進(jìn)行了描述。

  ICU TYPES  ICU種類

  The hospital you are in today is different from the hospital your attending physician claimed as his or her environment. Lengths of stay are down, patient acuity is rising, and critical care units are proliferating. Although the health care system is changing, hospitals will always need an area to care for their sickest patients--a critical care center. The need for these units is growing as patients at all extremes of life—the most premature infants, adults with cardiovascular disease, the severely injured—are growing, both in absolute numbers and in proportion to the general population. Citizens of developed nations around the world are living--and staying active--into the ninth and tenth decades of life. When they become ill, they often require aggressive intervention to stabilize their delicate physiologic balance so they can heal.  你今天所在的醫(yī)院與你主治醫(yī)生所說的那種環(huán)境已大不相同。病人住院時間縮短、病人要求提高、危重護(hù)理病房不斷增多。雖然健康護(hù)理系統(tǒng)正在不斷發(fā)生變化,但醫(yī)院將始終需要有一個護(hù)理最病重的病人的區(qū)域 – 一個危重病護(hù)理中心。由于處于生命極端狀態(tài)病人的增多,如早產(chǎn)兒、成人心血管疾病患者和重傷病人等,無論是按絕對數(shù)字還是按總?cè)丝诒嚷视?jì)算,對這些病房的需求也在增長。發(fā)達(dá)國家人口正進(jìn)入到人生的90和100歲。一旦生病,他們就常常需要采取入侵性措施使他們那脆弱的生理平衡得以穩(wěn)定,使疾病得以治愈。

  The interventions required to manage life-threatening illnesses generally include both core supports--intensive nursing care and cardiopulmonary monitoring--as well as supports focused on the patient's particular illness. While nearly all ICUs are capable of providing a spectrum of care, many have developed a focused area of excellence: care of critically ill and injured children in the pediatric ICU (PICU); adult cardiac diseases in the coronary care unit (CCU); perioperative care, trauma care, and care of multiple organ dysfunction in the surgical ICU (SICU); care of neurological and neurosurgical patients in the neuroscience ICU; and so on. Many teaching hospitals also have graded critical care centers such as intermediate care units and telemetry units where patients who require more than ward care can benefit from specific monitoring and intervention.  威脅生命的疾病的處理措施包括核心支持—重癥護(hù)理和心肺監(jiān)護(hù)—及以病人特定疾病為重點(diǎn)的支持措施。盡管幾乎所有的ICU都能夠提供整套的護(hù)理,但很多ICU都有自己 重點(diǎn)關(guān)注的強(qiáng)項(xiàng):兒科ICU(PICU)危重病及受傷兒童的護(hù)理;冠心病監(jiān)護(hù)室的成人心臟病護(hù)理;外科ICU(SICU)的圍手術(shù)期護(hù)理、外傷護(hù)理和多種器官功能障礙的護(hù)理等;神經(jīng)科ICU的神經(jīng)和神經(jīng)外科病人護(hù)理;等等。很多教學(xué)醫(yī)院也有不同等級的危重病護(hù)理中心,如過渡監(jiān)護(hù)治療病房和遠(yuǎn)程治療病房等。需要病房外護(hù)理的病人可以從遠(yuǎn)程治療特殊的監(jiān)護(hù)和介入中受益。

  The ICU Team  ICU小組

  The more things get busy, the more you will appreciate that each team member in the ICU has a specific role.

  The team leader is a physician. Students typically are assigned to train in intensive care units where the team leader is an intensivist physician who has received advanced training in the art and science of critical care medicine. In North America, added qualifications in critical care medicine are obtained after board certification in a primary specialty such as pediatrics, internal medicine, surgery, or anesthesiology. Many countries have established critical care medicine as an independent specialty.

  Irrespective of the training pathway, your team leader embraces the philosophy of critical care medicine, namely that a physician-led, multidisciplinary team can provide optimal care to the critically ill patient.  事情越忙,你就越能體會每個ICU成員所起的特殊作用。

  ICU小組長是一位醫(yī)生。在指定的醫(yī)學(xué)生實(shí)習(xí)重癥監(jiān)護(hù)室里,ICU組長通常是一個重癥??漆t(yī)生,他在危重病人護(hù)理醫(yī)學(xué)方面受過高級培訓(xùn)。在北美地區(qū),額外的危重病護(hù)理醫(yī)學(xué)資格是在其有了基本的??谱C書---如兒科、內(nèi)科、外科或麻醉科等??瀑Y格證書---后獲得的。很多國家已將危重病護(hù)理醫(yī)學(xué)設(shè)為一個獨(dú)立的專業(yè)科室。

  不管組長接受的是何種途徑的培訓(xùn),他都會掌握危重病護(hù)理醫(yī)學(xué)的基本原理,也就是說,一個由醫(yī)生領(lǐng)導(dǎo)的多學(xué)科小組能夠向危重病人提供最佳的護(hù)理。

  The term "multidisciplinary" refers not only to other physicians who may participate as consultants or coattendings in the ICU, but also to the other health care professionals who work side by side, around the clock in the ICU. The most numerous of these are the critical care nurses, many of whom also have advanced training and certification in critical care and are recognized as CCRNs. Some have achieved even greater recognition and responsibility. They are the acute care nurse practitioners and clinical nurse specialists who complement the physician staff in establishing plans, writing orders, and directing management. Physician assistants also provide care in the ICU.  “多學(xué)科”一詞并不僅僅是指以會診醫(yī)師或合作主治醫(yī)師身份加入ICU的其他醫(yī)生,它同時也指在ICU內(nèi)并肩工作24小時的其他衛(wèi)生保健專業(yè)人員,人數(shù)最多的是重癥監(jiān)護(hù)護(hù)士。這些護(hù)士多數(shù)在重癥護(hù)理方面受過高級培訓(xùn),并獲得相應(yīng)的證書,是公認(rèn)的“重癥監(jiān)護(hù)注冊護(hù)士”。有些護(hù)士所獲得的認(rèn)可不盡于此,他們的職責(zé)也更重大。他們是急癥護(hù)理醫(yī)生和臨床護(hù)理專家,也可以制定計(jì)劃、寫醫(yī)囑和指導(dǎo)治療,是醫(yī)生的補(bǔ)充。醫(yī)生助理也提供ICU護(hù)理。

  Respiratory therapists are experts in many forms of pulmonary diagnosis and intervention. In addition to operating the mechanical ventilator, therapists often obtain and analyze arterial blood for blood gases and test patients' breathing strength by obtaining forced vital capacity, negative inspiratory pressure, and other parameters. In some hospitals, respiratory therapists perform endotracheal intubation in addition to supporting ventilation with "bag-and-mask" devices. The ICU team typically includes a pharmacist who helps you review medication profiles and determine if your patient is predisposed to side effects or drug interactions.

  The pharmacist will help you calculate clearance rates from measured drug levels and plan dosing schedules for many of the medications used in the ICU.  呼吸治療師是多種肺病診斷和治療的專家,除了使用機(jī)械呼吸機(jī)外,這些治療師常常獲取并分析動脈血?dú)?,通過用力肺活量、負(fù)壓吸氣及其他參數(shù)測試病人的呼吸力。在一些醫(yī)院,呼吸治療師除了用“袋-面罩”裝置支持通氣外也施行氣管內(nèi)插管。一個典型的ICU小組都有一個藥劑師,他幫助護(hù)士評估藥物性質(zhì),確定病人是否會誘發(fā)副作用或藥物相互作用。

  藥劑師根據(jù)測得的藥物濃度幫助你計(jì)算藥物清除率,為ICU使用的多種藥物計(jì)劃給藥方案。

  The team also typically includes someone who is an expert in nutrition support such as a dietitian who has advanced training in enteral (gut) and parenteral (intravenous) nutritional support strategies and pitfalls. Other important members of the ICU team are the medical social worker, who provides ongoing psychosocial assessments and support; representatives of the chaplaincy staff, who are available on call to offer spiritual support to patients, families, and ICU staff members; and a unit secretary, who manages administrative tasks such as reception, telecommunications, and chart maintenance. In addition, the ICU staff generally includes many other trainees who are there to learn with you such as fellows, residents, nursing students, and dietetics students.  典型的ICU小組還會包括一位營養(yǎng)專家,如在腸道和非腸道(靜脈內(nèi))營養(yǎng)支持方法及缺陷方面受過高級培訓(xùn)的營養(yǎng)師等。ICU小組其他重要成員有醫(yī)務(wù)社會工作者,他為病人提供不斷的心理社會評估和支持;牧師代表,可以隨時招他為病人、家屬和ICU成員提供精神上的幫助;以及一位病房秘書,處理一些行政性工作,如接待、聯(lián)系及圖表保管。此外,ICU成員通常包括其他很多在此學(xué)習(xí)的實(shí)習(xí)人員,如同行、居民、護(hù)生及營養(yǎng)學(xué)學(xué)生等。

  The Patients  ICU病人

  Patients are admitted to the intensive care unit either because they require high-intensity monitoring and life support by specially trained health care providers or because they require high-intensity nursing care that cannot be provided on a general medical or surgical ward. As noted previously, surgical patients are admitted to the surgical intensive care unit and medical patients to the medical or coronary intensive care units.

  Many surgical patients are admitted with medical problems such as pneumonia or sepsis.  病人進(jìn)入ICU,不是因?yàn)樾枰山?jīng)過特殊訓(xùn)練的健康護(hù)理人員進(jìn)行高強(qiáng)度監(jiān)護(hù)和生命支持,就是因?yàn)樗麄兯枰母邚?qiáng)度護(hù)理是其他變通內(nèi)科或外科病房所無法提供的。如前所述,外科病人進(jìn)入外科ICU,內(nèi)科病人進(jìn)入內(nèi)科或冠狀病ICU。許多外科病人住進(jìn)來時都會有內(nèi)科疾病,如肺炎、濃毒癥等。

  Patients come to the ICU from several areas:l Operating room (OR) or post-anesthesia care unit (PACU) -- Surgical patients who require invasive monitoring, mechanical ventilation, or resuscitation after surgery may be transported directly to the ICU from the OR or the PACU after a period of observation. Such direct transport is considered a transfer from one critical care area to another. Therefore, their ICU management is a continuation of care that they received from the anesthesiology team in the operating room or PACU.  ICU病人來自下例科室:手術(shù)室(OR)或麻醉后監(jiān)護(hù)病房(RACU)—術(shù)后需要侵入性監(jiān)測、機(jī)械通氣或復(fù)蘇的病人在經(jīng)過一段觀察后可以直接從手術(shù)室或麻醉后監(jiān)護(hù)病房送到ICU,這種直接運(yùn)送方式也就是由一個危重病護(hù)理區(qū)轉(zhuǎn)到另一個危重病護(hù)理區(qū),因此,其ICU處理只是OR或PACU麻醉小組護(hù)理的繼續(xù)。

  l Emergent care center (ECC) or emergency room -- Medical, surgical, trauma, or burn patients can be admitted to the ICU from the ECC or emergency room. These patients typically undergo a series of diagnostic tests prior to their transfer, and the etiology of their illness may or may not be known by the time they come to the ICU. They are admitted to manage their acute illness.  急診護(hù)理中心(ECC)或急診室—內(nèi)科、外科、創(chuàng)傷或灼傷病人可以由ECC或急診室收住ICU。這些病人在轉(zhuǎn)來之前通常都做過一系列的診斷檢查,到ICU時,其病因可能已經(jīng)知道,也可能還不知道。他們住進(jìn)ICU是因?yàn)橛屑辈∫幚怼?/p>

  l Medical or surgical ward -- Patients may be admitted to the ICU from a general medical or surgical ward. These are patients who were initially stable but who developed respiratory distress, low blood pressure, shock, cardiopulmonary arrest, or other physiologic instabilities on the ward. They require aggressive resuscitation, treatment, and invasive monitoring and are transferred to the ICU for closer observation, more frequent measurement of vital signs, invasive monitoring, or mechanical ventilation.  內(nèi)科或外科病房—病人可以從普通內(nèi)科或外科病房收住ICU。這些病人開始時的病情都很穩(wěn)定,但在病房時發(fā)生了呼吸窘迫、低血壓、休克、心肺停止或其他的生理不穩(wěn)定情況,需要超常規(guī)的復(fù)蘇、治療和侵入性監(jiān)護(hù),轉(zhuǎn)到ICU進(jìn)行更密切的觀察、增加生命體征測量、采取侵入性監(jiān)護(hù)或進(jìn)行機(jī)械通氣。

  l Other facilities -- Patients may also be transferred from another facility that does not have the resources to provide the level or type of care they require.  其他機(jī)構(gòu)—病人也可以從另一個機(jī)構(gòu)轉(zhuǎn)到這里,因?yàn)樵摍C(jī)構(gòu)沒法提供所需的護(hù)理。

  Common Reasons for Admission to the ICU:l Respiratory compromise--Patients with respiratory distress, manifested either as an inability to oxygenate or an inability to ventilate, are transferred to the ICU for supplemental oxygen and mechanical ventilation. Etiologies of respiratory distress are numerous and include pneumonia, acute respiratory distress syndrome, pulmonary embolism, and exacerbations of chronic obstructive lung disease.  ICU入院常見原因呼吸系統(tǒng)損傷—呼吸窘迫病人可表現(xiàn)為無法氧合或通氣不能,轉(zhuǎn)到ICU就是為了補(bǔ)充氧氣、機(jī)械通氣。呼吸窘迫病因很多,包括肺炎、急性呼吸窘迫綜合癥、肺栓塞和慢性阻塞性肺部疾病等。

  l Hemodynamic compromise--Patients with hemodynamic instability are admitted for management of arrhythmias, hypotension, or hypertension. Patients with hypotension are typically resuscitated with fluid or medications (e.g., vasopressors or inotropes) to increase vascular tone. If a predetermined minimal mean blood pressure cannot be maintained, or if the patient has signs of inadequate oxygen delivery to the tissues (i.e., altered mental status, decreased urine output, cool skin, and lactic acidosis), a pulmonary artery catheter (PAC) may be inserted to monitor cardiac output. Measurements obtained from the PAC aid the clinician in deciding, for example, whether to treat the patient with more fluids to improve preload—the filling pressure of the left ventricle--or to initiate inotropes to improve contractility. In these instances, an arterial catheter is often inserted to monitor systemic blood pressure continuously. Patients with severe hypertension are generally managed with titratable intravenous medications.  血液動力學(xué)功能損傷—血液動力學(xué)功能不穩(wěn)病人收住ICU以處理心律失常、低血壓或高血壓。低血壓病人主要是通過液體或藥物進(jìn)行復(fù)蘇(如血管升壓類藥物或收縮性藥物),增加血管張力。如果無法保持預(yù)定的最低平均血壓,如果病人出現(xiàn)組織供氧不足癥狀(如精神狀態(tài)改變、排尿量減少、皮膚發(fā)冷和乳酸性酸中毒),就可能需要施行肺動脈導(dǎo)管(PAC)以監(jiān)測心排血量。PAC測量結(jié)果可以幫助臨床醫(yī)生作出決定,如是否需要增加輸液改善前負(fù)荷—即左室充盈壓—或使用收縮性藥物以提高收縮性。在上術(shù)情況中,常常要通過插入動脈導(dǎo)管來連續(xù)監(jiān)測體循環(huán)血壓。有嚴(yán)重高血壓的病人通常采用可滴定靜脈給藥法進(jìn)行處理。

  l Myocardial ischemia or infarction -- Patients with inadequate oxygen delivery to their myocardium are admitted for the management of angina and myocardial infarction. They may require titration of nitroglycerin, beta blockers, and morphine. Each medication can result in further complications such as hypotension, decreased heart rate, bronchospasm, or decreased respiratory drive, respectively. These patients are often candidates for thrombolytic agents and cardiac catheterization. The goal of admission, to reverse ischemia and minimize myocardial injury, requires close monitoring and rapid intervention.  心肌缺血或梗死—心肌供氧不足病人入院處理心絞痛或心肌梗死。這些病人可能需要甘油滴定、β-阻止劑或嗎啡。每種藥物都可能導(dǎo)致進(jìn)一步的并發(fā)癥,如低血壓、心率減慢、支氣管痙攣或呼吸動力減弱等。這些病人常常是血栓溶解劑和心導(dǎo)管插管的使用對象。收治目的是逆轉(zhuǎn)心肌缺血減少心肌損傷,這需要密切的監(jiān)護(hù),并迅速采取措施。

  l Neurological compromise -- Patients with alterations in mental status are admitted to the ICU for frequent neurologic checks. If their condition deteriorates, they may need to have an endotracheal tube placed to protect their airway.  神經(jīng)損傷—精神狀態(tài)變化病人住進(jìn)ICU進(jìn)行頻繁的神經(jīng)檢查。如果病情惡化,就可能需要放置氣管內(nèi)插管以保護(hù)氣道。

  l Gastrointestinal -- Patients with life-threatening gastrointestinal bleeding are admitted to treat hypotension with IV fluids, blood and blood products. Diagnostic tests such as endoscopy will likely be performed to locate and treat the source of bleeding in unstable patients in the ICU.  胃腸—出現(xiàn)危及性命的胃腸出血病人住進(jìn)ICU,通過IV輸液、全血或血液制品治療低血壓。有可能在ICU通過內(nèi)窺鏡之類的診斷檢查來定位和治療不穩(wěn)定病人的出血。

  l Renal and metabolic -- Patients may be admitted for treatment of the complications of renal failure, including acidosis, volume overload, and electrolyte abnormalities. More often, patients develop renal failure in the ICU secondary to hypotension and sepsis. Treatment with careful attention to acid-base balance, electrolytes, and volume status is provided in the ICU. Other metabolic crises, such as hypercalcemia, unrelated to renal failure, may result in a patient's admission to the ICU.  腎和代謝問題—病人入院也可能是為了治療腎衰引發(fā)的各種并發(fā)癥,包括酸中毒、容量過度負(fù)荷、電解質(zhì)異常等。更常見的情況是,病人在ICU時因低血壓和膿毒癥而繼發(fā)腎衰。ICU治療時應(yīng)密切注意酸堿平衡、電解質(zhì)和容積狀況。其他代謝性危象如高鈣血癥等,盡管與腎衰無關(guān),但也可能導(dǎo)致病人收住 ICU

  l Postoperative -- There are many reasons for admitting patients to the ICU. They may still be on a ventilator, or they may have other invasive monitoring. They may have a history of coronary artery disease and therefore be at risk for a perioperative MI. They may have had extensive bleeding and require frequent observation. They may have had an extensive surgical procedure, including open-heart surgery, organ transplantation, vascular surgery, or general abdominal surgery. Each surgical intervention has specific perioperative issues that require observation and treatment in the ICU. Patients with trauma, orthopedic injuries, and extensive thermal injuries are also admitted to ICUs.  術(shù)后—很多原因可以使病人住進(jìn)ICU。他們可能仍在使用呼吸機(jī),也可能是在接受其他入侵性監(jiān)測。他們可能有冠狀動脈疾病史,因此有圍手術(shù)期心肌梗死危險(xiǎn)。病人也可能有大出血,需要密切觀察。病人可能接受過大型外科手術(shù),如開胸手術(shù)、器管移植、血管手術(shù)、或腹部手術(shù)。每次手術(shù)都有特定的圍手術(shù)期問題需要在ICU進(jìn)行觀察和治療。創(chuàng)傷、骨傷和大面積熱損傷病人也會收住ICU。

  Transporting the Patient to the ICUOnce it is clear that a patient requires management in the intensive care unit, the ICU personnel should be notified. An attending, fellow, or resident should call the ICU charge nurse and indicate the patient's name, illness, reason for transfer to the ICU, and immediate plans for treatment. Alerting the staff in the ICU prior to patient transport allows them to prepare for the patient's arrival. Advance communication with the ICU physician ensures that the appropriate support is available when the patient arrives. It is essential that the appropriate personnel, equipment, and monitors are available for all transfers to the ICU.  運(yùn)送病人到ICU一旦明確病人需要由ICU處理,就應(yīng)通知ICU醫(yī)護(hù)人員。由主治醫(yī)師、普通醫(yī)生或住院醫(yī)師呼叫ICU主管護(hù)師,弄清病人的姓名、疾病、轉(zhuǎn)室原因,立即制訂治療計(jì)劃。在病人送到前提醒ICU工作人員可以使他們?yōu)椴∪说絹碜骱脺?zhǔn)備。事先與ICU醫(yī)師溝通可確保病人到達(dá)時得到合適的支持。使轉(zhuǎn)到ICU的所有病人都有合適的人手、器械和監(jiān)護(hù),這一點(diǎn)極為重要。

  The Equipment  設(shè) 備

  The vast array of technology present in an average patient's room can be overwhelming. Even the beds have become incredibly complex, costing tens of thousands of dollars and requiring detailed operating instructions. It is stressful enough just to be in the room of a patient who is critically ill, let alone to cope with the anxiety that the equipment might alarm or malfunction and require an intervention. In reality, the machines in the ICU have many fail-safe backup systems so that mechanical failure is rare. Furthermore, devices that require more supervision are usually accompanied by an individual with expertise, such as a cardiac technician for an intra-aortic balloon pump or a hemodialysis technician for a hemodialysis machine. Respiratory therapists are in close proximity to patients' rooms and intervene quickly if a mechanical ventilator alarms or malfunctions. The best way to resolve anxiety is to become familiar with all of the different devices.   普通病人病房里的技術(shù)多得使人暈頭轉(zhuǎn)向,連床鋪也復(fù)雜得令人難以置信,不但要花數(shù)萬美元,還要有詳細(xì)的操作說明。在危重病人病房里就已夠緊張的了,更不用說還要應(yīng)付器械告警或故障需要處理這樣令人焦慮的事。在現(xiàn)實(shí)中,ICU機(jī)器都有很多故障保險(xiǎn)備份系統(tǒng),因此,出現(xiàn)機(jī)械故障的可能性很小。而且,需要監(jiān)督的裝置通常都由專業(yè)人員看著,如由心臟科技師負(fù)責(zé)主動脈內(nèi)氣囊泵或血透技師負(fù)責(zé)血液透析機(jī)等。呼吸治療師離病人房間很近,一旦機(jī)械呼吸機(jī)告警或故障,他可以很快進(jìn)行處理。減輕焦慮的最佳方法是熟悉各種裝置。

  Bedside monitorsAll patients are connected to a bedside monitor whose screen displays several parameters. Channels I and II typically display two EKG leads providing continuous monitoring of the patient's heart rhythm. The patient's blood pressure is displayed either continuously from a catheter in the patient's arterial system or intermittently from an automatically inflating blood pressure cuff on channel III. The arterial line allows beat-to-beat measurement of blood pressure. An A-line is also inserted in patients who require numerous arterial blood gases in order to avoid repeated punctures.  床邊監(jiān)測儀所有病人都接有一個床邊監(jiān)測儀,它可以顯示多種參數(shù)。其中通道I、II 主要顯示兩臺EKG 導(dǎo)聯(lián)儀,對病人心律進(jìn)行連續(xù)監(jiān)測。病人血壓監(jiān)測有連續(xù)和間斷兩種,前者通過病人動脈系統(tǒng)插管監(jiān)測,后者通過通道III自動充氣血壓袖帶監(jiān)測。動脈插管可以測量每一搏動的血壓情況,它可以用于需要大量動脈血?dú)獾牟∪?,避免重?fù)穿刺。

  Patients may have a central venous catheter placed in the superior vena cava through the internal jugular or subclavian vein. A central venous catheter allows measurement of central venous pressure (CVP). The CVP serves as an estimate of the patient's volume status. Central lines are also used to rapidly infuse fluid and to administer substances that cannot be infused into a peripheral vein such as hypertonic parenteral fluids and medications such as vasopressors.  病人也可以經(jīng)由頸內(nèi)靜脈或鎖骨下靜脈放置上腔靜脈中心靜脈插管,測定中心靜脈壓(CVP),由此估計(jì)病人的容積狀態(tài)。中心靜脈插管也可用于快速輸液和給藥。一些周圍靜脈難以輸入的藥物或液體,如高滲非腸道液體、血管升壓類藥物等,都可以通過該插管輸入。

  When more data about a patient's hemodynamic physiology is required, a pulmonary artery catheter can be inserted and advanced through the right ventricle into the pulmonary artery. The PAC allows continuous display of pulmonary artery pressure, and variables such as cardiac output and pulmonary artery occlusion pressure, or wedge pressure, can be intermittently obtained. The "wedge pressure" is a measurement that reflects the patient's preload. The catheter is used to diagnose and manage hemodynamic instability.  如需要更多的病人血液動力生理學(xué)資料,就可以施行肺動脈插管(PAC),經(jīng)由右室插入肺動脈。PAC可以連續(xù)顯示肺動脈壓及其他多種變量,如心排血量,也可以間斷性顯示肺動脈閉塞壓或楔壓。楔壓反映了病人的前負(fù)荷情況,插管用于診斷和處理血液動力學(xué)的不穩(wěn)定性。

  The respiratory rate and the pulse oximeter reading, which indicates the patient's oxygen saturation, are also displayed on the monitor. The pulse oximeter is a noninvasive monitor attached to the patient's finger or earlobe to measure oxygen saturation continuously. Bedside monitors can be set to alarm for bradycardia or tachycardia, hypotension or hypertension, tachypnea, and/or oxygen desaturation.   監(jiān)測儀還可顯示呼吸頻率和脈氧值。脈氧儀顯示病人氧飽和度,這是一種非侵入式監(jiān)測儀,套在病人指頭或耳垂上連續(xù)監(jiān)測氧飽和度。經(jīng)過設(shè)置,床邊監(jiān)測儀可以警示下列情況:心動過緩或過速,低或高血壓、呼吸急促和/或氧減飽和。

  Mechanical ventilatorsPatients are mechanically ventilated for several reasons. If they are unable to protect their airway due to encephalopathy or massive stroke, they may be intubated (have an endotracheal tube placed through their mouth or nose into the trachea) to minimize the possibility of aspiration. If they have refractory hypoxemia (low oxygen saturation that does not respond to oxygen delivered by face mask), the ventilator will allow higher concentrations of FIO2 to be delivered to the alveoli, and pressure can be delivered through the ventilator to open alveoli that have collapsed. If they have respiratory failure and are unable to take adequate tidal volume, the ventilator can deliver a preselected tidal volume and respiratory rate. Patients remain on the ventilator until the underlying disease is resolved. When this occurs, the doctors and respiratory therapists begin the process of decreasing, or "weaning," ventilator support until the endotracheal tube can be removed, a process known as extubation.  機(jī)械呼吸機(jī)病人因多種原因需要進(jìn)行機(jī)械通氣。如果病人因腦病或大面積中風(fēng)無法保護(hù)氣道,這時就需要插管(即經(jīng)口或鼻施行氣管內(nèi)插管),最大限度地減少抽吸可能性。如果病人有難治性低氧血癥(低氧飽和度,面罩供氧無效),呼吸機(jī)就可以將高濃度的吸入氧輸送到肺泡,并通過呼吸機(jī)輸送的壓力張開塌陷的肺泡。如果病人呼吸衰竭潮氣量不足,呼吸機(jī)就可以按預(yù)先設(shè)置的潮氣量和呼吸率進(jìn)行輸送。在疾病消失前,病人都要使用呼吸機(jī)。如要除去呼吸機(jī),醫(yī)生和呼吸治療師通常要先逐漸減少或“斷奶”呼吸機(jī)支持,最后才撥掉氣管內(nèi)插管,即撥管。

  Other common devicesIntravenous medication pumps allow the nursing staff to titrate medications; Foley catheters and urine collection bags aid in monitoring urine output; sequential compression devices squeeze the lower extremities and reduce the incidence of deep venous thrombosis; transvenous pacemakers stimulate the patient's heart to beat; dialysis machines remove fluid and correct electrolyte and acid-base disturbances; intraaortic balloon pumps assist the heart's contractility; and neurologic monitoring systems measure intracranial pressure.  其他常用裝置靜脈內(nèi)給藥泵由普通護(hù)士用于滴定藥物;弗利氏導(dǎo)管和集尿袋幫助監(jiān)測排尿量;連續(xù)壓迫裝置擠壓下肢,減少深部靜脈血栓形成;經(jīng)靜脈起搏器刺激病人心臟跳動;透析儀除去液體,糾正電解質(zhì)和酸堿紊亂;主動脈內(nèi)氣囊泵支持心臟收縮;神經(jīng)病學(xué)監(jiān)測系統(tǒng)測定顱內(nèi)壓。

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