确认脑死亡和护理潜在器官捐献者及其家属的护士任务

Beata Haor, S. Wróblewska, K. Daszuta, Dominik Daszuta
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摘要

介绍。器官移植是医学中最年轻的领域,也是最困难的领域。的目标。本研究的目的是分析确认脑死亡后器官捐献者的护理护士的任务,并宣传移植的思想。病例报告。一名52岁的病人在颅脑外伤后住进了医院的神经内科。头部的计算机断层扫描显示脑挫伤,颅骨盖骨骨折,颅腔内有少量空气。入院后,患者立即纠结,意识清醒,不愿回答问题,无麻痹和短期癫痫发作。神经外科给予抗水肿和抗癫痫治疗。开始治疗后,有一个暂时的改善,随后是大脑和脑干衰竭的二次恶化,并伴有深度脑昏迷。病人被转到重症监护室接受进一步治疗。讨论。器官移植包括从供体收集器官并将其植入受者体内。捐赠者可以是活着的人(当涉及成对的器官或肝脏碎片以及组织和细胞时),也可以是死者,他们生前没有对死后器官捐赠表示反对。在这种情况下,主要原则是宣布脑死亡,即确认患者死亡,从而改变治疗目标。结论。移植是一个跨学科的医学领域,其成功依赖于许多专业人员的合作。护士积极参与团队的工作,从捐赠者的器官资格,到移植,再到移植后对患者的护理。护士还参与营造有利于与潜在捐赠者家庭建立良好关系的氛围。[j] .神经网络学报,2019;8(3):124-132
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Confirming the Brain Death and the Nurse’s Tasks in the Care of Potential Organ Donors and Their Families
Introduction. Transplantology is the youngest area of medicine dealing with organ transplantation that is considered to be the most difficult. Aim. The aim of the work is to analyse the nurse’s tasks in the care of the organ donor after confirming brain death and propagate the idea of transplantology. Case Report. A 52-year-old patient admitted to the hospital at the neurological department after a craniocerebral trauma. Computed tomography of the head showed brain contusion, fractures of the bones of the skull cover, the presence of a small amount of air in the cranial cavity. Immediately after admission, the patient was tangled, conscious, reluctant to answer questions, without paresis and a short-term seizure. Anti-oedema and anti-epileptic treatment was implemented in the neurosurgery department. After starting treatment, there was a temporary improvement, followed by a secondary worsening of brain and brain stem failure with deep cerebral coma. The patient was referred for further treatment in the Intensive Care Unit. Discussion. Organ transplantation involves collecting them from the donor and implanting them into the recipient. The donor can be either a living person (when it comes to paired organs or fragment of the liver as well as the tissues and cells) or the deceased person, who during their life did not express objection to organ donation after their death. The major principle in this case is the pronouncement of brain death, i.e. confirmation of patient’s death resulting in changing the therapeutic goals. Conclusions. Transplantology is an interdisciplinary field of medicine, the success of which relies on the cooperation of many professionals. The nurse takes an active part in the team’s work starting from the donor’s organs eligibility, through transplantation, to the care of the patient after the transplantation. The nurse also participates in building up an atmosphere favourable for good relations with the potential donor’s family. (JNNN 2019;8(3):124–132) Key Words: transplantation, brain death, nursing care
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