InternationalTraumaLifeSupportInternationalTraumaLifeSupportforPrehospitalCareProvidersSixthEditionforPrehospitalCareProvidersSixthEditionPatriciaM.Hicks,MS,NREMTPRoyAlson,PhD,MD,FACEPDonnaHastings,EMT-PJohnEmoryCampbell,MD,FACEPandAlabamaChapter,AmericanCollegeofEmergencyPhysiciansPatriciaM.Hicks,MS,NREMTPRoyAlson,PhD,MD,FACEPDonnaHastings,EMT-PJohnEmoryCampbell,MD,FACEPandAlabamaChapter,AmericanCollegeofEmergencyPhysiciansCampbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJChapter19TraumainPregnancyChapter19TraumainPregnancyCampbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJTraumainPregnancy孕妇创伤TraumainPregnancy孕妇创伤Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJOverview概要Dualgoalsinmanagingpregnanttrauma需要处理两个或以上的病人Physiologicalchangesofpregnancy孕妇生理改变•Responsetohypovolemia对血溶积减少的反应Typesofinjuriesmostcommonlyassociated常见伤势Initialassessmentandmanagement初步检查及处理Traumapreventioninpregnancy预防孕妇创伤3TraumainPregnancy-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJTraumainPregnancy孕妇创伤Uniquechallenges挑战•Vulnerabilityofpregnanttraumapatient孕妇于创伤时之弱点•Potentialinjuriestounbornchild对胎儿的伤害Dualroles双重角色•Providecaretomother照顾母体•Providecaretofetus照顾胎儿4TraumainPregnancy-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJTraumainPregnancyLeadingcauseofmorbidityandmortality为孕妇发病率及死亡率的主要原因•6–7%ofpregnanciesexperiencesometrauma6-7%孕妇曾遇上创创•1in12injuredexperiencesignificanttrauma1-2%遭遇严重创伤•Majorcauses主要原因•Motor-vehiclecollisions交通意外•Falls高处堕下•Abuseanddomesticviolence虐待及家庭暴力•Penetratinginjuries穿刺性创伤•Burns烧伤5TraumainPregnancy-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJPregnantPatientIncreasedriskfortrauma创伤的风险增加•Faintingspells,hyperventilation,excessfatiguecommonlyassociatedwithearlypregnancy孕妇初期较易头晕,呼吸过速,易疲倦•Balanceandcoordinationaffectedbychangesthroughoutpregnancy怀孕过程可影响其平衡力及身体协调6TraumainPregnancy-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJFetalDevelopment7TraumainPregnancy-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJViabilityAssessment8TraumainPregnancy-阴道出血肚脐耻骨联合流产可被见宫高Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJPhysiologicChanges9TraumainPregnancy-肠蠕动血色素心输出量血量血压心率血含二氧化碳量Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJPhysiologicChanges孕妇生理的改变Respiratorysystem呼吸系统•Diaphragmelevatedduetouterinesize日渐长大的子宫令横隔膜上升•Decreasedthoracicvolume肺容量下降•Relativealkalosis血液相对为碱性•Predisposedtohyperventilation较易出现呼吸过速10TraumainPregnancy-Campbell,InternationalTraumaLifeSupport,6thEd.©2008PearsonEducation,Inc.,UpperSaddleRiver,NJVitalSignsinPregnancy孕妇生命表征的改变Donotmistakenormalvitalsignsforsignsofshock.切勿把正常的生命表征当作休克•Normalpulse:10–15beatsfaster正常脉搏:...
