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The interview in the examination of medical institutions is also an important part of the preparation for the examination. I have sorted out the answering skills, precautions and other related contents for the recruitment interview of medical institutions for everyone, hoping to make your interview easier. Let's learn together!
Professional interview for medical institutions: try to describe the precautions for gastric lavage in case of acute poisoning
Scan code to add customer service teacher to consult Guizhou medical examination
[Reference analysis]
Gastric lavage is the key to saving the lives of drug users. In general, except those who swallow corrosive agents (strong acids, strong alkalis, etc.), they should all wash their stomach quickly and thoroughly within 6 hours, and those who take more than 6 hours should also try to wash their stomach as much as possible.
Precautions:
① First of all, pay attention to the poisoning situation of the patient, such as the time, route, type, nature and quantity of the poison, and whether the patient vomited before coming to the hospital.
② Accurately master the contraindications and indications of gastric lavage. Indications: Non corrosive toxicosis, such as organophosphorus, sleeping pills, heavy metals, alkaloids and food poisoning. Contraindications: strong corrosive poisons (such as strong acids and bases), poisoning, cirrhosis with esophageal and gastric varices, thoracic aortic aneurysm, upper gastrointestinal bleeding, gastric perforation, gastric cancer, etc. in the near future. Patients who swallow corrosive drugs such as strong acids and alkalis should avoid gastric lavage to avoid perforation. Medications or physical antagonists such as milk, soy milk, egg white, rice soup can be given as per doctor's instructions to protect gastric mucosa. Patients with upper gastrointestinal ulcer, esophageal varices, gastric cancer, etc. generally do not have gastric lavage, and patients with coma should be cautious in gastric lavage.
③ The temperature of the irrigation solution is 25~38 ℃, which cannot be too high or too low. The appropriate amount of each irrigation is 300~500ml.
④ For patients with acute poisoning, oral emesis should be adopted urgently, and gastric lavage should be carried out when necessary to reduce the absorption of poison. When intubating, move gently, and do not damage the esophageal mucosa or enter the trachea by mistake.
⑤ Select appropriate gastric lavage solution. When the toxic substance is unknown, warm boiled water or normal saline can be selected as gastric lavage solution. After the nature of the poison is clear, the antagonist can be used for gastric lavage. When gastric lavage is performed for patients with pyloric obstruction, it is necessary to record the intragastric retention flow to understand the obstruction for clinical transfusion reference. At the same time, gastric lavage should be performed 4-6 hours after meals or on an empty stomach.
⑥ During gastric lavage, closely observe the face color, vital signs, consciousness, pupils, oral and nasal mucosa, and the balance of the color, smell, and volume of the washing liquid to prevent asphyxia and gastric lavage complications, including gastric dilatation, gastric perforation, water poisoning caused by a large amount of hypotonic gastric lavage liquid, water electrolyte disorder, and acid-base imbalance, Asphyxia caused by aspiration or excessive reflux of intragastric fluid in coma patients, vagus nerve excitatory reflex cardiac arrest, etc., timely observe and take corresponding emergency measures, and make records.
⑦ Pay attention to the patient's psychological state, cooperation degree and rehabilitation confidence. Tell the patient about possible discomfort during operation, such as nausea, and hope to get the patient's cooperation; Inform patients and their families of the possibility and risk of aspiration, and gain understanding; Introduce the precautions after gastric lavage, patiently persuade those who take poison by themselves, provide targeted psychological care, help them change their cognition, keep secrets and privacy for patients, and reduce their psychological burden.
⑧ After gastric lavage, pay attention to the clearance of toxic substances in the stomach of the patient, and whether the poisoning symptoms are alleviated and suppressed.
(Editor: liyulu)
