照顧一位有機磷自殺個案之護理經驗

Organophosphate is commonly used to attempt suicide. Because of its toxicity and quick effect, improper or delayed first aid treatment, and quick time to respiratory failure and death, professionals need first-aid knowledge and the ability to care for these cases to help them survive the critical period.The purpose of this report is to describe a patient who attempted suicide by taking organic phosphorus. The care was provided from May 21, 2007 to May 26, 2007. Data were collected through direct patient care, observation, communication, and review of medical records. The problems identified included physical injury by organophosphate poisoning, sleep pattern disturbance, ineffective coping, and anxiety. In response to the problems above, the patient was given care to help him maintain normal functioning of respiratory system and circulatory system. Gastric lavage and antidote were used to reduce the harm. The patient was also treated for sleep disturbance, which enabled him to rest. To establish a good nurse-patient relationship, the patient was provided with care and listened by an empathetic nurse. Moreover, the patient was provided with psychological support to encourage him to express feelings and develop the ability to cope with stress. The patient gradually recovered through the treatment of the medical team and the implementation of nursing measures. The patient also indicated that, when facing stress or conflicts in the future, he would adopt-positive coping strategies.
有機磷中毒為現今普遍的自殺現象，其毒性大、作用快，如急救不當或延誤治療，在短時間內會因呼吸衰竭而死亡，因此醫護人員須具有良好的急救知識及專業能力來照顧此類個案，以協助渡過危險期。本篇為照顧一位有機磷自殺個案之護理經驗，照護期間自2007年3月21日至26日止，經由直接護理、觀察法、會談、病歷查閱的方式取得資料，運用羅氏適應模式評估，確立護理問題有「現存性危險傷害」、「睡眠型態紊亂」、「無效性因應能力」及「焦慮」，針對上述問題，提供維持個案呼吸及循環系統正常、利用洗胃及解毒劑的使用將傷害降至最低；協助排除干擾睡眠導因，讓個案得到充分休息；運用關懷、傾聽及同理心了解個案困擾，從中建立良好護病關係，給予心理支持、鼓勵表達心中感受，提供面對壓力的因應能力；經由醫療團隊的治療及護理措施的執行，個案能逐漸恢復健康，且表示日後面對壓力衝突事件會採取正向的應變措施。