照顧一位塵爆燒傷個案之加護經驗

An ICU Nursing Experience of a Burn Patient in Dust Explosion

2015年發生震驚全台的遊樂園粉塵爆炸事件，本文個案為大學四年級女學生，在此意外中，粉塵燒傷共63％TBSA，筆者於2015年6月30日至7月24日，加護病房期間，運用Gordon十一項功能性健康型態進行身、心、靈全面性評估，確認個案的健康問有：皮膚完整性受損／與嚴重皮膚屏障受損有關、疼痛／與傷口及換藥有關、身體心像改變／擔心疤痕導致外觀改變有關。提供個別化護理措施及傷口照護相關知識，讓換藥過程中減少傷口的疼痛，主動關心、傾聽、支持、陪伴，給予正向回饋，鼓勵接納自己，面對此次災害造成的改變，做好心理調適，重返家庭、校園與社會。期望藉此護理經驗分享，能提供護理人員在照顧燒燙傷相關個案之參考。

A 2015 cornstarch dust explosion in the Formosa Fun Coast sent shockwaves through the nation. The patient in this article is a fourth-year university female student who was caught in the explosion and suffered second-and-third degree burn with 63% total body burn surface (TBSA). The nursing period lasted from June 30^(th) to July 24^(th), 2015. The author applied Gordon's 11-functional health patterns as a framework for a comprehensive assessment (physical, psychological, and spiritual) of the patient. The following health issues were established: impaired skin integrity/compromised skin barrier, pain/wound dressing, and body image change/changes in appearance due to scarring. The author provided individualized nursing interventions and knowledge on wound care to reduce pain during dressing; offer active care, listening, support, companionship, and positive feedback to encourage and facilitate acceptance of self, to cope with the changes that came with the accident, and prepare for reintegration to normal living, campus life, and society. We hope this nursing experience can serve as a reference for other nursing staff when attending to patients with burn injuries.