Procedure of anesthesia respiratory supplies

　　Acute respiratory failure refers to the normal respiratory function of the primary lung, due to a variety of rapidly developing lesions in a short period of time caused by serious gas exchange disorders, resulting in hypoxia, with or without carbon dioxide retention, with acute ventilation dysfunction caused by hypoxemia and respiratory distress as the main manifestations. Oxygen partial pressure ≤60mmHg (1mmHg = 0.133kPa) and/or carbon dioxide partial pressure ≥50mmHg when inhaling air. The onset of acute respiratory failure is sudden and the disease develops rapidly. Improving the pre-hospital emergency system and improving the quality of emergency care, taking correct emergency measures and using advanced pre-hospital emergency equipment can gain precious time for pre-hospital treatment and rescue, which is of great significance for identifying the cause, saving the lives of patients and reducing complications.

　　The ambulance is portable with anesthesia respiratory supplies

　　1 Preparation before transshipment

　　1.1 Condition assessment Upon arrival at the scene, the medical staff shall immediately assess the patient's consciousness, respiration, circulation and other conditions, closely observe the heart rate, respiration, blood pressure, blood oxygen saturation and other conditions, and promptly deal with the symptoms if any problems are found.

　　1.2 Maintaining an open respiratory tract An open respiratory tract is a necessary condition for all types of respiratory support. In severe acute respiratory failure, especially in patients with unconsciousness, loss of normal muscle tone in the pharynx muscles, soft tissue relaxation, and falling back of the tongue may block the upper respiratory tract. anesthesia respiratory supplies will be given to assist breathing after emergency removal of respiratory secretions. Closely observe the patient's respiratory rate, rhythm, thorax fluctuation amplitude, face, mouth lip, extremity temperature, etc. If the patient's blood oxygen saturation is low, check whether the ventilator tube has fallen off, whether the airway is blocked by sputum, and clear the airway and oral secretions in time to keep the airway smooth.

　　1.3 Communicate well Patients should be transferred to the nearest hospital for further treatment as soon as possible after initial treatment on site. The complex condition of critically ill patients, coupled with the instability of the condition, and the difficulties such as insufficient medical equipment and personnel during transit, have resulted in a high incidence of dangerous incidents during transit for critically ill patients. Family members should be fully communicated before transport, inform them of possible complications on the way, obtain family members' consent and sign the informed consent letter before transport.

　　2 Precautions in transit

　　2.1 Once anesthesia respiratory supplies fails, patients will experience hypoxia symptoms, such as decreased oxygen saturation, rapid heart rate, facial color, and lip cyanosis. Nurses should closely observe the patient's vital signs. As vehicle turbulence and patient irritability can increase the safety risks on the way, it is easy to lead to pipe fall off, discount, the nurse should regularly check whether the pipe connection is smooth.

　　2.2 Airway Management For patients undergoing anesthesia respiratory supplies, airway management should not be ignored during transportation. The turbulence of the vehicle is easy to cause sputum gushing, blocking the respiratory tract and causing asphyxia. The nurse should closely observe the condition on the way and aspirate sputum in time. Awake patients should be given a semi-decumbent or upright position if necessary.

　　2.3 Strict aseptic operation and good occupational protection Due to the special working environment of emergency vehicles, nurses are easy to ignore sterility problems. As a means of transportation to pick up patients, emergency vehicles have direct or indirect contact with patients, small space in the car, more people, some invasive operations need to be carried out in the car, disinfection isolation and aseptic concept is directly related to the success or failure of patient rescue. Especially for patients with open airway management, the nurse's slight negligence may aggravate the patient's infection. Therefore, aseptic procedures should be strictly carried out to maximize the protection of patients and medical staff.

　　2.4 Do a good job of psychological care Respiratory failure patients due to hypoxia and dyspnea, hard breathing has been unable to meet the need for oxygen patients will feel the great threat of death, produce a sense of near-death. With the aggravation of dyspnea or the establishment of artificial airway and mechanical ventilation, the emotional communication between patients and others is affected. If the expressed wishes are not well understood and met, the patient may become agitated, depressed, and even refuse treatment and care. Therefore, the conscious patients should talk more with them, understand the psychological dynamics of patients, with patience and meticulous nursing work, obtain the trust and cooperation of patients, and at the same time help patients overcome bad emotions with the cooperation of family members, establish the confidence of patients to overcome the disease.

　　3 Maintenance of the machine after transfer

　　After the patient is transferred to the hospital, terminal disinfection of portable ventilators should be carried out in time to prevent infection. Check the status of the ventilator, such as whether the oxygen is sufficient, whether the pipes are tightly connected, etc., to ensure that the rescue instrument is in standby state.

　　4 Summary

　　Pre-hospital emergency and transport is the extension of the hospital emergency department, shouldering the responsibility of saving patients' lives, it is the forefront of emergency medical services, but also the most important part of the process of rescuing patients. Portable anesthesia respiratory supplies play an important role in pre-hospital emergency treatment and transportation of critically ill patients because of its simplicity, safety, efficiency, stability, small size and light weight. However, it is undeniable that the risk of transferring patients by ventilator is large, which can increase the mortality coefficient of patients and increase the difficulty of implementing treatment. With the gradual popularization and application of portable ventilators, higher requirements have been put forward for emergency nurses. The provision of exquisite nursing technology is the premise of ensuring the safe transport of patients. Medical personnel in the emergency department should master the operating procedures and closely observe the condition of patients during use, so as to improve the success rate of rescue, reduce the fatality rate and reduce complications.

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