为了获取更好的使用体验,丁香公开课推荐使用 Chrome 或 Firefox 浏览器

如果您使用 IE 浏览器,推荐使用 IE11 版本

APP下载

Bryan I. Fagan

丁香诊所 急诊科

急诊科视频 / 时长50分钟

丁香诊所全科培训课程 15:伤口处理知多少

¥12.00

加载中... 已有 90 人购买

课程介绍

伤口管理目标是优化伤口外观和功能,减少感染,提供快速照护,减缓疼痛以达到患者满意度最大化。缝合之前应清洁伤口,减少张力促进愈合。

问诊包括损伤方式,受伤时间,基础疾病(如糖尿病,免疫抑制),过敏史,破伤风接种史等。

体格检查需在光线充足的环境下进行,出血量大时先控制出血,检查包括神经血管(感觉或功能)情况,肌肉或肌腱损伤程度,怀疑异物时需进行 X 线检查。

处理伤口准备的物品包括冲洗液、抗菌溶液、纱布垫、无菌毛巾、无菌手套、注射器和针头,必要时可用麻醉剂,缝合器械,皮钉,皮肤粘合剂,胶带等。

处理伤口首先要控制出血,再用注射器和无菌水或无菌生理盐水冲洗伤口,注意力度,观察创面。清除坏死组织和异物,清洁伤口边缘便于对齐愈合。

关闭缝合:伤口处理越晚,感染率越高;手、脚、手指、脚趾的伤口,超过小时后不应缝合创面。颜面部伤口可在 24 小时后修复。

皮肤粘合剂具有快速方便,粘合力强,无需麻醉,有良好的美容效果的优点,适用于止血清洁后的小张力表情伤口。不建议用于有皮损或皮炎的伤口。将创面对合后,粘合剂滴在创面处,一般无需纱布覆盖。第 1 天不能碰水,第 2 天可以淋浴,禁游泳、盆浴。愈合时间同缝合时间。而外科胶带适用于无张力无皮肤渗液的浅表伤口。

本期丁香公开课,丁香园特邀马里兰大学医学院附属医院急诊科医生助理 Dr. Bryan Fagan 和大家一起来讨论《伤口处理》。

更多精彩内容请点击此处观看丁香公开课全部课程。

展开全部

Bryan I. Fagan 丁香诊所 急诊科

Bryan I. Fagan,马里兰大学医学院附属医院急诊科医生助理(PA)、PA学校带教老师。

EDUCATION:
2002-2004 Bachelor of Science, University of Nebraska, College of Medicine-Interservice Physician Assistant Program (U.S. Army)
1996-1997 Associate of Science, George Washington University, Health Laboratory Sciences

EMPLOYMENT:
2013-present: Physician Assistant/US Army Maryland National Guard officer (65D) Care and treatment of military personnel.
2010-present: Physician Assistant, Bel Air Center for Plastic and Hand Surgery/Ramon A. de Jesus, MD, LLC; evaluation and treatment of patients with upper extremity problems/trauma and plastic/reconstructive needs.
2004-present: Physician Assistant, Dept. of Emergency Medicine, Upper Chesapeake Health System- under the direction of the attending physician, assessment and treatment of acute illnesses and injuries in the urgent care and main emergency department. I have been the Lead PA/Director of MLPs since 2012.
1995-2006: US Army Reserve, (Honorable Discharge 02/16/2006) Team member in US Army Medical Department NCO and Commisioned Officer
1998-2004: Medical Laboratory Technician, Johns Hopkins Hospital processing and evaluation of routine and STAT clinical medical specimens in microbiology, virology, hematology, immunology, and clinical chemistry.

CERTIFICATIONS and LICENSES:
Physician Assistant-Certified, NCCPA (recertified 11/2010)
Maryland State License
Maryland CDS
National DEA
BLS
ACLS
PALS
ATLS trained

MEMBERSHIPS:
American Academy of Physician Assistants

COMMITTEES:
Allied Health Review Committee
Meditech (hospital interface) introduction team Forerun and Dragon (voice -recognition EMR) introduction team
Clinical preceptor to PA students from Towson/CCBC and Anne Arundel Community College PA programs
Department peer review team
High Risk Patient management team
Emergency Department leadership
更多

网友讨论