j**********i
发帖数: 3758 | 1 【 以下文字转载自 Sociology 讨论区 】
发信人: jpostsildavi (ID), 信区: Sociology
标 题: The brief Code of bedridden patient care workers
发信站: BBS 未名空间站 (Sat Feb 2 11:19:09 2013, 美东)
Patient in charge often come with a fever, phlegmatic, edema，urine
turbid, arrhythmia and abnormal blood pressure. Be careful not to let
patient have bed sores, always check 6 vital signs of physical condition
of the patient:
1. heart rate 2. respiratory rate 3. body temperature 4. blood pressure
5. oxyhemoglobin 6. blood glucose level
Care workers must communicate with the family members concerned and
doctors in charge promptly in case of emergency.
Home Phone numbers: ( )
Cell Phone number : ( )
Emergency Phone call: ( )
Doctor’s Phone number: ( )
A. Eat
6:30AM a small lunch box
Breakfast 10:30AM a small lunch box
3:00 a bottle of milk
Lunch 4:00 pm a small lunch box
Evening meal 8:00-9:00pm a small lunch boxes
B. Drink
1000-1500 ml per day, Increase the amount of water in case of fever, or
the urine turbid. If there is no diabetes, reduce the amount of intaking
water when eating fruits.
C. Wash
Morning time: washing face, washing lower body part
Afternoon time: washing body parts
D. Nursing care
Assist excrement: 2-3 days a time.
Assist urine: flush the bladder under the guidance of nurses .
Turn over the patient very two hours (very important to prevent bed sores).
Pat the back of the patient from bottom to top several times a day.
Assist sputum suctioning.
E. Monitoring
Measuring body temperature, blood pressure, to understand oxyhemoglobin,
heart rate and respiratory rate, to know the normal range of 6 vital signs
of physical condition of individual patient：
1. heart rate 2. respiratory rate 3. body temperature 4. blood pressure 5.
oxyhemoglobin 6. blood glucose level
F. To pay "very strictly" attention to room temperature, ventilation.
Keep air fresh, Keep room temperature neither hot nor cold. Average winter
daytime temperature is 22 degrees, and 23 degrees at night。 Keep summer
room temperature below 26 degrees, recommended room temperature is 24
degrees. Different place has different views. | j**********i
发帖数: 3758 | 2 This is the 6 vital signs ranges of my parents I showed to their care
workers :
Normal Emergency Dangerous
Heart rate 60-120/minute >120 or <50/m >150 or <45/m
respiratory rate 16-20 / minute >45 or <12/m
body temperature night 36-37.1 >39 degrees >40 degrees
blood pressure 90/60-120/80 >150/100 > 200/110
low pressure below 45
oxyhemoglobin 95% -100% <90% <85%
blood
glucose level before meal 3.6-6.4 <3 <2.8 or > 11.1
after meal 7.8 >11.1
Doctors Remarks: | j**********i
发帖数: 3758 | 3 The proposal is the idea of the individual thought and each patient's
condition is not the same. If the family members run into big health trouble
, to sue the doctors in charge could not reverse the tragedy. Different
doctors have difference in skills, knowledge level, experience,
qualifications. Also, there are the limitations of hospital equipment per se
, and the doctors could not always keep perfect status and judgment.
Most family members could not standby the patient 24 hours a day, 365 days a
year. Care workers, nurses and doctors would be the full duty safe keepers.
.
We could not assume that each care worker has a high education level and the
ability to make the sound judgment, and could not assume either, that the
care workers have general or enough medical knowledge. As the matter of fact
, some of them only have very weak capability and very low education level,
however, care workers can act in according with the simple and clear
guidances. Nor we can assume that doctors are very skilled and have amazing
power. Moreover, we can not assume that each hospital or nursing center is
equipped with very advanced. facilities.
But individual family members could make an agreement with the care workers
according to the
conditions of patient and recommendation of qualified doctors. Namely: The
care workers should notify the family members concerned in case the vital
signs of patient is out of normal range so that the family members could
communicate with the doctors and solve the problem with more care.
In addition, we need to give a careful buffer to the dangerous ranges of 6
vital signs of individual patient based on the conditions of the patient and
recommendations of qualified doctors. This is the convention of most
engineer fields. It is not a universal principle, not a 100% assurance.
However, medical professionals would generally agree that before the sudden
death of most patients, in a large proportion, some vital signs would have
abnormal signals.
Each doctor may have different views on patient in charge, to make a
judgment about the clinical situation at hand is based on more complex
integrated considerations. This is beyond the general knowledge and ability
of care workers. Nonetheless, it is a more easy way to coordinate the
doctors, nurses and care workers with a clear principle. Give the family
members more chance to take serious responsibility of the patients.
The standards are not the same for each patient, but the family members of
the patient have the right to request care workers to make a prompt report
in case the vital signs of the patient are in dangerous range. If care
workers intentionally avoid notifying the family members concerned, it is
considered as a breach of agreement, even if care workers do not inform the
family members concerned due to the negligence, it is still considered as a
violation of professional ethics. The phone records would give everything.
Care workers may not be compelled to make any agreement, but, some people
can still make a good negotiation.
My remarks only represent my personal opinions, however, to fully understand
my remarks depends on the reader's moral standards and judgment. | j**********i
发帖数: 3758 | |
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