减轻危重病人临终时皮肤衰竭:一例报告。

IF 2 4区 医学 Q3 CRITICAL CARE MEDICINE
Lynn Kordasiewicz, Katie Fik, Christy Petry, Janice Sturtz
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引用次数: 0

摘要

在预防和管理皮肤衰竭事件,如深部组织损伤和肯尼迪终末期溃疡有限的研究是可用的。尽管有循证护理干预以增强皮肤完整性,但这些皮肤衰竭事件经常出现在皮肤灌注不足的多器官衰竭患者中。临床表现:一名68岁的白人男子在最近几次在家摔倒后出现在创伤医院。他立即要求住院治疗。随后出现了包括深层组织压力损伤在内的一些医疗并发症。在他住院期间,压伤在临床上保持稳定。诊断:患者被诊断为深部组织压力损伤。干预措施:积极的医疗管理,在低空气损耗表面上实施转向计划,泡沫敷料和卸载靴用于防止皮肤损伤和保持皮肤完整性。结果:患者病情下降,骶骨发生深部组织压伤,没有进展或感染。家人同意采取安慰措施,他很快就去世了。结论:危重患者、老年患者、接近生命末期患者及其他体表长期受压患者常发生深部组织压力损伤、Kennedy终末溃疡等皮肤衰竭事件。医疗保险和医疗补助服务中心要求医院对医院获得性全层压力损伤相关事件的后遗症负责。将皮肤衰竭事件归类为继发于灌注不足而非医疗管理不善的进一步研究可以优化患者安全,并对医疗机构的财务和信誉产生积极影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mitigating Skin Failure in Critically Ill Patients at the End of Life: A Case Report.

Introduction: Limited research on preventing and managing skin failure events such as deep tissue injuries and Kennedy terminal ulcers is available. These skin failure events often appear among patients experiencing multiple organ failure with hypoperfusion to the skin despite evidence-based nursing interventions to enhance skin integrity.

Clinical findings: A 68-year-old White man presented at a trauma hospital after several recent falls at home. He immediately required hospitalization. Several medical complications, including a deep tissue pressure injury, evolved. The pressure injury remained clinically stable throughout his hospitalization.

Diagnosis: The patient received a diagnosis of deep tissue pressure injury.

Interventions: Aggressive medical management, implementation of a turning schedule on a low-air-loss surface, foam dressings, and offloading boots were used to prevent skin damage and preserve skin integrity.

Outcomes: The patient's condition declined and he developed a deep tissue pressure injury on the sacrum that did not advance or become infected. The family agreed to comfort measures and he soon died.

Conclusion: Skin failure events such as deep tissue pressure injuries and Kennedy terminal ulcers often occur among critically ill patients, older patients, those approaching end of life, and other patients with prolonged pressure upon body surfaces. The Centers for Medicare & Medicaid Services holds hospitals financially accountable for sequelae of events associated with hospital-acquired full-thickness pressure injuries. Additional research to categorize skin failure events as secondary to hypoperfusion and not medical mismanagement can optimize patient safety and positively impact the finances and credibility of medical organizations.

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来源期刊
Critical care nurse
Critical care nurse 医学-护理
CiteScore
2.80
自引率
0.00%
发文量
68
审稿时长
>12 weeks
期刊介绍: Critical Care Nurse (CCN) is an official publication of the American Association of Critical-Care Nurses (AACN). Authors are invited to submit manuscripts for consideration and peer review. Clinical topics must meet the mission of CCN and address nursing practice of acute and critically ill patients.
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