国际学校医务室急救问答

以下是针对国际学校医务室可能面临的各种紧急情况的建议处理流程：

1) 癫痫：在教室发生癫痫该如何做

• 保护患者：首先，保持冷静，迅速清理周围环境，移开可能对患者造成伤害的物品。
• 侧卧姿势：让患者侧卧以避免窒息，不要试图强行控制发作或放任何物品进入患者口中。
• 记录发作时间：拨打急救电话并记录发作开始和结束的时间。
• 发作后处理：发作结束后，安抚患者，确保其恢复清醒。避免患者在完全恢复前站立或走动。

2) 哮喘：运动时哮喘发作该如何做

• 停止运动：立即停止所有运动，带患者到一个安静的地方休息。
• 使用吸入器：让患者使用其随身携带的哮喘吸入器。如果患者没有携带吸入器，尽快联系校医或拨打急救电话。
• 观察症状：如果使用吸入器后症状没有缓解，或出现呼吸急促、紫绀等严重症状，应立即拨打急救电话。

3) 如何判断学生是呼吸困难

• 观察呼吸频率：呼吸急促、深而费力、胸部或腹部明显起伏。
• 症状表现：面色苍白或青紫，出现焦虑、恐惧，可能伴有明显的呼吸音如喘鸣声。
• 学生描述：学生可能会自述呼吸困难、胸部紧迫或喘不过气。
• 氧饱和度检测：如果条件允许，使用脉搏血氧仪检查氧饱和度，低于92%表示有严重呼吸困难。

4) 学生自述心率过高，该如何做

• 检查脉搏：手动检查学生的脉搏，观察心率是否正常。通常儿童的正常心率在60-100次/分钟。
• 记录其他症状：询问学生是否有其他不适如胸痛、头晕、出汗等。
• 让学生休息：如果学生心率明显高于正常范围，立即停止活动，令其休息。
• 校医评估：联系校医进一步评估，如果症状持续或伴有其他严重症状，需尽快送医。

5) 如何判断心脏病，如学生自述胸闷

• 询问胸闷特征：了解学生的胸闷感是否为压迫性、持续性，是否伴有放射到颈部、肩膀或手臂的疼痛。
• 观察其他症状：检查是否有出冷汗、呼吸困难、晕眩或恶心等症状。
• 立即就医：如果学生胸闷伴有上述症状，应立即拨打急救电话并安排送医。
• 安静休息：让学生平卧或坐位休息，避免紧张或活动。

6) 麦麸严重过敏，发生严重过敏的急救流程

• 立即识别症状：过敏症状可能包括皮疹、呼吸困难、面部和喉咙肿胀、呕吐、腹痛等。
• 使用肾上腺素注射器：如患者有携带，应立即使用肾上腺素自动注射器（如EpiPen），通常注射于大腿外侧。
• 拨打急救电话：即使症状有所缓解，仍需立即拨打急救电话，因为过敏反应可能反复或加重。
• 保持气道通畅：让患者保持平躺，抬高双腿，观察其呼吸状况，必要时进行心肺复苏（CPR）。

7) 外伤后如何判断是否有骨折风险

• 观察肢体畸形：检查受伤部位是否有明显的畸形、肿胀或瘀血。
• 疼痛与活动受限：如果轻微触碰或移动引起剧烈疼痛，或患者完全不能活动该部位，可能存在骨折。
• 骨摩擦音：患者自述或你在触诊时感到骨摩擦声或感觉。
• 需进一步检查：如果怀疑骨折，应避免移动，尽快联系校医或安排送医进行X光检查。

8) 外伤后学生因疼痛无法站立，该如何规范的移动

• 避免移动：如果怀疑有骨折或严重损伤，除非必要，不应移动患者。
• 固定伤肢：如果必须移动，先使用夹板或布条对受伤肢体进行简单固定，避免进一步损伤。
• 使用担架：若可行，使用担架或椅子将患者平稳抬起，确保其受伤部位固定和不受挤压。
• 保持平稳：移动过程中应保持慢速和平稳，防止二次伤害。

9) 学生误服或过量服用药物，学校医疗处理流程是

• 立即识别药物：确定误服的药物类型、剂量和时间，尽可能收集药物包装或说明书。
• 联系毒物控制中心：立即拨打当地毒物控制中心或急救电话，提供药物信息并遵循专业指导。
• 监控生命体征：监测学生的呼吸、脉搏和意识状态，注意观察是否有呕吐、昏迷或抽搐等症状。
• 紧急送医：根据毒物控制中心或急救人员的建议，尽快将学生送往医院进行进一步处理。

这些步骤旨在帮助国际学校医务室的工作人员在紧急情况下快速有效地处理学生的健康问题。

the guidelines for dealing with various issues that might be encountered in a school nurse’s office at an international school:

1) Seizures: What to do if a student has a seizure in the classroom

• Protect the student: Stay calm, quickly clear the area of any objects that could cause injury.
• Recovery position: Place the student on their side to prevent choking. Do not try to restrain the seizure or put anything in their mouth.
• Record the seizure duration: Note the start and end time of the seizure. Call emergency services immediately.
• Post-seizure care: After the seizure ends, comfort the student and ensure they regain full consciousness. Avoid letting the student stand or walk until they have fully recovered.

2) Asthma: What to do if a student has an asthma attack during physical activity

• Stop all activity: Immediately halt all physical activity and move the student to a quiet place to rest.
• Use an inhaler: Have the student use their asthma inhaler. If they don’t have one, contact the school nurse or call emergency services immediately.
• Monitor symptoms: If symptoms do not improve after using the inhaler, or if severe symptoms such as shortness of breath or cyanosis occur, call emergency services.

3) How to recognize if a student is experiencing breathing difficulties

• Observe breathing rate: Look for rapid, deep, and labored breathing, or significant chest or abdominal movement.
• Symptom indicators: Pale or bluish skin, anxiety, fear, or audible respiratory sounds like wheezing.
• Student's description: The student may describe difficulty breathing, chest tightness, or feeling out of breath.
• Check oxygen saturation: If available, use a pulse oximeter to check oxygen saturation. Levels below 92% indicate serious breathing difficulty.

4) What to do if a student reports a high heart rate

• Check the pulse: Manually check the student’s pulse to determine if the heart rate is within a normal range. Typically, a normal heart rate for children is 60-100 beats per minute.
• Assess other symptoms: Ask if the student is experiencing other symptoms like chest pain, dizziness, or sweating.
• Rest the student: If the heart rate is significantly above normal, have the student rest immediately.
• Consult the school nurse: Contact the school nurse for further evaluation. If symptoms persist or are severe, seek medical attention promptly.

5) How to identify a heart problem if a student reports chest tightness

• Ask about the nature of the chest tightness: Determine if the tightness is pressing, persistent, or radiating to the neck, shoulder, or arm.
• Observe other symptoms: Look for signs such as cold sweats, shortness of breath, dizziness, or nausea.
• Seek immediate medical attention: If the student experiences chest tightness with these symptoms, call emergency services and arrange for medical evaluation.
• Keep the student calm: Have the student lie down or sit quietly, avoiding any exertion or stress.

6) Severe wheat allergy: Emergency procedure for severe allergic reactions

• Identify symptoms immediately: Symptoms may include rash, difficulty breathing, facial or throat swelling, vomiting, or abdominal pain.
• Use an epinephrine injector: If the student has one, administer the epinephrine auto-injector (e.g., EpiPen) immediately, typically into the outer thigh.
• Call emergency services: Even if symptoms improve, call emergency services right away, as the allergic reaction may recur or worsen.
• Ensure airway is clear: Keep the student lying down with legs elevated, monitor their breathing, and be prepared to perform CPR if necessary.

7) How to assess the risk of a fracture after an injury

• Look for limb deformity: Check for obvious deformity, swelling, or bruising at the injury site.
• Pain and movement limitation: If gentle touch or movement causes severe pain, or the student cannot move the affected area, there may be a fracture.
• Crepitus: The student or you may hear or feel a grating sound or sensation, indicating bone friction.
• Further examination needed: If a fracture is suspected, avoid moving the student and contact the school nurse or arrange for transport to a hospital for X-ray evaluation.

8) How to properly move a student who cannot stand due to pain after an injury

• Avoid moving the student: If a fracture or severe injury is suspected, do not move the student unless absolutely necessary.
• Stabilize the injured limb: If movement is required, first stabilize the injured area with a splint or sling to prevent further injury.
• Use a stretcher: If possible, use a stretcher or chair to lift the student, ensuring that the injured area is stabilized and not under pressure.
• Move with care: Ensure slow and steady movement to prevent additional harm.

9) What to do if a student accidentally ingests or overdoses on medication

• Identify the medication: Determine the type of medication taken, the dose, and the time of ingestion. Collect any packaging or instructions available.
• Contact Poison Control: Immediately call the local poison control center or emergency services, provide the medication information, and follow their instructions.
• Monitor vital signs: Keep an eye on the student’s breathing, pulse, and consciousness. Watch for symptoms like vomiting, unconsciousness, or seizures.
• Arrange emergency transport: Follow the advice of poison control or emergency services and arrange for the student to be transported to a hospital for further treatment if necessary.

These steps aim to help staff at an international school nurse's office respond quickly and effectively to student health emergencies.