德江县妇幼保健院护理应急预案及处理流程编制:德江县妇幼保健院护理部生效日期:2013年5月目录一、突发公共卫生事件应急预案及处理流程··································1二、停水和突然停水时的应急预案及处理流程································2三、泛水时的应急预案及处理流程··········································3四、停电和突然停电时的应急预案及处理流程································4五、失窃时的应急预案及处理流程··········································5六、火灾时的应急预案及处理流程··········································6七、地震时的应急预案及处理流程··········································7八、护理职业暴露应急预案及处理流程······································8九、患者突然发生病情变化时的应急预案及处理流程··························9十、术后患者出现出血倾向时的应急预案及处理流程··························10十一、患者有自杀倾向时的应急预案及处理流程······························11十二、患者自杀后的应急预案处理流程······································12十三、患者外出或外出不归的应急预案及处理流程····························13十四、患者发生躁狂时的应急预案及处理流程································14十五、患者跌倒与坠床时的应急预案及处理流程······························15十六、病房发现传染病患者时的应急程序及处理流程··························17十七、患者气管切开导管脱落时的应急预案及处理流程························18十八、使用呼吸机过程中突然断电时的应急预案及处理流程····················20十九、患者发生输液反应时的应急预案及处理流程····························21二十、患者发生静脉空气栓塞时的应急预案及处理流程························22二十一、患者输液过程中发生左心衰时的应急预案及处理流程··················23二十二、患者发生输血反应的应急预案及处理流程····························25二十三、患者应用化疗药物出现外渗时的应急预案及处理流程··················26二十四、患者发生药物过敏反应时的应急预案及处理流程······················28二十五、患者发生误吸时的应急预案及处理流程······························29二十六、吸痰过程中中心吸引装置出现故障时的应急预案及处理流程············31二十七、洗胃过程中洗胃机出现故障时的应急预案及处理流程··················32二十八、吸氧过程中中心吸氧装置出现故障时的应急预案及处理流程············33二十九、使用过程中输液泵.心电图机等仪器出现故障时的应急预案及处理流程···34三十、用药错误应急预案及处理流程········································35三十一、标本采集不符合要求或遗失的应急预案及处理流程····················36三十二、紧急封存患者病历的应急预案及处理流程····························37三十三、紧急封存反应标本的应急预案及处理流程····························38三十四、护理不良事件应急预案及处理流程··································39三十五、护理投诉应急预案及处理流程······································40三十六、遭遇暴徒的应急预案及处理流程····································41三十七、患者发生心跳骤停的应急预案及处理流程····························42三十八、患者发生急腹症应急预案及处理流程································43三十九、患者发生突发脑疝应急预案及处理流程······························44四十、医护人员发生针刺伤时的应急预案及处理流程··························46四十一、患者发生中毒应急预案及处理流程··································48四十二、患者发生压疮的应急预案及处理流程································49四十三、门诊病人发生意外事件应急预案及处理流程··························50四十四、急诊科护理人员应急预案及处理流程································52四十五、紧急状态下护理人力资源调配预案及处理流程························54四十六、癫痫持续状态病人应急预案及处理流程······························55四十七、住院患者发生过敏性休克时的应急预案及处理流程····················57四十八、住院患者烫伤的应急预案及处理流程································58四十九、住院患者发生消化道大出血时的应急预案及处理流程··················59五十、患者发生噎食时的应急预案及处理流程································61五十一、输液过程中出现肺水肿的应急预案及处理流程························62五十二、患者发生低血糖昏迷时的应急预案及处理流程························63五十三、护士工作站系统发生故障时的应急预案及处理流程····················65五十四、新生儿温箱发生故障时的应急预案及处理流程························661一、突发公共卫生事件应急预案及处理流程一、突发公共卫生事件(一)对于各种科室进行的重大抢救活动应及时向医院有关部门及向院领导报告,以便医院能及时掌握情况、协调各方面的工作,更好地组织力量进行及时有效的抢救和治疗。(二)对突发公共卫生事件或涉及灾害事故发生的时间、地点、伤亡人数及分类,伤亡人员的姓名、性别、年龄、致伤、死亡的原因,伤病员的病情、预后,采取的医疗措施等,要详细报告。二、处置措施(一)医务科、护理部、院值班接到报告后应在10分钟内向院领导报告(二)根据突发事件中的伤病员来院救治情况,医务科、护理部或院值班及时组织、协调人员增援。三、处理流程见下图。参加抢救医务人员上报报告医务科、护理部,夜间或节假日报告院值班10分钟内向医院领导报告及时组织、协调人员增援2二、停水和突发停水时的应急预案及处理流程一、接到停水通知后,做好停水准备(一)告诉患者停水时间;(二)给患者备好生活用水和饮用水;(三)病房热水炉烧好热水备用,同时尽可能多备生活用水。二、突然停水时,白天通知后勤一站式服务中心联系维修,夜间或节假日要院值班联系,汇报停水情况,查询原因。三、加强病室巡视,随时解决患者饮水及用水需求。四、处理流程见下图。通知患者停水时间,协助患者备饮用水加强巡视,解决好患者的饮水和用水问题根据情况及时向有关领导汇报,夜间或节假日与院值班联系为患者准备热水,尽可能多备水病房接到停水通知后及时通知后勤一站式服务中心联系维修突然停水3三、泛水时的应急预案及处理流程一、立即查找泛水的原因,如能自行解决应立即解决。二、不能自行解决的立即电话通知后勤人员联系维修,夜间或节假日通知院值班协助。三、协助维修人员的工作,白天可通知病室清洁人员及时清扫泛水;夜间要主动将污水清理。四、告诫患者,切不可涉足泛水区或潮湿处,防止跌倒,保证患者安全。五、处理流程见下图。发现泛水后,立即查找原因能自行解决的应马上解决,并将污水处理干净不能自行解决的立即电话通知后勤人员联系维修,夜间或节假日通知院值班协助协助维修科人员及清洁员清扫地面、清理污水保证患者安全,告诫病室患者及工作人员行走时要注意,防止滑倒叮嘱行动不便的患者尽量不要下地行走,协助患者进行生活护理。4四、停电和突然停电时的应急预案及处理流程一、通知停电后,立即做好停电准备,备好应急灯、手电、蜡烛等,如有抢救患者使用电动力机器时,需找替代的方法。二、突然停电后,立即启动抢救患者机器运转的动力方法,维持抢救工作,并开启应急灯或点燃蜡烛照明。三、通知后勤值班人员联系维修,查询停电原因,并通知护士长,夜间或节假日可通知院值班协助。四、加强病房巡视,安抚患者,同时注意防火、防盗。五、处理流程见下图。五、失窃时的应急预案及处理流程通知停电后,立即做好停电准备,备好应急灯、手电、蜡烛等,如有抢救患者使用电动力机器时,需找替代的方法维持病室秩序,组织人力保证患者医疗安全加强病室巡视,安抚患者,同时注意防火、防盗通知后勤班人员联系维修,查询停电原因,并向有关领导汇报,夜间或节假日可通知院值班突然停电后,立即寻找抢救患者机器运转的动力方法,维持抢救工作,并开启应急灯或点燃蜡烛照明5一、发现失窃,保护现场。二、电话通知保卫科来现场处理,报告护士长,夜间或节假日报告院值班。三、协助保卫科人员进行调查工作。四、维持病室秩序,保证患者医疗护理安全。五、填写“护理不良事件登记表”上报护理部。六、处理流程见下图。发生失窃后,值班人员电话通知保卫人员保护现场,协助保卫人员进行调查维持病室秩序,保证患者医疗护理安全报告护士长,夜间或节假日报告院值班6六、火灾时的应急预案及处理流程一、立即报告院保卫科及上级领导,夜间或节假日电话通知院值班。二、集中现有的灭火器材和人员积极扑救。三、发现火情无法扑救,马上拨打“119”报警,并告知火灾的准确方位。四、三关:关门、关气、关阀;关好邻近房间的门窗,关氧气阀门等,减少火势扩散的速度五、将患者撤离疏散到安全地带。六、尽可能切断电源,撤出易燃易爆物品,并抢救贵重仪器及有价值的科技资料。七、组织患者撤离时,不要乘坐电梯,可走安全通道。叮嘱患者用湿毛巾捂住口鼻,尽可能以最低的姿势或匍匐快速前进。八、处理流程见下图。火势较小时,组织人力应用病室内消防器材和自来水积极灭火火势猛烈时,马上拨打“119”报警,并告知准确位置三关:关门、关气、关阀;关好邻近房间的门窗,关氧气阀门等,减少火势扩散的速度将患者撤离疏散到安全地带尽可能切断电源,撤出易燃易爆物品,并抢救贵重仪器及有价值的科技资料组织患者撤离时,不要乘坐电梯,可走安全通道。叮嘱患者用湿毛巾捂住口鼻,尽可能以最低的姿势或匍匐快速前进发现火情后冷静面对,立即呼叫周围人员,分别组织灭火及报告保卫科及上级领导7七、地震时的应急预案及处理流程一、地震来临时,值班人员应冷静面对,关闭电源、水源、气源、热原,全力保障人员的生命及国家财产安全。二、发生强烈地震时,需将患者撤离病房,疏散至广场、空地。撤离过程中,护理人员要注意维护秩序,安慰患者,以减少患者的恐惧。三、情况紧急不能撤离时,叮嘱在场人员及患者寻找有支撑的地方蹲下或坐下,保护头颈、眼睛,捂住口鼻。四、维持秩序,防止混乱发生