CN109718450B - Anesthesia induction method and device and anesthesia machine - Google Patents

Anesthesia induction method and device and anesthesia machine Download PDF

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CN109718450B
CN109718450B CN201811653042.XA CN201811653042A CN109718450B CN 109718450 B CN109718450 B CN 109718450B CN 201811653042 A CN201811653042 A CN 201811653042A CN 109718450 B CN109718450 B CN 109718450B
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anesthesia
induction
machine
carbon dioxide
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CN109718450A (en
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张红宇
王卓强
郭峰
华威
杜国峰
丛玉孟
刘续
李凯
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Beijing Aeonmed Co Ltd
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Abstract

The invention discloses an anesthesia induction method, an anesthesia induction device and an anesthesia machine, wherein the method comprises the following steps: receiving an induction instruction to enable the machine to enter an induction process according to the induction instruction; after receiving the induction instruction, executing an oxygen supply and denitrification stage, flushing nitrogen in the loop and the breathing pipeline; after flushing nitrogen for a preset time, executing a drug induction stage, starting a machine control machine to ventilate according to the current spontaneous respiratory frequency of the patient, and sending out tracheal intubation reminding according to the current exhaling oxygen concentration and the current inhaled oxygen concentration of the patient; and in the trachea intubation stage, after the respiratory pipeline is reconnected, sending intubation completion reminding when the ventilation is judged to be effective according to the current ventilation data, the current concentration value of inhaled carbon dioxide and the current concentration value of exhaled carbon dioxide of the patient, or sending intubation re-reminding. The anesthesia induction method can effectively assist an anesthesiologist to complete an anesthesia induction process, improves the working efficiency, effectively improves the safety and reliability of anesthesia, and is simple and convenient.

Description

Anesthesia induction method and device and anesthesia machine
Technical Field
The invention relates to the technical field of medical anesthesia, in particular to an anesthesia induction method, an anesthesia induction device and an anesthesia machine.
Background
In the related art, in a common general anesthesia induction, after an anesthesiologist administers a drug, consciousness of a patient gradually disappears, and spontaneous breathing gradually weakens to stop, so that the anesthesiologist needs to assist breathing for the patient through a mask. When the anesthesiologist believes that the patient's muscles have sufficiently relaxed (if a muscle relaxant is used) and that the oxygen reserve can tolerate the cessation of ventilation during intubation, the endotracheal intubation or the laryngeal mask is performed and the correct position of the artificial airway is confirmed, then the mechanical ventilation is started and the anesthesia maintenance phase is entered.
However, when an anesthesiologist pinches the balloon to ventilate the mask, the risk that the airway pressure is too high and gas enters the stomach to cause reflux and aspiration can occur; or when the ventilation of the lower jaw is difficult to support by one hand, the lower jaw is supported by two hands and an assistant is used for assisting the ventilation; or when the face guard leaks gas and fresh gas flow is less again, the sacculus sinks easily, and the fast oxygenation button that the anesthesiologist need press is full of the sacculus, leads to the complex operation inconvenience among the induction process, not only reduces work efficiency, and security and reliability are lower moreover, await the solution urgently.
Disclosure of Invention
The present invention is directed to solving, at least to some extent, one of the technical problems in the related art.
Therefore, an object of the present invention is to provide an anesthesia induction method, which can improve the work efficiency, effectively improve the safety and reliability of anesthesia, and is simple and convenient.
Another object of the present invention is to provide an anesthesia induction device.
It is a further object of the present invention to provide an anesthesia machine.
In order to achieve the above object, an embodiment of an aspect of the present invention provides an anesthesia induction method, including the following steps: receiving an induction instruction to enable a machine to enter an induction process according to the induction instruction, wherein the induction process comprises an oxygen supply and nitrogen removal stage, a drug induction stage and an endotracheal intubation stage; after receiving the induction instruction, the anesthesia machine executes the oxygen supply and nitrogen removal stage to flush nitrogen in a loop and a breathing pipeline; the anesthesia machine executes the drug induction stage after flushing nitrogen for a preset time, starts a machine control machine to ventilate according to the current spontaneous respiratory frequency of the patient, and sends out tracheal intubation reminding according to the current exhaling oxygen concentration and the current inhaled oxygen concentration of the patient; and the anesthesia machine executes the tracheal intubation stage after the respiratory pipeline is reconnected, and sends out intubation completion reminding when the effective ventilation is judged according to the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value of the patient, or else sends out intubation re-reminding.
The anesthesia induction method provided by the embodiment of the invention can enable the anesthesia machine to assist an anesthesia doctor to complete an anesthesia induction process according to the current stage of the anesthesia machine, and realize functions of automatic ventilation adjustment, automatic identification of an induction intubation state, key information prompt and the like according to the state of a monitored patient, so that the induction process is more automatic and standardized, the working efficiency is improved, the safety and reliability of anesthesia are effectively improved, and the method is simple and convenient.
In addition, the anesthesia induction method according to the above embodiment of the present invention may further have the following additional technical features:
further, in one embodiment of the present invention, the nitrogen in the flushing circuit and the breathing circuit comprises: and controlling the anesthesia machine to output oxygen with preset concentration so as to flush nitrogen gas to a loop and a breathing pipeline of the anesthesia machine.
Further, in one embodiment of the present invention, the initiating of the motorized ventilation based on the current spontaneous respiratory rate of the patient and the issuing of the endotracheal intubation reminder based on the current expiratory oxygen concentration and the current inspiratory oxygen concentration of the patient comprises: acquiring the current spontaneous breathing frequency; if the current spontaneous breathing frequency is smaller than the preset threshold value, starting machine control ventilation of the anesthesia machine; when the current autonomous respiration frequency disappears and the current exhalation oxygen concentration and the current inhalation oxygen concentration meet the preset conditions, judging that the oxygen supply is sufficient, and sending out the tracheal intubation prompt.
Further, in an embodiment of the present invention, before starting the mechanically controlled ventilation, the method further comprises: sending out the anesthetic injection reminding.
Further, in an embodiment of the present invention, when it is determined that ventilation is effective according to the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value of the patient, an intubation completion reminder is issued, otherwise, an intubation resuming reminder is issued, which includes: obtaining the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value; if the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value are all in a preset interval, judging that the ventilation data is valid; determining to be invalid if any one of the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value is not within the preset interval.
In order to achieve the above object, another embodiment of the present invention provides an anesthesia induction device, including: the receiving module is used for receiving an induction instruction so as to enable the machine to enter an induction process according to the induction instruction, wherein the induction process comprises an oxygen supply and nitrogen removal stage, a drug induction stage and an endotracheal intubation stage; the oxygen supply and denitrification module is used for executing the oxygen supply and denitrification stage after the anesthesia machine receives the induction instruction, and flushing nitrogen in a loop and a breathing pipeline; the drug induction module is used for executing the drug induction stage after the anesthesia machine flushes nitrogen for a preset time, starting a machine control machine to ventilate according to the current spontaneous respiratory frequency of the patient, and sending out tracheal intubation reminding according to the current exhaling oxygen concentration and the current inhaled oxygen concentration of the patient; and the tracheal intubation module is used for executing the tracheal intubation stage after the respiratory pipeline is reconnected by the anesthesia machine, and sending intubation completion reminding when the ventilation is judged to be effective according to the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value of the patient, or sending intubation re-reminding if not.
The anesthesia induction device provided by the embodiment of the invention can enable the anesthesia machine to assist an anesthesia doctor to complete an anesthesia induction process according to the current stage of the anesthesia machine, and realize functions of automatic ventilation adjustment, automatic identification of an induction intubation state, key information prompt and the like according to the state of a monitored patient, so that the induction process is more automatic and standardized, the working efficiency is improved, the safety and reliability of anesthesia are effectively improved, and the anesthesia induction device is simple and convenient.
In addition, the anesthesia induction device according to the above-mentioned embodiment of the present invention may further have the following additional technical features:
further, in an embodiment of the present invention, the oxygen supplying and nitrogen removing module is further configured to control the anesthesia machine to output oxygen of a preset concentration to flush a circuit and a breathing circuit of the anesthesia machine with nitrogen.
Further, in an embodiment of the present invention, the drug induction module is further configured to acquire the current spontaneous respiratory frequency, start a machine-controlled ventilation of the anesthesia machine when the current spontaneous respiratory frequency is smaller than the preset threshold, and determine that oxygen is sufficiently given when the current spontaneous respiratory frequency disappears and the current expiratory oxygen concentration and the current inspiratory oxygen concentration meet preset conditions, and send the tracheal intubation reminder.
Further, in an embodiment of the present invention, the endotracheal intubation module is further configured to obtain the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value, and determine that the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value are valid when all of the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value are in a preset interval, and determine that the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value are invalid when any of the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value.
In order to achieve the above object, according to another embodiment of the present invention, an anesthesia apparatus is provided, which includes the above anesthesia induction device. This anesthesia machine can assist the anesthesia doctor to accomplish the induced process of anesthesia according to the present stage of locating of anesthesia machine to realize the automatically regulated of ventilating according to monitoring patient's state, the automatic identification of induced intubate state and the suggestion of key information etc. function, make induced process more automatic and standardization, not only improve work efficiency, and have the security and the reliability that effectively improve anesthesia, it is simple convenient.
Additional aspects and advantages of the invention will be set forth in part in the description which follows and, in part, will be obvious from the description, or may be learned by practice of the invention.
Drawings
The foregoing and/or additional aspects and advantages of the present invention will become apparent and readily appreciated from the following description of the embodiments, taken in conjunction with the accompanying drawings of which:
FIG. 1 is a flow chart of a method of anesthesia induction according to one embodiment of the present invention;
fig. 2 is a schematic structural view of an anesthesia induction device according to an embodiment of the present invention.
Detailed Description
Reference will now be made in detail to embodiments of the present invention, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to the same or similar elements or elements having the same or similar function throughout. The embodiments described below with reference to the drawings are illustrative and intended to be illustrative of the invention and are not to be construed as limiting the invention.
The anesthesia induction method, the anesthesia induction device and the anesthesia machine according to the embodiments of the present invention will be described below with reference to the drawings, and first, the anesthesia induction method according to the embodiments of the present invention will be described with reference to the drawings.
FIG. 1 is a flow chart of a method of anesthesia induction in accordance with one embodiment of the present invention.
As shown in fig. 1, the anesthesia induction method comprises the following steps:
in step S101, an induction instruction is received to cause the machine to enter an induction process according to the induction instruction, wherein the induction process comprises an oxygen supply and nitrogen removal stage, a drug induction stage and an endotracheal intubation stage.
In an embodiment of the present invention, the anesthesia machine induction process may be divided into three phases: the device comprises an oxygen supply and denitrification stage, a drug induction stage and a trachea cannula stage, so that the operation of the anesthesia machine is correspondingly controlled in each stage, and an anesthesia induction process is completed by an anesthesiologist. The following describes in detail how to achieve the functions of automatic ventilation adjustment, automatic identification of the state of the induced intubation, prompt of key information and the like according to the state of a monitored patient, and achieve the automation and standardization of the induction process.
In step S102, the anesthesia machine executes the oxygen supply and nitrogen removal phase after receiving the instruction for induction, and flushes the nitrogen in the loop and the breathing pipeline.
Wherein, in one embodiment of the invention, flushing nitrogen in the circuit and breathing circuit comprises: controlling the anesthesia machine to output oxygen with preset concentration so as to flush nitrogen gas to a loop and a breathing pipeline of the anesthesia machine.
Specifically, after receiving the induction instruction, the anesthesia machine enters an oxygen supply and denitrification stage, the anesthesia machine is used for supplying oxygen with high oxygen concentration, nitrogen is flushed for a loop and a breathing pipeline of the anesthesia machine, and oxygen is inhaled for a patient through a mask, so that the oxygen concentration of the loop, the breathing pipeline and an airway of the patient gradually rises. It should be noted that the preset concentration can be set by a person skilled in the art according to actual conditions, so as to meet the requirement of high concentration, and no specific limitation is made herein.
In step S103, the anesthesia machine executes the drug induction phase after flushing nitrogen for a preset time, starts the machine control machine to ventilate according to the current spontaneous respiratory frequency of the patient, and sends out an endotracheal intubation reminder according to the current expiratory oxygen concentration and the current inspiratory oxygen concentration of the patient.
Wherein, in one embodiment of the present invention, initiating the ventilator on the basis of the patient's current spontaneous respiratory rate and issuing an endotracheal intubation reminder on the basis of the patient's current expiratory oxygen concentration and current inspiratory oxygen concentration comprises: acquiring the current spontaneous respiratory frequency; if the current spontaneous breathing frequency is less than the preset threshold value, starting machine control ventilation of the anesthesia machine; when the current autonomous respiration frequency disappears and the current exhalation oxygen concentration and the current inhalation oxygen concentration meet the preset conditions, the oxygen supply is judged to be sufficient, and the tracheal intubation prompt is sent.
Further, in one embodiment of the present invention, before the starting machine is ventilated, the method further comprises: sending out the anesthetic injection reminding.
Specifically, after flushing nitrogen gas for at least 1 minute, the anesthesia machine enters a drug induction stage, prompts a doctor to inject anesthetic, the anesthesia machine automatically supports ventilation, records the spontaneous respiratory frequency of a patient, the spontaneous respiratory frequency of the patient gradually decreases along with the drug, and when the spontaneous respiratory frequency of the patient decreases to a certain degree, the anesthesia machine starts a machine to control the ventilation. The preset time may be set by a person skilled in the art according to actual situations, and is not particularly limited herein.
It will be appreciated that when the patient's spontaneous breathing rate is monitored to be completely absent, the anesthesia machine passes through the patient's expiratory oxygen concentration EtO2 and inspiratory oxygen concentration FiO2, and when sufficient oxygen administration is achieved, it is indicated that endotracheal intubation is enabled.
In step S104, the anesthesia machine executes a tracheal intubation phase after the respiratory tube is reconnected, and sends an intubation completion reminder when it is determined that ventilation is effective according to the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value of the patient, or else sends a new intubation reminder.
In an embodiment of the present invention, when it is determined that ventilation is effective according to the current ventilation data, the current concentration value of inhaled carbon dioxide and the current concentration value of exhaled carbon dioxide of the patient, an intubation completion reminder is sent, otherwise, a new intubation reminder is sent, including: acquiring current ventilation data, a current inhaled carbon dioxide concentration value and a current exhaled carbon dioxide concentration value; if the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value are all in a preset interval, judging that the ventilation data is effective; and if any one of the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value is not in the preset interval, judging that the ventilation data is invalid. Illustratively, the ventilation data may be a ventilation tidal volume.
It should be noted that the preset interval may be set by the field according to actual situations, and is not limited herein.
Specifically, when the intubation of a doctor is finished, the breathing pipeline is reconnected, the anesthesia machine enters a trachea intubation stage, namely when the doctor performs trachea intubation, the anesthesia machine monitors that the breathing pipeline is disconnected, when the monitoring pipeline is reconnected, the intubation of the doctor is finished, the anesthesia machine can judge through the ventilation tidal volume and the concentration values of carbon dioxide inhaled and exhaled by a patient, and when the ventilation tidal volume and the concentration values of the carbon dioxide are normal, the judgment is that the ventilation is effective, and the completion of the intubation of the doctor is prompted; if the tidal volume of ventilation and the above-mentioned carbon dioxide concentration values are incorrect, the ventilation is judged to be invalid, and the doctor is prompted that the intubation position is incorrect and the intubation is required again.
According to the anesthesia induction method provided by the embodiment of the invention, the anesthesia machine can assist an anesthesia doctor to complete an anesthesia induction process according to the current stage of the anesthesia machine, and the functions of automatic ventilation adjustment, automatic identification of the induction intubation state, key information prompt and the like are realized according to the state of a monitored patient, so that the induction process is more automatic and standardized, the working efficiency is improved, the safety and reliability of anesthesia are effectively improved, and the method is simple and convenient.
Next, an anesthesia induction apparatus according to an embodiment of the present invention will be described with reference to the accompanying drawings.
Fig. 2 is a schematic structural view of an anesthesia induction device according to an embodiment of the present invention.
As shown in fig. 2, the anesthesia induction apparatus 10 comprises: a receiving module 100, an oxygen and nitrogen administration module 200, a drug induction module 300, and an endotracheal intubation module 400.
The receiving module 100 is configured to receive an inducing instruction to enable the machine to enter an inducing process according to the inducing instruction, wherein the inducing process includes an oxygen supply and nitrogen removal stage, a drug inducing stage and an endotracheal intubation stage. The oxygen and nitrogen supplying and removing module 200 is used for the anesthesia machine to execute an oxygen and nitrogen supplying and removing stage after receiving the induction instruction, and flushing nitrogen in a loop and a breathing pipeline. The drug induction module 300 is used for the anesthesia machine to execute a drug induction stage after flushing nitrogen for a preset time, starts a machine control machine to ventilate according to the current autonomous respiratory rate of the patient, and sends out an endotracheal intubation reminder according to the current expiratory oxygen concentration and the current inspiratory oxygen concentration of the patient. The trachea cannula module 400 is used for executing a trachea cannula stage after the breathing pipeline of the anesthesia machine is reconnected, and sending a cannula completion prompt when the ventilation is judged to be effective according to the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value of the patient, or sending a re-cannula prompt. The method provided by the embodiment of the invention can effectively assist an anesthesiologist to complete an anesthesia induction process, improves the working efficiency, effectively improves the safety and reliability of anesthesia, and is simple and convenient.
Further, in an embodiment of the present invention, the oxygen and nitrogen supplying module 200 is further configured to control the anesthesia machine to output a preset concentration of oxygen to flush the circuit and the breathing circuit of the anesthesia machine with nitrogen.
Further, in an embodiment of the present invention, the drug inducing module 300 is further configured to obtain a current spontaneous respiratory frequency, start a machine-controlled ventilation of the anesthesia machine when the current spontaneous respiratory frequency is less than a preset threshold, and determine that oxygen is sufficiently provided when the current spontaneous respiratory frequency disappears and the current expiratory oxygen concentration and the current inspiratory oxygen concentration meet preset conditions, and issue an endotracheal intubation reminder.
Further, in an embodiment of the present invention, the endotracheal intubation module 400 is further configured to obtain current ventilation data, a current inhaled carbon dioxide concentration value, and a current exhaled carbon dioxide concentration value, and determine that the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value are valid when all of the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value are in the preset interval, and determine that the current ventilation data, the current inhaled carbon dioxide concentration value, and the current exhaled carbon dioxide concentration value are invalid when any of the current ventilation data, the current inhaled carbon dioxide concentration.
It should be noted that the above explanation of the embodiment of the anesthesia induction method is also applicable to the anesthesia induction apparatus of this embodiment, and is not repeated herein.
According to the anesthesia induction device provided by the embodiment of the invention, an anesthesia machine can assist an anesthesia doctor to complete an anesthesia induction process according to the current stage of the anesthesia machine, and functions of automatic ventilation adjustment, automatic identification of an induction intubation state, key information prompt and the like are realized according to the state of a monitored patient, so that the induction process is more automatic and standardized, the working efficiency is improved, the safety and reliability of anesthesia are effectively improved, and the anesthesia induction device is simple and convenient.
In addition, the embodiment of the invention also provides an anesthesia machine, which comprises the anesthesia induction device. This anesthesia machine can assist the anesthesia doctor to accomplish the induced process of anesthesia according to the present stage of locating of anesthesia machine to realize the automatically regulated of ventilating according to monitoring patient's state, the automatic identification of induced intubate state and the suggestion of key information etc. function, make induced process more automatic and standardization, not only improve work efficiency, and have the security and the reliability that effectively improve anesthesia, it is simple convenient.
Furthermore, the terms "first", "second" and "first" are used for descriptive purposes only and are not to be construed as indicating or implying relative importance or implicitly indicating the number of technical features indicated. Thus, a feature defined as "first" or "second" may explicitly or implicitly include at least one such feature. In the description of the present invention, "a plurality" means at least two, e.g., two, three, etc., unless specifically limited otherwise.
In the description herein, references to the description of the term "one embodiment," "some embodiments," "an example," "a specific example," or "some examples," etc., mean that a particular feature, structure, material, or characteristic described in connection with the embodiment or example is included in at least one embodiment or example of the invention. In this specification, the schematic representations of the terms used above are not necessarily intended to refer to the same embodiment or example. Furthermore, the particular features, structures, materials, or characteristics described may be combined in any suitable manner in any one or more embodiments or examples. Furthermore, various embodiments or examples and features of different embodiments or examples described in this specification can be combined and combined by one skilled in the art without contradiction.
Although embodiments of the present invention have been shown and described above, it is understood that the above embodiments are exemplary and should not be construed as limiting the present invention, and that variations, modifications, substitutions and alterations can be made to the above embodiments by those of ordinary skill in the art within the scope of the present invention.

Claims (5)

1. An anesthesia induction device, comprising:
the receiving module is used for receiving an induction instruction so as to enable the machine to enter an induction process according to the induction instruction, wherein the induction process comprises an oxygen supply and nitrogen removal stage, a drug induction stage and an endotracheal intubation stage;
the oxygen supply and denitrification module is used for executing the oxygen supply and denitrification stage after the anesthesia machine receives the induction instruction, and flushing nitrogen in the loop and the breathing pipeline;
the drug induction module is used for executing the drug induction stage after the anesthesia machine flushes nitrogen for a preset time, starting a machine control machine to ventilate according to the current spontaneous respiratory frequency of the patient, and sending out tracheal intubation reminding according to the current exhaling oxygen concentration and the current inhaled oxygen concentration of the patient; and
and the tracheal intubation module is used for executing the tracheal intubation stage after the respiratory pipeline is reconnected by the anesthesia machine, and sending intubation completion reminding when the ventilation is judged to be effective according to the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value of the patient, or sending intubation re-reminding if not.
2. The anesthesia induction device of claim 1, wherein the oxygen supply and denitrification module is further configured to control the anesthesia machine to output a preset concentration of oxygen to flush the circuit and breathing circuit of the anesthesia machine with nitrogen.
3. The anesthesia induction device of claim 1, wherein the drug induction module is further configured to obtain the current spontaneous breathing frequency, and when the current spontaneous breathing frequency is less than a preset threshold, start a machine-controlled ventilation of the anesthesia machine, and when the current spontaneous breathing frequency disappears and the current exhaled oxygen concentration and the current inhaled oxygen concentration satisfy preset conditions, determine that oxygen is sufficiently given, and issue the tracheal intubation reminder.
4. The anesthesia induction device of claim 1, wherein the endotracheal tube module is further configured to obtain the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value, and determine to be valid when the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value are all within a preset interval, and determine to be invalid when any one of the current ventilation data, the current inhaled carbon dioxide concentration value and the current exhaled carbon dioxide concentration value is not within the preset interval.
5. An anesthesia machine, comprising: the anesthesia induction device of any of claims 1-4.
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