吸入性損傷合併創傷後反應個案之護理經驗

Nursing Experience of a Patient with Inhalation Injury and Posttraumatic Stress Disorder in the Fire Disaster

本文旨在說明筆者於至期間，照顧一位經歷蘆洲大火後，導致吸入性損傷合併急性創傷後壓力症候群個案之護理經驗。經由系統模式為導引，採直接護理、觀察、與病人家屬會談等技巧整體性評估後，發現個案有無法有效維持呼吸道通暢、急性疼痛、創傷後反應、家庭運作過程改變等健康問題，經運用潮濕高濃度氧氣、蒸氣吸入、深呼吸咳痰、止痛藥物的給予、採冷流質飲食等護理措施，促使個案呼吸型態及血氧飽和濃度恢復正常，疼痛情形改善。另個案於住院期間表現出焦慮、無望冷漠、哭泣、做惡夢等情緒反應，透過給予心理支持、適度提供資訊、協調家人的團聚等措施，使個案的情緒轉為正向積極面對的態度，並發揮了在家庭中的角色功能，協助其家庭恢復生活秩序。此次特別的護理經驗使筆者深刻體認到，對於災難倖存者以及受災家庭，除了首先緩解生理部分的危機，更要發揮協商者之角色功能，善用各方資源，協助個案度過急性壓力期，加速身心靈家庭的回復，期能提供給護理同仁做為參考。

This article described the nursing experience of a patient who suffered frominhalation injury and posttraumatic stress disorder from a fire at Luzhou City. Nursingproblems such as ineffective airway clearance, acute pain, posttraumatic response,and altered family processes were assessed with Neuman System Model. The respiratorypattern of the patient was improved with high flow humid oxygen, steam inhalation,cough and deep breathing exercises, analgesic, and a cold liquid diet. The posttraumaticstress disorder was successfully managed with mental support providing availableinformation and resources. The author concluded with emphasis on the necessity ofthe nurse being a coordinator to provide any resources in helping the disastersurvivors and traumatized family through the stage of acute stress.