河豚魚中毒個案之急診照護經驗

Nursing Care of Puffer Fish Poisoning Cases in the Emergency Department

河豚是亞洲最常見的魚類中毒，死亡率高達60%，臨床上無有效的治療方法，儘早降低毒素在體內的吸收及促進排出，可提高此類個案的存活率。本文係探討一位誤食河豚魚中毒個案於急診之照護經驗，個案因河豚毒素中毒出現呼吸、神經系統等症狀，由於病程進展快速，個案歷經插管急救及獲悉同時食用的友人因中毒死亡而出現因應能力失調，筆者於照護期間運用整體性護理評估，確立主要健康問題有「低效性呼吸型態」、「體液容積缺失」、「恐懼」，協助氧氣、液體補充及心理支持，於4月8日轉至病房，4月20日出院後家庭生活正常。僅以此急診照護經驗之分享，增進第一線醫護人員對海洋生物毒的認識，提供護理人員臨床照護之參考。

Puffer fish poisoning is Asia's most common fish poisoning, with a mortality rate as high as 60%. There is no clinically effective treatment method, so the promptest treatment possible is to reduce the absorption of toxins in the body, facilitate discharge and reduce injury. This paper will examine nursing experience with puffer fish poisoning cases in the emergency department: cases of tetrodotoxin poisoning causing respiratory and neurological symptoms. During intubation, the patient experienced fear which was increased by news of a friend who had died of the same poisoning. The use of holistic nursing care during the assessment has established major health problems like ineffective breathing pattern, fl uid volume defi cit and fear. The patient was admitted on April 8 and was discharged on April 20. Sharing experiences with puffer fish poisoning cases with front-line health care workers can help to increase understanding the kind of risk that marine life care poses and the appropriate nursing care implementation.