Pediatric Palliative Care

Elsevier医学出版社权威医学经典书籍以下所列书籍大部分都有货，没有的也陆续进货中，保证中国独家最低价出售，凡是发现有比本店低价有货的，绝对会更低价格给您Allergy, Asthma & ImmunologyAdkinson: Middleton's Allergy: Principles and Practice, 7th ed. - 2008 - MosbyAlternative MedicineRakel: Integrative Medicine, 2nd ed. - 2007 - SaundersAnesthesiology & Pain ManagementAtlee: Complications in Anesthesia, 2nd ed. - 2006 - SaundersBenzon: Essentials of Pain Medicine, 3rd ed. - 2011 - SaundersBenzon: Raj's Practical Management of Pain, 4th ed. - 2008 - MosbyBrown: Atlas of Regional Anesthesia, 4th ed. - 2010 - SaundersChestnut: Obstetric Anesthesia, 4th ed. - 2009 - Mosby, Inc.de Leon: Cancer Pain, 1st ed. - 2006 - SaundersFleisher: Anesthesia and Uncommon Diseases, 5th ed. - 2005 - SaundersFleisher: Evidence Based Practice of Anesthesiology, 2nd ed. - 2009 - SaundersGallagher: Simulation in Anesthesia, 1st ed. - 2006 - SaundersHagberg: Benumof's Airway Management, 2nd ed. - 2007 - Mosby, Inc.Hemmings: Foundations of Anesthesia, 2nd ed. - 2005 - MosbyHines & Marschall: Stoelting's Anesthesia and Co-Existing Disease, 5th ed. - 2008 - Churchill LivingstoneKaplan: Essentials of Cardiac Anesthesia, 1st ed. - 2008 - SaundersKaplan: Kaplan's Cardiac Anesthesia, 6th ed. - 2011 - SaundersMcMahon: Wall and Melzack's Textbook of Pain, 5th ed. - 2006 - Churchill LivingstoneMelzack: Handbook of Pain Management, 1st ed. - 2003 - Churchill LivingstoneMiller: Basics of Anesthesia, 6th ed. - 2011 - SaundersMiller: Miller's Anesthesia, 7th ed. - 2009 - Churchill LivingstoneMotoyama & Davis: Smith's Anesthesia for Infants and Children, 8th ed. - 2011 - MosbyNeal: Complications in Regional Anesthesia and Pain Medicine, 1st ed. - 2006 - SaundersNewman: Perioperative Medicine, 1st ed. - 2007 - SaundersRaj: Interventional Pain Management: Image-Guided Procedures, 2nd ed. - 2008 - Saunders Shorten: Postoperative Pain Management, 1st ed. - 2006 - SaundersSidebotham: Practical Perioperative Transesophageal Echocardiography, 2nd ed. - 2011 - Saunders Smith: Current Therapy in Pain, 1st ed. - 2008 - SaundersWaddell: The Back Pain Revolution, 2nd ed. - 2004 - Churchill LivingstoneWaldman: Pain Management, 2nd ed. - 2011 - SaundersCardiologyBonow: Braunwald's Heart Disease - A Textbook of Cardiovascular Medicine, 9th ed. - 2011 - Saunders Goldberger: Clinical Electrocardiography: A Simplified Approach, 7th ed. - 2006 - MosbyKeane: Nadas' Pediatric Cardiology, 2nd ed. - 2006 - SaundersKern: Cardiac Catheterization Handbook, 5th ed. - 2011 - SaundersKern: Interventional Cardiac Catheterization Handbook, 2nd ed. - 2003 - MosbyNorell: Essential Interventional Cardiology, 2nd ed. - 2008 - SaundersRagosta: Textbook of Clinical Hemodynamics, 1st ed. - 2008 - SaundersTopol: Textbook of Interventional Cardiology, 5th ed. - 2008 - SaundersCritical CareBersten & Soni: Oh's Intensive Care Manual, 6th ed. - 2008 - Butterworth-HeinemannFuhrman: Pediatric Critical Care, 4th ed. - 2011 - MosbyLayon: Textbook of Neurointensive Care, 1st ed. - 2003 - SaundersNichols: Critical Heart Disease in Infants and Children, 2nd ed. - 2006 - MosbyPapadakos: Mechanical Ventilation, 1st ed. - 2007 - SaundersParrillo & Dellinger: Critical Care Medicine, 3rd ed. - 2007 - MosbyParsons: Critical Care Secrets, 4th ed. - 2007 - MosbySidebotham: Cardiothoracic Critical Care, 1st ed. - 2007 - Butterworth-HeinemannVincent: Textbook of Critical Care, 6th ed. - 2011 - SaundersDermatologyHabif: Clinical Dermatology, 5th ed. - 2009 - MosbyEmergency MedicineAdams: Emergency Medicine, 1st ed. - 2008 - SaundersAuerbach: Wilderness Medicine, 5th ed. - 2007 - MosbyBaren: Pediatric Emergency Medicine, 1st ed. - 2007 - SaundersCadogan: Marshall & Ruedy's On Call, 1st ed. - 2007 - Elsevier Australia (a division of Reed International Books Australia Pty Ltd)Ciottone: Disaster Medicine, 1st ed. - 2006 - MosbyGaspari: Emergency Ultrasound: Principles and Practice, 1st ed. - 2005 - MosbyHarris: The Toxicology Handbook for Clinicians, 1st ed. - 2006 - Hanley and BelfusMarx: Rosen's Emergency Medicine, 7th ed. - 2009 - MosbyRoberts: Clinical Procedures in Emergency Medicine, 5th ed. - 2009 - SaundersShannon: Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose, 4th ed. - 2007 - SaundersTrott: Wounds and Lacerations: Emergency Care and Closure, 3rd ed. - 2005 - MosbyEndocrinology & MetabolismMelmed: Williams Textbook of Endocrinology, 12th ed. - 2011 - SaundersFamily MedicineACLM: Legal Medicine, 7th ed. - 2007 - MosbyACLM: The Medical Malpractice Survival Handbook, 1st ed. - 2007 - MosbyApgar: Colposcopy: Principles and Practice, 2nd ed. - 2008 - SaundersButtaravoli: Minor Emergencies, 2nd ed. - 2007 - MosbyEiff: Fracture Management for Primary Care, 3rd ed. - 2011 - SaundersFerri: Ferri's Clinical Advisor 2012, 1st ed. - 2011 - MosbyHeidelbaugh: Clinical Men's Health: Evidence in Practice, 1st ed. - 2007 - ElsevierMcGee: Evidence-Based Physical Diagnosis, 2nd ed. - 2007 - SaundersMercier: Practical Orthopedics, 6th ed. - 2008 - MosbyPalay & Krachmer: Primary Care Ophthalmology, 2nd ed. - 2005 - MosbyPfenninger: Pfenninger and Fowler's Procedures for Primary Care, 3rd ed. - 2010 - MosbyRakel: Textbook of Family Medicine, 8th ed. - 2011 - SaundersRatcliffe: Family Medicine Obstetrics, 3rd ed. - 2008 - MosbyTallia: Swanson's Family Medicine Review, 6th ed. - 2008 - MosbyGastroenterologyFeldman: Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed. - 2010 - SaundersGeneralStewart: The Australian Medico-Legal Handbook, 1st ed. - 2007 - Elsevier Australia (a division of Reed International Books Australia Pty Ltd)Geriatric MedicineDuthie: Practice of Geriatrics, 4th ed. - 2007 - SaundersHematologyHoffman: Hematology: Basic Principles and Practice, 5th ed. - 2008 - Churchill LivingstoneHospice & Palliative CareWalsh: Palliative Medicine, 1st ed. - 2008 - SaundersHospital MedicineAlbert: Clinical Critical Care Medicine, 1st ed. - 2006 - MosbyKruse: Saunders Manual of Critical Care, 1st ed. - 2003 - SaundersMcDonough & Larson: Manual of Evidence-Based Admitting Orders and Therapeutics, 5th ed. - 2006 - Elsevier Merli & Weitz: Medical Management of the Surgical Patient, 3rd ed. - 2008 - SaundersSteinberg: Evidence-Based Medical Consultation, 1st. ed. - 2007 - SaundersSun: The Most Common Inpatient Problems in Internal Medicine: Ward Survival, 1st ed. - 2007 - Saunders Williams: Comprehensive Hospital Medicine, 1st ed. - 2007 - SaundersZaoutis & Chiang: Comprehensive Pediatric Hospital Medicine, 1st ed. - 2007 - ElsevierInfectious DiseaseCohen & Powderly: Infectious Diseases, 3rd ed. - 2010 - MosbyDolin: AIDS Therapy, 3rd ed. - 2008 - Churchill LivingstoneFeigin: Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 6th ed. - 2009 - SaundersLong: Principles and Practice of Pediatric Infectious Diseases Revised Reprint, 3rd ed. - 2009 - Churchill Livingstone Mandell: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed. - 2009 - Churchill LivingstonePlotkin: Vaccines, 5th ed. - 2008 - SaundersSchaaf: Tuberculosis, 1st ed. - 2009 - SaundersVolberding: Global HIV/AIDS Medicine, 1st ed. - 2008 - SaundersWalker: Immigrant Medicine, 1st ed. - 2007 - SaundersInternal MedicineBope: Conn's Current Therapy 2011, 1st ed. - 2010 - SaundersCleveland Clinic: Current Clinical Medicine, 2nd ed. - 2010 - SaundersFerri: Ferri's Clinical Advisor 2012, 1st ed. - 2011 - MosbyFerri: Practical Guide to the Care of the Medical Patient, 8th ed. - 2010 - Mosby Goldman: Goldman's Cecil Medicine, 24th ed. - 2011 - SaundersPiccini & Nilsson: The Osler Medical Handbook, 2nd ed. - 2006 - Johns Hopkins University NephrologyBrenner: Brenner and Rector's The Kidney, 8th ed. - 2007 - SaundersNeurologyBradley: Neurology in Clinical Practice, 5th ed. - 2008 - Butterworth-Heinemann Obstetrics & GynecologyGabbe: Obstetrics: Normal and Problem Pregnancies, 5th ed. - 2007 - Churchill Livingstone Katz: Comprehensive Gynecology, 5th ed. - 2007 - MosbyOncologyAbeloff: Abeloff's Clinical Oncology, 4th ed. - 2008 - Churchill Livingstone OphthalmologyYanoff & Duker: Ophthalmology, 3rd ed. - 2008 - MosbyOrthopedic SurgeryBrowner: Skeletal Trauma, 4th ed. - 2008 - W. B. Saunders CompanyCanale & Beaty: Campbell's Operative Orthopaedics, 11th ed. - 2007 - MosbyDeLee: DeLee and Drez's Orthopaedic Sports Medicine, 3rd ed. - 2009 - SaundersGreen & Swiontkowski: Skeletal Trauma in Children, 4th ed. - 2008 - ElsevierOtolaryngologyFlint: Cummings Otolaryngology: Head & Neck Surgery, 5th ed. - 2010 - MosbyPathologyKumar: Robbins and Cotran Pathologic Basis of Disease, Professional Edition, 8th ed. - 2009 - Saunders McPherson: Henry's Clinical Diagnosis and Management by Laboratory Methods, 22nd ed. - 2011 - Saunders PediatricsBergelson: Pediatric Infectious Diseases: Requisites, 1st. ed. - 2008 - MosbyChernick: Kendig's Disorders of the Respiratory Tract in Children, 7th ed. - 2006 - SaundersDormans: Pediatric Orthopaedics and Sports Medicine: Requisites, 1st ed. - 2004 - MosbyFenichel: Clinical Pediatric Neurology, 6th ed. - 2009 - SaundersGarfunkel: Pediatric Clinical Advisor, 2nd ed. - 2007 - MosbyJohns Hopkins: The Harriet Lane Handbook, 19th ed. - 2011 - MosbyKaplan & Meyers: Pediatric Nephrology and Urology: Requisites, 1st ed. - 2004 - MosbyKeane: Nadas' Pediatric Cardiology, 2nd ed. - 2006 - SaundersKliegman: Nelson Textbook of Pediatrics, 19th ed. - 2011 - SaundersLiacouras & Piccoli: Pediatric Gastroenterology: Requisites, 1st ed. - 2007 - MosbyMoshang: Pediatric Endocrinology: Requisites, 1st ed. - 2004 - MosbyPanitch: Pediatric Pulmonology: Requisites, 1st ed. - 2005 - MosbyPark: Pediatric Cardiology for Practitioners, 5th ed. - 2008 - MosbySlap: Adolescent Medicine: Requisites, 1st ed. - 2008 - MosbySperling: Pediatric Endocrinology, 3rd ed. - 2008 - SaundersVetter: Pediatric Cardiology: Requisites, 1st ed. - 2006 - MosbyWetmore: Pediatric Otolaryngology: Requisites, 1st ed. - 2007 - MosbyWolraich: Developmental-Behavioral Pediatrics, 1st ed. - 2007 - MosbyZitelli & Davis: Atlas of Pediatric Physical Diagnosis, 5th ed. - 2007 - ElsevierPhysical Medicine & RehabilitationFrontera: Essentials of Physical Medicine and Rehabilitation, 2nd ed. - 2008 - SaundersPsychiatryJacobson: Psychiatric Secrets, 2nd ed. - 2001 - Hanley and BelfusStern: Massachusetts General Hospital Comprehensive Clinical Psychiatry, 1st ed. - 2008 - Mosby Pulmonary MedicineMason: Murray and Nadel's Textbook of Respiratory Medicine, 5th ed. - 2010 - SaundersRadiologyAdam: Grainger & Allison's Diagnostic Radiology, 5th ed. - 2008 - Churchill LivingstoneAllan & Baxter: Clinical Ultrasound, 3rd ed. - 2011 - Churchill LivingstoneBassett: Diagnosis of Diseases of the Breast, 2nd ed. - 2005 - SaundersDalrymple: Problem Solving in Abdominal and Pelvic Imaging, 1st ed. - 2009 - MosbyEll & Gambhir: Nuclear Medicine in Clinical Diagnosis and Treatment, 3rd ed. - 2004 - Churchill Livingstone Goodman: Felson's Principles of Chest Roentgenology, 3rd ed. - 2006 - SaundersHaaga: CT and MRI of the Whole Body, 5th ed. - 2008 - MosbyHansell: Imaging of Diseases of the Chest, 5th ed. - 2009 - MosbyHelms: Musculoskeletal MRI, 2nd ed. - 2008 - SaundersMettler: Essentials of Radiology, 2nd ed. - 2005 - SaundersMorrison & Sanders: Problem Solving in Musculoskeletal Imaging, 1st ed. - 2008 - Mosby Resnick: Bone and Joint Imaging, 3rd ed. - 2005 - SaundersResnick: Internal Derangements of Joints, 2nd ed. - 2006 - SaundersRumack: Diagnostic Ultrasound, 4th ed. - 2010 - MosbySiegelman: Body MRI, 1st ed. - 2004 - SaundersTartar: Breast Cancer Imaging: A Multidisciplinary, Multimodality Approach, 1st ed. - 2008 - Mosby Valji: Vascular and Interventional Radiology, 2nd ed. - 2006 - SaundersWeissleder: Primer of Diagnostic Imaging, 5th ed. - 2011 - MosbyYousem & Beauchamp: Radiology Business Practice: How to Succeed, 1st ed. - 2007 - Mosby RheumatologyFirestein: Kelley's Textbook of Rheumatology, 8th ed. - 2008 - W. B. Saunders Company Surgery, GeneralAsensio: Current Therapy of Trauma and Surgical Critical Care, 1st ed. - 2008 - MosbyBland: The Breast, 4th ed. - 2009 - SaundersBlumgart: Surgery of the Liver, Biliary Tract and Pancreas, 4th ed. - 2006 - Saunders Buchwald: Surgical Management of Obesity, 1st ed. - 2006 - SaundersCameron: Current Surgical Therapy, 10th ed. - 2010 - Churchill LivingstoneCronenwett: Rutherford's Vascular Surgery, 7th ed. - 2010 - SaundersEvans: Surgical Pitfalls, 1st ed. - 2008 - SaundersFazio: Current Therapy in Colon and Rectal Surgery, 2nd ed. - 2004 - MosbyGrosfeld: Pediatric Surgery, 6th ed. - 2006 - MosbyHallett: Comprehensive Vascular and Endovascular Surgery, 2nd ed. - 2009 - Mosby Holcomb & Murphy: Ashcraft's Pediatric Surgery, 5th ed. - 2010 - Saunders Khatri: Operative Surgery Manual, 1st ed. - 2003 - SaundersMorris: Kidney Transplantation: Principles and Practice, 6th ed. - 2008 - Saunders Sellke: Sabiston and Spencer's Surgery of the Chest, 8th ed. - 2009 - Saunders Townsend: Sabiston Textbook of Surgery, 18th ed. - 2007 - SaundersYeo: Shackelford's Surgery of the Alimentary Tract, 6th ed. - 2007 - Saunders UrologyWein: Campbell-Walsh Urology, 9th ed. - 2007 - Saunders。

2018'SCI 新期刊榜（生物医学类） ：入选 SCI 的 65 本新杂志本文档整理数据来自科睿唯安官网的 MJL , 然后在 w o s 上按照 I F 预测方法进行预测 。

若定有遗漏之处或不妥之处 ，望大家多指正 ！公元 2018 年 4 月 15 日“解说国自然“公众号Ebiome dicineSCIE 497 ,5.39Journal 期刊名称SCI /SCIE 2015 和 2016 年发表Article 和 Review 总数1J ournal of Ex 扛acellular Vesicles SC I E 722Science AdvancesSCI/SCIE 7653J AMA Cardio lo gySCIE 1054Journal for f mmunoTherapy of Cancer SCTE 1 315Acta Phann aceutica S ini ca B SC I E 1396Biomo l ecules 、4俨 LSCIE 203 夏 V 左7\1 1 \ - 厂8Journal of C l inica l Medicine SClE 2359Advances in Wound CareSCIE 11510Therape utic Advances in Chronic Di sease SCIE 50II G ut Microb esSCJE 5012Journ a l of Advanced R eseru ·cbSCIE 20813World Journal of Stem CellsSCIE 14114Asian Journal of Pharmaceutical Sc ienc esSClE4.0915Th e rapeutic Advances ill Endocr inolo gy and Metabolism SCJ E 4516Frontiers in OncologySCIE 6031 7Cell Di scoverySCI E 9118Ctment Opinion in F ood Science SCIE 17319Di abetes & Metabolism Journal SCIE 10720Ce ll sSCIE 8221Therape u ti c Advances in Musc uloskelet a l Di sea se S C IE 4022Experim e nt a l Neurobi o l ogy SC IE 7923Ph armaceu t icsSC IE 6724npj Biofi l ms and MicrobiomesSCIE 392526Wor ld Jou rn a l of Gastrointestina l O n co l og y Di a b e t es M et a bolic S y ndrome a nd Ob es it y -Ta r g et s SCIE S C I E 143102a nd Th erapy27Mo l ecu l ar Gene ti cs & Genomic M ed i ci n e SCIE 10528Conflict a nd Healt h SCIE 5929Gastroe n tero l ogy R eportSCIE 10930npj G e n o mi c M e dicin e S CIE305.12313233343536373839404142434445464748495051.5253545556575859v ,心' .Journa l of Stomato l ogy Ora l and Max i llofacia l 60Surge t -y SCIE61 Micro bi al Genomics SCIE 62 M olecu l ar Om i cs SC l /SClE 63 N a ture Biom e dical E n g in e erin g S C IE 64 Peptide Science SCI/SCI E 65 Trends in Cancer S C IE注 ：红色为 w o s 检索不到 ，但 M J L 上确实标注新入选 S CI 。

palliative care 官方译文全文共四篇示例，供读者参考第一篇示例：Palliative care（姑息护理）是一种关注病人综合健康，并尊重患者和家属的医疗服务。

它旨在帮助缓解患者面临的生理、心理、社会和精神的痛苦，提高他们的生活质量。

Palliative care并非只是针对末期病患者的服务，它可以在疾病诊断后的任何阶段提供帮助。

Palliative care的目标是让患者在生命的最后阶段获得安宁和舒适，同时帮助他们保持尊严和控制自己的生活。

该服务涵盖了多方面的工作，包括控制症状、精神支持、社会支持、心理支持、饮食和营养指导等。

该服务通常由一支由医生、护士、社会工作者、心理医生、牧师和志愿者组成的多学科团队来提供。

在Palliative care的实践中，医护人员致力于缓解患者的痛苦，帮助他们应对病情，提供心理支持和安慰。

该团队还会与患者的家属和医护人员合作，协调医疗服务，提供关于疾病治疗和症状管理的建议。

Palliative care的服务范围非常广泛，不仅包括提供疼痛缓解和症状管理的药物治疗，还包括提供心理治疗、物理治疗、社会服务、心理支持和悲伤辅导等服务。

这些服务的目的是帮助患者和家属理解疾病过程，促进患者的身心健康，提高患者的生活质量。

在近年来，随着人口老龄化和慢性疾病的增加，Palliative care的需求不断增加。

各国政府和卫生机构也逐渐认识到Palliative care的重要性，并采取措施提升该服务的质量和覆盖范围。

第二篇示例：镇痛治疗是一种专注于提供对病患的身心及精神疾病管理的医学护理方法。

它旨在减缓病患不适症状，提高他们的生活质量，同时促进他们与家人的团聚。

这项治疗并不仅仅是对病痛的缓解，更是为病患及其家人提供全方位的支持。

镇痛治疗的目标是通过积极的治疗措施来提高病患的生活质量。

这种治疗方法并非只适用于末期疾病患者，也适用于任何需要缓解与救治结合的病患。

镇痛治疗不仅关注病患的生理需求，还注重心理、社交和心灵层面的支持。

icu知识点总结IntroductionIntensive Care Units (ICUs) are specialized hospital units that provide care for critically ill patients who require constant monitoring and support. The patients admitted to an ICU may suffer from life-threatening illnesses or injuries that require close observation and intervention by a team of healthcare providers.ICUs are equipped with specialized medical equipment and facilities to provide intensive care to patients. The care in an ICU is provided by a multidisciplinary team of healthcare professionals, including critical care physicians, nurses, respiratory therapists, pharmacists, and other specialists.ICU care is characterized by its focus on advanced life support, close monitoring, and specialized interventions to support organ function and stabilize the patient's condition. This article will discuss the key knowledge points related to ICU care, including the types of ICUs, the role of healthcare providers in the ICU, patient assessment and monitoring, common ICU interventions, and ethical considerations in ICU care.Types of ICUsThere are different types of ICUs, each specializing in the care of specific patient populations or medical conditions. Some common types of ICUs include:1. Medical ICU (MICU): This type of ICU provides care for patients with medical conditions such as respiratory failure, sepsis, and acute exacerbations of chronic diseases.2. Surgical ICU (SICU): SICUs are dedicated to the care of postoperative patients who require close monitoring and support following surgery.3. Cardiac ICU (CICU): CICUs focus on the care of patients with acute heart conditions, including myocardial infarction, heart failure, and arrhythmias.4. Neuro ICU (NICU): NICUs specialize in the care of patients with neurological conditions such as stroke, traumatic brain injury, and spinal cord injury.5. Pediatric ICU (PICU): PICUs provide care for critically ill infants, children, and adolescents with a wide range of medical and surgical conditions.The Role of Healthcare Providers in the ICUThe care of critically ill patients in the ICU is provided by a multidisciplinary team of healthcare professionals. The key members of the ICU team include:1. Intensivist/Critical Care Physician: These physicians are specially trained in the management of critically ill patients and lead the medical care team in the ICU.2. Critical Care Nurses: ICU nurses are highly skilled in the care of critically ill patients and play a crucial role in patient monitoring, medication administration, and communication with the medical team.3. Respiratory Therapists: Respiratory therapists are responsible for managing mechanical ventilation and providing respiratory support for patients with lung disorders.4. Pharmacists: ICU pharmacists are involved in medication management, dosing, and monitoring for critically ill patients to ensure safe and effective drug therapy.5. Nutritionists/Dietitians: These professionals assess the nutritional needs of ICU patients and develop specialized feeding plans to support their recovery.6. Physical and Occupational Therapists: These therapists help ICU patients regain strength and function through mobilization, exercise, and rehabilitation.Patient Assessment and MonitoringThe assessment and monitoring of critically ill patients in the ICU are essential for early recognition of changes in their condition and prompt intervention. Key aspects of patient assessment and monitoring in the ICU include:1. Vital Signs Monitoring: This includes monitoring of vital signs such as heart rate, blood pressure, respiratory rate, and temperature to detect changes in a patient's condition.2. Continuous Cardiac Monitoring: ECG monitoring is essential for detecting arrhythmias and other cardiac abnormalities in critically ill patients.3. Pulse Oximetry: This non-invasive technique measures the oxygen saturation of arterial blood, providing valuable information about a patient's respiratory status.4. Arterial Blood Gas Analysis: This test provides information about a patient's acid-base balance, oxygenation, and ventilation status, which is critical for managing respiratory failure and other conditions.5. Neurological Assessment: Regular assessment of a patient's level of consciousness, cognitive function, and neurological status is important for detecting changes in brain function.Common ICU InterventionsICU patients often require a range of specialized interventions to support their organ function, stabilize their condition, and facilitate their recovery. Some common ICU interventions include:1. Mechanical Ventilation: This life-saving intervention provides respiratory support for patients with acute respiratory failure, acute lung injury, or respiratory distress.2. Hemodynamic Monitoring: This involves the continuous monitoring of a patient's cardiovascular status, including blood pressure, cardiac output, and fluid balance.3. Vasopressor and Inotropic Support: These medications are used to support blood pressure and optimize cardiac function in critically ill patients with cardiovascular instability.4. Continuous Renal Replacement Therapy (CRRT): CRRT is used for patients with acute kidney injury who require continuous renal support to manage fluid and electrolyte imbalances.5. Enteral and Parenteral Nutrition: ICU patients who cannot tolerate oral intake may require specialized nutritional support through feeding tubes or intravenous nutrition. Ethical Considerations in ICU CareThe care of critically ill patients in the ICU raises important ethical considerations related to decision-making, end-of-life care, and patient autonomy. Some key ethical issues in ICU care include:1. Shared Decision-Making: ICU care often involves complex medical decisions, and it is important to involve patients, their families, and the healthcare team in the decision-making process.2. Advanced Care Planning: Discussions about patients' treatment preferences, goals of care, and end-of-life wishes should be initiated early in their ICU admission.3. Palliative Care and Symptom Management: ICU patients may benefit from palliative care interventions to manage pain, dyspnea, anxiety, and other distressing symptoms.4. Withdrawal of Life-Sustaining Treatment: In cases where further medical interventions are futile or burdensome, discussions about the withdrawal of life-sustaining treatment may be necessary.ConclusionICU care is a specialized area of medicine that provides life-saving support and treatment for critically ill patients. The care provided in the ICU is complex and multidisciplinary, involving a wide range of specialized interventions and close monitoring. Understanding the key knowledge points related to ICU care is essential for healthcare professionals working in critical care settings to provide high-quality, compassionate care for their patients.。

夜大本科毕业综述气管切开术后护理学生姓名：李燕枝指导教师：梁慧敏专业：护理班级：护本一班学号：14121245定稿日期年月日气管切开术后护理摘要：气管切开术后气道作为有创人工呼吸道，其护理一直是护理人员研究和探讨的重要课题。

本文从护理的角度出发，对气管切开术后护理的重要性,对气管切开术后并发症发生的原因、危害、预防以及护理进行全面阐述。

方法:通过检索近年来的相关研究文献，针对气管切开的相关护理方法进行综述。

结论：根据相关文献结果可知，气管切开术后气道护理的重点是及时吸痰、充分湿化、预防局部感染、谨防气管导管引起阻塞等护理方法。

科学的气管套管护理和科学的气道湿化方法能降低病人气管切开术后的感染及脱管等风险提高病人其安全性。

关键词：气管切开;气道护理；气道湿化；感染为了解决气管切开手术后病患者的气道护理问题，近年来国内外护理界同行在气道管理中进行了大量的研究[1],尤其是对吸入气的加温加湿、痰液抽吸、气囊管理、气道感染预防和控制等方面,现就上述问题综述如下。

1环境的要求气管切开后，患者气道与外界直接相通,尘埃、细菌易进入呼吸道。

呼吸道防御机能受损，加之患者抵抗力弱，易出现肺部感染,因此要保持室内温度在22℃左右，相对湿度60％～70％[2]；定时紫外线消毒空气[3］，地面、物品用0.1％～0。

2％过氧乙酸或含氯消毒液擦拭，有条件者可使用层流洁净装置，定期做空气培养;严格探视制度及执行无菌操作原则；在患者床头备气管切开包，相同型号的气管套管、药品、物品等，以备急救之需[4—5］.2气管套管的护理2。

1外套管固定气管套管固定是气管切开病人护理的常规性工作。

一般采用无菌纱布覆盖气管切开伤口，并在气管套管两翼的固定孔系寸带打死结，固定于病人的颈部.更换纱布及寸带时需要用剪刀剪开。

当前主要的固定方法为：携用物至患者床旁，做好解释,协助患者适宜卧位,头略后仰。

撤下覆盖于患者气管套管口处的纱布,一手固定外套管，另一手持无菌镊子取出内套管放入治疗碗内。

ELSO GUIDELINES FOR ECMO CENTERSPURPOSEThese guidelines developed by the Extracorporeal Life Support Organization, outline the ideal institutional requirements needed for effective use of extracorporeal membrane oxygenation (ECMO). The Extracorporeal Life Support Organization recognizes that differences in regional and institutional regulations especially concerning hospital policies may result in variations from these guidelines.INFORMATION AND BACKGROUNDExtracorporeal Membrane Oxygenation (ECMO) was first used successfully for neonates with respiratory failure in 1975. Today it is an accepted treatment modality for neonatal, pediatric and adult patients with respiratory and/or cardiac failure failing to respond to conventional medical therapy.ECMO is defined as the use of a modified cardiopulmonary bypass circuit for temporary life support for patients with potentially reversible cardiac and/or respiratory failure. ECMO provides a mechanism for gas exchange as well as cardiac support thereby allowing for recovery from existing lung and/or cardiac disease.It has been estimated that approximately 2800 newborns could benefit could benefit from ECMO annually in the US (one of every 1309 live births). Pediatric and adult patients are being successfully treated in increasing numbers.GENERALA.ECMO centers should be located in tertiary centers with a tertiary level NeonatalIntensive Care Unit, Pediatric Intensive Care Unit and/or Adult Intensive CareUnitB.ECMO Centers should be located in geographic areas that can support a minimumof 6 ECMO patients per center per year. The cost effectiveness of providing fewer than 6 cases per year combined with the loss, or lack of clinical expertise associated with treating fewer than this number of patients per year should be taken into account when developing a new program.C.ECMO Centers should be actively involved in the Extracorporeal Life SupportOrganization (ELSO) including participation in the ELSO Registry. ORGANIZATIONA.General Structure: The ECMO center should be located in a tertiary levelintensive care unit with the following components.1. A single physician ECMO program director with responsibility for theoverall operation of the center. While there may be several associatedirectors with specific interests or focus in limited areas of ECMO care, theprimary medical director should be responsible for assuring appropriatespecialist training and performance, directing quality improvement meetingsand projects, assuring proper and valid data submission to ELSO, andshould also be responsible for the credentialing of other physicians whocare for ECMO patients or who manage the ECMO circuit.2.An ECMO coordinator with responsibility for the supervision and training ofthe technical staff, maintenance of equipment, and collection of patient data.3. A multi-disciplinary ECMO Team should have quality assurance reviewprocedures in place for annual ECMO evaluation internally.4.Formal Policy and Procedures outlining the indications and contraindicationsfor ECMO, clinical management of the ECMO patient, maintenance ofequipment, termination of ECMO therapy, and follow-up of the ECMOpatient should be available for review.5.Appropriate laboratory space for training and continuing medical educationshould be available.B.Staffing Issues:1.The ECMO physician staff should meet the requirements of theirsubspecialty training as set forth by their specific governing board(American Board of Surgery, American Board of Pediatrics, etc.). Inaddition, ECMO staff should meet the training requirements describedbelow.2.The medical director should be a board certified neonatologist, a boardcertified critical-care specialist, or a board certified pediatric,cardiovascular, thoracic surgeon, trauma surgeon, or other board certifiedspecialist with specific training and experience in ECMO support.3.The ECMO coordinator may be an experienced neonatal, pediatric, oradult intensive care registered nurse or registered respiratory therapist witha strong ICU background (minimum of 1 year of ICU experience), or acertified clinical perfusionist with ECMO experience.4.An ECMO-trained physician will provide 24-hour on-call coverage for theECMO patient. The physician may be a neonatologist, pediatric or adultcritical-care specialist, a neonatology,critical care, subspecialty fellow, orother physician who has completed at least three years of post-graduatepediatric, surgical, or adult medical training and has specific ECMOtraining.5.There shall be an ECMO clinical specialist in addition to the ICU nurse oran ECMO trained nurse, as described below, to provide care throughoutthe course of ECMO. (Refer to C-7)6.The ECMO Specialist should have a strong intensive care background (atleast 1 year of NICU, PICU, MICU, CCU or other critical care experiencepreferred) and have attained one of the following:(1)Successful completion of an approved school of nursing andachievement of a passing score on the state written exam given by theBoard of Nursing for that state (this may also include nursepractioners with appropriate experience and training);OR(2)Successful completion of an accredited school of respiratory therapyand have successfully completed the registry examination for advancedlevel practitioners and be recognized as a Registered Respiratory Therapist(RRT) by the National Board of Respiratory Care (NBRC).OR(3)Successful completion of an accredited school of perfusionand national certification through the American Board ofCardiovascular Perfusion (ABCP).OR(4)Physicians trained in ECMO who have successfully completedinstitutional training requirements for the clinical specialists.OR(5)Other medical personnel such as biomedical engineers ortechnicians who received specific ECMO training and have practiced asan ECMO specialist since the initiation of their programs, and who havecompleted equivalent training in ECMO management as the otherspecialists, have successfully documented necessary skills as an ECMOspecialist, and who have been approved specifically as an ECMOspecialist by the medical director. These personnel can be approvedinstitutionally as an ECMO specialist under the “grandfather” principle.However ELSO does not encourage or support the new training ofindividuals except as outlined in 1-4 above.7.In clinical settings where the ECMO patient is primarily managed by theICU nurse (the single care giver model) the ICU nurse should bespecifically trained in ECMO patient and circuit management. Nurses withthis responsibility should be approved by the program director. TheECMO specialist team is responsible for managing equipment andsupplies, circuit preparation, troubleshooting, daily rounds, education, andservice administration. Additional trained personnel should be readilyavailable for support.8.Additional support personnel from the permanent hospital staff should beavailable including:a.Physicians or other medical personnel:•Pediatric/adult cardiology•Pediatric/adult cardiovascular surgery•Pediatric/general surgery•Cardiovascular perfusion•Pediatric/adult anesthesiology•Pediatric/adult neurosurgery•Pediatric/general radiology•Geneticsb.Biomedical engineerc.Respiratory therapists experienced in intensive care (in USA)9.The following consultants should be available as needed.•Pediatric/adult neurology•Pediatric/adult nephrology•Pediatric/adult pulmonology•Pediatric/adult infectious disease•Occupational/physical therapist•Developmental/rehabilitation specialist•Speech therapy/feeding therapy specialist•Social Services/Palliative Care•Spiritual Support10.If out of hospital ECMO transport is available, a fully trained andequipped transport team should be available 24 hours a day. A team for in-hospital transport should be available at all institutions.11.Trained individuals capable of providing development follow-up orrehabilitation should be available and capable of providing long-termfollow-up to the ECMO patient. Appropriate subspeciality services shouldalso be accessible.C.Physical Facilities and Equipment1.If the space allocated for ECMO is located outside the ICU, it should be inclose proximity to and have appropriate communication with the ICU toassure additional staff support for any emergency that may arise.2.An ECMO system consists of a suitable blood pump, a system for servo-regulation to balance venous drainage rate from the patient and bloodreturn to the patient, an appropriate blood heat exchanger and warmingunit, appropriate disposable materials including membrane oxygenatortubing packs, and connectors, all suitable for prolonged extracorporealsupport.3. A device for monitoring the level of anticoagulation (ACT or other) withappropriate supplies should be at the bedside.4.The following equipment should be readily available:a.Backup components of the ECMO system and supplies for allcircuit components.b.Adequate lighting to support surgical interventions.c.Surgical instrument set for revision of cannulae or exploration forbleeding complications.5.The following support facilities with staff should be available on a 24-hour basis.a. A blood gas laboratoryboratory for blood chemistry and hematologic testingc.Blood bankd.Radiographic support including cranial ultrasound and CATscane.Cardiovascular operating room facilities with cardiopulmonarybypass capabilities located within the hospital doing ECMO andavailable 24 hours a day.D.Physician and Staff Training and Continuing Education1.Each ECMO center should have a well-defined program for ECMOphysician and staff training, certification, and re-certification. Thisprogram should include: didactic lectures, laboratory training with theECMO equipment, bedside training, and a defined system for testingproficiency of the team members (See ELSO Red Book 4th edition,Chapter 34.)2.Each member of the ECMO team should successfully complete thisprogram.3. A well-defined program of routine continuing education and emergencytraining for ECMO staff should be outlined with records documentingparticipation by active team members. Smaller ECMO programs (<20cases/year) may need additional continuing education for all teammembers.4.It is recommended that team members not involved in ECMO pumpmanagement for >3 months participate in a required recertificationprocess as defined by the ECMO program.E.Selection Criteria1.ECMO is indicated for selected neonatal, pediatric and adult patients withsevere, acute cardiac and/or respiratory failure who have failed to respondto conventional medical management.2.Each ECMO center should develop institutional criteria for ECMOtherapy, including indications and contraindications.3.It is recommended that the ECMO center develop guidelines for transferof the potential ECMO patient and ECMO patients requiring servicesprovided only at an ECMO referral center.F.Patient Follow-upEach ECMO center should have a well-defined developmental follow-up program for the ECMO patient with appropriate subspecialty support (refer to ELSO Guidelines for Follow-up).G.Program Evaluation1. A well-defined system should be instituted for assuring that formalmeetings of key ECMO team members occurs on a routine basis toreviewcases, equipment needs, administrative needs, and other pertinentissues. Minutes to these meetings should be available for review.2. A prompt review of any major complication or death should be held bothwith ECMO team members and with the responsible Morbidity andMortality committee in the hospital. These reviews should be conductedunder the relevant quality assurance laws for the state where the center islocated.3.Formal clinical-pathological case reviews with a multi-disciplinaryapproach should be regularly conducted (as outlined by JCAHOregulations).4.An Annual Data Report, utilizing the center's collated data, or the collatedreport of data submitted to the ELSO ECMO Registry, should be availablefor quality assurance review.5.Records documenting maintenance of equipment should be kept (as perJCAHO regulations).。

医学学术英语——词汇部分复习资料Unit11. neuron 神经2. office visit(诊所)就诊3. scan 扫描4. medical practice 行医5. blood pressure 血压6. maintenance(健康)保持7. mammogram 乳房X线8. physical 身体9. side effect 副作用10. panic 恐慌11. practicing 执业12. transplant 移植13. budget 预算14. tablet 药片15. childproof 防孩子16. randomized 随机17. allocation(随机)分配18. prognosis 预后19. control 对照20. follow-up 跟踪21. ward 病房22. hepatitis 肝炎23. malaise 身体不适24. metabolism 代谢25. liver 肝病理生理27. literature 文献28. investigation 调查29. incidence 率30. epidemiology 流行病学31. bed rest 卧床休息32. hospital stay 住院33. jaundice 黄疸34. course 病程35. intravenous 静脉注射36. diastolic 舒张37. perfusion 灌注38. primary 初级39. bypass(冠脉)旁路40. informed 知情41. humanitarian 人道主义42. the Red Cross 红十字会43. relief 援助44. casualty 人员伤亡45. emergency 紧急Unit21. re-emerging 再现2. strain 变种3. vaccine 疫苗4. infectious 传染性的5. emerging 新出现6. prevention 预防7. plague 鼠疫8. pathogenic 病原的9. authorities 机构10. drug resistanc 抗药性11. course 疗程12. scarlet fever 猩红热13. virulence 毒性14. pandemic 大流行15. antigen 抗原16. genetic 基因的17. neurological 神经性18. immunity 免疫力19. infrastructure 基础设施20. case 病例21. swine 猪22. tuberculosis 结核23.morbidity/incidence 发病率24. professionals 专业人士25. latent 潜伏26. skin test 皮试27. screening 筛查28. interferon 干扰素29. toxicity 毒性30. curable 可治愈的31. intractable 难治的32. pathogen 病原体33. ulcer 溃疡34. exposure 接触(带病者)35. recombination 重组36. bioterrorism 生物恐怖活动37. foodborne 生物传播Unit31. adrenaline 肾上腺素2. residency 实习3. autoimmune 自身免疫4. stamina 持久力5. transient 短暂的6. bedridden 卧床不起7. building block 基本构件8. model 模型9. neurodegeneration 神经退化排除(毒素)优化载量复发自我实验试验神经肌肉治疗师微量营养素功能跟踪协调心血管亲密同步传染调节生物心理慰藉M R I激活强制性无把握的背景概念方案并发症抗肿瘤标准的药理学的溶解性vivo 体内Unit41. complementary 补充2. alternative 替代(医学)3. paradigm 模式4. acupuncture 针灸5. adjunct 辅助6. nausea 恶心7. post-operative 术后8. clinical 临床的9. physicaltherapy 理疗10. therapeutic 治疗(方法)11. intervention 干预12. design 设计13. resonance 共振14. emission 发射PET15. analgesia 止痛16. establishment(生物医学) 界17. rehabilitation 康复18. licensed 持照(针灸师)19. strategies 策略20. formulas 配方21. wide array 各式各样的22. integrative( 中西医)结合23. acute 急性的24. administer 给药25. procedure 程序26. evaluation 评估27. prevalence 患病率28. conventional 传统 ( 疗法)29. evidence-based 循证的30. management( 压力)处理31. peripheral 外周／外围32. mechanisms 机制33. reductionistic 还原式的效益35. outcomes 结果36. preclinical 临床前37. plausible 可能的38. manipulative 推拿39. homeopathic 顺势40. naturopathic 自然 (疗法)41. meditation 冥想Unit51. crisis 危机2. symptoms 症状3. vitality 活力4. immune 免疫5. virus 病毒6. lifestyle 生活方式7. robust 健全的8. fragile 脆弱的9. balance 平衡10. spiritual 精神的11. blockages 路障12. repressed 被压抑的13. genuine 真实的(真情实感)14. physiological 心理15. integrated 整合的(十全十美)16. decaying teeth 蛀牙17. nutrition 营养18. waistline 腰围19. bottled 瓶装(水)20. intake 摄入21. appetite 食欲22. protein 蛋白质23. obesity 肥胖症24. lean 精益的(蛋白质)25. dietary 饮食(习惯)26. quality 质量27. dairy 乳制品28. diabetes 糖尿病29. content 含量Unit61. nursing home 养老院2. hospice 临终(关怀)3. failure(心)衰around-the-clock24 小时随叫随到5. coronary 冠心病6. respond(对治疗有)反应7. facility 机构8. end-of-life 终末期9. comfort 舒适的(护理)10. hospital discharge 出院11. care(症状)护理12. palliative 姑息的13. fatal illness 绝症14. pulmonary 肺的 C O P D15. experimental 实验性的16. advisors 顾问17. discontinue 终止18. dialysis 透析19. smear 涂片20. provider 医患关系21. care-as-usual 常规医护22. preventive 预防性23. beaten 常用的off the beatenpath 离开熟路,另辟蹊径24. moldinto the shape 塑形25. renew 重新开始 torenew aprescription 照旧处方再开药26. fertilization 授精27. basic 基础的(生物学)28. stem cell 干细胞29. collaborate 合作30. test-tube 试管(婴儿)31. reproductive 生殖的32. hormones 激素33. immature 未成熟的34. empirical 经验(观察)35. pioneering 首创的36. endoscope 内镜37. ethical 伦理的38. concern(社会)关注39. infertile 不孕不育的40. inherited 遗传性的41. fibrosis 纤维化42. dilemmas 困境Unit71. station(护士)站2. life-support 生命维持(系统)3. measures 护理措施4. withdraw 停止(治疗)5. paternalistic 家长式的6. empowerment 授权7. ethicists 伦理学家8. principles 准则9. ideal 理念以病人为中心的11. autonomy 自主权12. options 选择13. exclusivepurview 专属的(领域)14. emergency 紧急(决定)15. restraint 限制16. anxiety 焦虑17. transgression 违背18. practice(家庭)医疗19. metastases(广泛)转移20. aggressive 积极的21. primary 原发22. follow-up 随访23. record 病历24. embolism 栓塞25. tomography 断层摄像C T26. infiltrates 浸润27. chest 胸28. lower-lobe 左下叶29. labored(呼吸)困难30. team 团队31. chronic 慢性的32. psychosocial 社会心理33. guidelines 指南34. implement 实施(治疗方案)Unit91. curriculum 课程2. community 界3. expectations 期待4. attributes(个人)品质5. value 看重The place value on 看重6. maladies 疾患7. diagnostic 诊断的8. manifestations 临床表现Unit81. subject 受试对象2. biomedical 生物医学3. therapy 治疗4. protocol 方案5. beneficence 有利6. justice 公正7. autonomous 有自主能力的8. diminished 减弱Diminished autonomy自主性减弱9. exposed to 面临10. Oath 誓言11. distribution 分配12. consent 同意Informed consent 知情同意13. procedures 程序14. operating 手术台15. obligation 责任16. pediatric 儿科的17. perform 做(手术)18. flow(血)流19. intensive 重症的ICU20. adoptive 义(父) 生(父)22. psychological 心理的23. medical 医学的24. occupational 职业的25. contract 感染性的26. infection 感染27. blood vessel 血管28. circulation 循环29. welfare 安宁30. disapprove 不批准31. protocol 研究计划32. liability 责任9. civic mindednes 民本意识10. chatter 闲谈11. manner(临床)举止12. directories 名录13. integral 不可分割的14. underserved 服务匮乏的15. shortage(初级保健)缺乏16. certification 证书17. address 应对(需要)18. basics 基础知识19. teaching 教学(医院)20. academic 学术的Unit101. coverage 范围medical coverage 医疗保险支付范围2. Medicaid 医疗救助3. single-payer 单一支付4. subsidize 补贴5. deliver 提供6. duplicative 重复的7. sustained 长期的8. deficits(视力)缺陷9. echocardiogram 超声心动图10. thrombus 血栓11. stroke 中风12. artery 动脉13. intracranial 颅内的14. cerebral 大脑15. bleeding 出血16. brain-stem 脑干17. recovery 恢复18. ventilation 通气19. anticoagulant 抗凝血20. infusions 输液21. surgeon 外科医生22. administrators 管理者23. ambulances 救护车24. elective 可做可不做25. infarction 梗死时间要求紧迫的27. arrest 停止28. traumatic 外伤的,创伤的29. intervention 介入术30. multi-payer 多家支付的31. universal 全民的32. for-profit 以营利为目的的33. pharmaceutical 制药的34. remedies 治疗方法home-brewed remedy 自创的治疗方法35. out-of-pocket 自掏腰包21. affiliate with 隶属于继续医学教育。