置放口內氣管內管病患臉部皮膚暨口腔黏膜組織完整性缺損改善方案

Improving the Facial Skin and Oral Mucosa Integrity of Patients with Oral Endotracheal Intubation

氣管內管插管所造成的皮膚及口腔黏膜受損甚少受到關注，本專案目的在改善置放口內氣管內管病患，臉部皮膚暨口腔黏膜組織完整性缺損的發生率。經由觀察及實地查檢發現，造成缺損的主要因素為：（1）固定方法不當，（2）唇部黏膜乾燥，（3）阻咬器大且壓力點多，（4）病患頻繁的咬合動作，（5）病患對特殊管路膠布過敏等。針對原因，經由置放口內氣管內管固定標準的建立與推行以及更換新型阻咬器；其結果除受限於病患本身特性（如營養不良、癌末惡病體質等），無法經由本專案設計加以改善外，發生率由改善前的67%，下降至對策方案實施後的25%。由此結果可知本改善方案對置放口內氣管內管病患是有幫助的，且可提供臨床上固定口內氣管內管的參考。

The problems of damage to facial skin and oral mucus affecting intubated patients have seldom been effectively improved. The purpose of this project was to reduce the incidence of defects in facial skin and oral mucosa integrity in patients with oral endotracheal intubation. The main factors identified by data collection were: 1. Inappropriate endotracheal tube securement. 2. Dry lip mucosa. 3. Pressure points caused by large bite-blocks. 4. Patient's frequent movement of mouth. 5. Allergic reaction caused by adhesive tape. Through the implementation of a new standard for oral endotracheal tube securement and the application of new bite-blocks to deal with the problems mentioned above, the incidence rate of defects in facial skin and oral mucosa integrity decreased from 67% to 25%. The results indicate that the new standard of securement and the new bite-block can help to solve these problems.