放射科危急值报告制度

放射科危急值报告制度 第一条 为加强医院管理，提高医疗质量，保障医疗安全，全面贯彻落实《患者安全目标》，促进医疗质量持续改进，医院在借鉴国内外医院管理的成功经验的基础上，按照国际惯例(JCI的标准)，进一步修订临床实验室和放射科、心电功能科检查“危急值”报告制度和流程。 第二条 “危急值”的定义:指当出现这种实验和检查结果时，患者可能处于生命危急的边缘状态，需要临床紧急处理。 第三条 “危急值”的目的:第一时间将某一病人的某一项目或几项检验、检查“危急值”通知临床，引起医务人员的足够重视，积极采取相应的措施，保障医疗安全，维护生命安全。 第四条 “ 危急值”报告程序及注意事项: 1、医技科室工作人员发现“危急值”情况时，检查(验)者首先要确认仪器、设备和检查过程是否正常，操作是否正确;核查检验标本是否有错，检验项目质控、定标、试剂是否正常，仪器传输是否有误。 2、在确认检查出现“危急值”后，应立即报告患者所在临床科室、接诊开单医生，不得瞒报、漏报或延迟报告，需详细做好相关记录。口头告知患者及家属病情和严重程度。 3、“危急值”报告重点对象是急诊科、手术室、各类重症监护病房等有关科室和部门的急危重症患者，临床科室需将接电话人员的姓名告知报告人员。检查医生发现病情达到“危机值”，按操作常规完成扫描consciousness of malfeasance at catching good honest, practical action into ideas and County, the County discipline Inspection Commission of the deployment and requirements, adhere to the County and the County discipline Inspection Commission report implementation of clean two responsibilities. 2. clear a gang two accountability responsibilities. Early each year organize conferences, in charge of the leadership, departments, units of the town clean and studied anti-corruption work deployments, according to a gang dual accountability requirements, clear roles and responsibilities for members of the leading body of the Party Committee, put a gang two accountability targets, develop work plans, organizations honest responsibility, urged the team members to actively fulfil a gang double duty. Urged the first responsibility of grass-roots party branch secretaries to perform duties, efforts to form a team in unison, and the linkage of the work of the Party Committee. 3. pay close attention to the construction of a clean and honest government regulations implemented. Conscientiously implement the responsibility of uncorrupted, really formed by system in politics, according to the rules, effective mechanisms for the management of the system. First, build and improve the conversation reminded party members and cadres education system, auditing system of cadres, 18, for the full implementation of responsibility of uncorrupted to provide favorable institutional safeguards. Second, persist in combining focused inspections and special inspections, paying careful attention to supervision, implementation of the special inspection and the system of democratic appraisal of 后，应立即通知科内危重病人抢救小组成员，力争确保病人安全离开放射科。 4、医技科室建立《危急值报告记录表》，详细记录报告情况。“危急值”的报告与接收均遵循“谁报告(接收)，谁记录”原则。各临床科室、医技科室应分别建立检查(验)“危急值”报告登记本，对“危急值”处理的过程和相关信息做详细记录。记录内容如下:日期、病人姓名、科室床号、住院号、检验(检查)项目及结果、复查结果、报告人、接收人、报告时间、备注等。 5、主管医生或值班医生如果认为该结果与患者的临床病情不相符，应进一步对病人进行检查;如认为检验结果不符，应关注标本留取情况。必要时，应重新留取标本送检进行复查。若该结果与临床相符，应结合临床情况即刻采取相应处理措施，必要时及时报告上级医师或科主任。 6、主管医生或值班医生需6小时内在病程记录中记录接收到的“危急值”报告结果和所采取的相关诊疗措施。 7、各医技科室在对病人检查过程中发现急、危、重病人出现危急症状应立即启动急诊急救应急预案，并与临床医生、护士联系，采取紧急抢救措施。 8、“危机值”的界定根据医院实际情况和患者病情，与临床沟通机制，调整“危机值”。 9、病人离开后，详细记录检查及通知过程。 consciousness of malfeasance at catching good honest, practical action into ideas and County, the County discipline Inspection Commission of the deployment and requirements, adhere to the County and the County discipline Inspection Commission report implementation of clean two responsibilities. 2. clear a gang two accountability responsibilities. Early each year organize conferences, in charge of the leadership, departments, units of the town clean and studied anti-corruption work deployments, according to a gang dual accountability requirements, clear roles and responsibilities for members of the leading body of the Party Committee, put a gang two accountability targets, develop work plans, organizations honest responsibility, urged the team members to actively fulfil a gang double duty. Urged the first responsibility of grass-roots party branch secretaries to perform duties, efforts to form a team in unison, and the linkage of the work of the Party Committee. 3. pay close attention to the construction of a clean and honest government regulations implemented. Conscientiously implement the responsibility of uncorrupted, really formed by system in politics, according to the rules, effective mechanisms for the management of the system. First, build and improve the conversation reminded party members and cadres education system, auditing system of cadres, 18, for the full implementation of responsibility of uncorrupted to provide favorable institutional safeguards. Second, persist in combining focused inspections and special inspections, paying careful attention to supervision, implementation of the special inspection and the system of democratic appraisal of 第五条 质控与考核 (一)医技科室要认真组织学习“危急值”报告制度，人人掌握 “危急值”报告项目与“危急值”范围和报告程序。科室有专人负责本科室“危急值”报告制度实施情况的督察，确保制度落实到位。 (二)文件下发之日起，“危急值”报告制度的落实执行情况，将纳入科室一级质量考核内容。接受督察室、医务科、护理部等职能部门和各临床医技科室(如:急诊科、重症监护病房、手术室等危重病人集中科室)“危急值”报告制度的执行情况检查，及时 总结 初级经济法重点总结下载党员个人总结TXt高中句型全总结.doc高中句型全总结.doc理论力学知识点总结pdf 经验，提出“危急值”报告制度持续改进的具体措施。 第六条 “危急值”项目及报告范围 一、放射科危急值”项目: 1、在放射科检查过程中出现呼吸、心跳骤停者，即刻抢救并报告临床科室; 2、急性脑出血，经头颅CT发现的; 3、脑疝; 4、大量张力性气胸; 5、血气胸; 6、支气管异物; 7、大面积急性肺栓塞; 8、大量心包积液; 9、夹层动脉瘤、胸腹主动脉瘤; 10、消化道穿孔; consciousness of malfeasance at catching good honest, practical action into ideas and County, the County discipline Inspection Commission of the deployment and requirements, adhere to the County and the County discipline Inspection Commission report implementation of clean two responsibilities. 2. clear a gang two accountability responsibilities. Early each year organize conferences, in charge of the leadership, departments, units of the town clean and studied anti-corruption work deployments, according to a gang dual accountability requirements, clear roles and responsibilities for members of the leading body of the Party Committee, put a gang two accountability targets, develop work plans, organizations honest responsibility, urged the team members to actively fulfil a gang double duty. Urged the first responsibility of grass-roots party branch secretaries to perform duties, efforts to form a team in unison, and the linkage of the work of the Party Committee. 3. pay close attention to the construction of a clean and honest government regulations implemented. Conscientiously implement the responsibility of uncorrupted, really formed by system in politics, according to the rules, effective mechanisms for the management of the system. First, build and improve the conversation reminded party members and cadres education system, auditing system of cadres, 18, for the full implementation of responsibility of uncorrupted to provide favorable institutional safeguards. Second, persist in combining focused inspections and special inspections, paying careful attention to supervision, implementation of the special inspection and the system of democratic appraisal of 11、腹部实质性脏器破裂大出血; 12、颈、胸椎椎体爆裂性骨折、椎管占位截瘫; 13、可能危及生命的全身多处、多发骨折。 二、超声影像科“危急值”项目: 1、主动脉夹层动脉瘤(近段大动脉造成真腔狭窄的); 2、大量心包积液合并心包填塞。 3、股静脉及近心段大静脉血栓形成; 4、外周动脉主干血栓形成(动脉闭塞的); 5、腹腔内、胸腔内出血(中等量以上或疑有活动性出血的): 5.1、急诊外伤见腹腔积液，疑似肝脏、脾脏或肾脏等内脏器官破裂 出血的危重病人; 5.2、考虑为急性胆囊炎穿孔的患者; 5.3、考虑急性坏死性胰腺炎; 5.4、怀疑宫外孕破裂并腹腔内出血; 5.5、妊娠晚期胎盘早剥。 6、全心扩大合并急性心衰; 三、心电图“危急值”报告范围 1、心脏停搏; 2、急性心肌梗死(超急性期，急性发展期); 3、各种严重致命性心律失常: 3.1阵发性室上性心动过速 3.2阵发性室性心动过速 consciousness of malfeasance at catching good honest, practical action into ideas and County, the County discipline Inspection Commission of the deployment and requirements, adhere to the County and the County discipline Inspection Commission report implementation of clean two responsibilities. 2. clear a gang two accountability responsibilities. Early each year organize conferences, in charge of the leadership, departments, units of the town clean and studied anti-corruption work deployments, according to a gang dual accountability requirements, clear roles and responsibilities for members of the leading body of the Party Committee, put a gang two accountability targets, develop work plans, organizations honest responsibility, urged the team members to actively fulfil a gang double duty. Urged the first responsibility of grass-roots party branch secretaries to perform duties, efforts to form a team in unison, and the linkage of the work of the Party Committee. 3. pay close attention to the construction of a clean and honest government regulations implemented. Conscientiously implement the responsibility of uncorrupted, really formed by system in politics, according to the rules, effective mechanisms for the management of the system. First, build and improve the conversation reminded party members and cadres education system, auditing system of cadres, 18, for the full implementation of responsibility of uncorrupted to provide favorable institutional safeguards. Second, persist in combining focused inspections and special inspections, paying careful attention to supervision, implementation of the special inspection and the system of democratic appraisal of 3.3高、?度以上房室传导阻滞。 3.4病窦综合症(心室率,35次/分钟)。 3.5快速心房纤颤(心室率,150次/分钟) 3.6心室扑动，心室颤动。 4、急性心肌损伤、心肌梗死; 5、多源性、Ront型室性早搏; 6、频发室性早搏并QT间期延长; 7、预激综合征伴快速心室率心房颤动; 8、心室率大于180次/分的心动过速; 9、二度II型及二度II型以上的房室传导阻滞; 10、心室率小于40次/分的心动过缓; 11、大于2秒的心室停搏 12、活动平板过程中出现严重不良反应(如心绞痛、血压下降等)。 13、动态心电图出现窦性停搏,3秒或多次,2秒者;高度以上房室传导阻滞;尖端扭转性室性心动过速或室速,5秒者。 consciousness of malfeasance at catching good honest, practical action into ideas and County, the County discipline Inspection Commission of the deployment and requirements, adhere to the County and the County discipline Inspection Commission report implementation of clean two responsibilities. 2. clear a gang two accountability responsibilities. Early each year organize conferences, in charge of the leadership, departments, units of the town clean and studied anti-corruption work deployments, according to a gang dual accountability requirements, clear roles and responsibilities for members of the leading body of the Party Committee, put a gang two accountability targets, develop work plans, organizations honest responsibility, urged the team members to actively fulfil a gang double duty. Urged the first responsibility of grass-roots party branch secretaries to perform duties, efforts to form a team in unison, and the linkage of the work of the Party Committee. 3. pay close attention to the construction of a clean and honest government regulations implemented. Conscientiously implement the responsibility of uncorrupted, really formed by system in politics, according to the rules, effective mechanisms for the management of the system. First, build and improve the conversation reminded party members and cadres education system, auditing system of cadres, 18, for the full implementation of responsibility of uncorrupted to provide favorable institutional safeguards. Second, persist in combining focused inspections and special inspections, paying careful attention to supervision, implementation of the special inspection and the system of democratic appraisal of