Objective:To summarize the nursing experience in 2 patients with cardiogenic shock combined with acute respiratory distress syndrome(ARDS) treated by extracorporeal membrane oxygenation (ECMO) and transferred outer-hospital in long distance.Methods:There were many risk factors in this transport: high parameters of ECMO included V-A mode, 100% oxygen, and a flow of oxygen from 6 L/min to 10 L/min. High ventilator parameters included oxygen concentration of 100% and positive end-expiratory pressure of 15-17 cmH 2O(1 cmH 2O=0.098 kPa). Transport distance was up to 196 km. And the transport time was up to 2 h 36 min. In this regard, we carried out adequate preparations before transport and professional cares during transport. The main points were as follows: setted up a professional transport team; prepared adequate power and oxygen supply; reduced the number of interruption of ECMO and ventilator support during transport; provided the reasonable remedial actions when ECMO and ventilator support were interrupted. Results:Two patients arrived at the destination safely.Conclusions:Adequate preparations before transport and professional cares during transport could effectively avoid and respond to the occurrence of adverse events, and it is feasible and safe to patients supported by ECMO for long distance outer-hospital transport.

Objective Using the stage management to evaluate the normalized pain management and to alleviate pain of primipara during delivery and improve comfort .Methods Sixty pregnant women were selected and were divided into the control group and the observation group , each with 30 cases.The control group was given the usual care during the first stage of delivery , while the observation group was given a set of normalized pain management and alternative experiences of intervention , therapeutic massage , meditation with music and birth ball.The numerical rating scale (NRS) and visual analog score (VAS) were used to assess the degree of pain, emotions and comfort feelings .Then, the degree of pain and changes of emotions and comfort were compared between groups .Results Within the observation group , 12 primipara ( 40.00%) had mild pain, 17 primipara (56.67%) had moderate pain, 1 primipara (3.33%) had severe pain.Within the control group, 5 primipara (16.67%) had mild pain, 21 primipara (70.00%) had moderate pain, 4 primipara (13.33%) had severe pain.There was a significant difference between groups (U =2.235, P =0.025).Within the observation group, 22 primipara (73.33%) had mild discomfort, 8 primipara (26.67%) had moderate discomfort.Within the control group, 10 primipara (33.33%) had mild discomfort, 17 primipara (56.67%) had moderate discomfort , 3 primipara ( 10 .00%) had severe discomfort .There was a significant difference between groups (U=3.222, P=0.001).There was no significant difference in the emotions between groups (U=0.800,P=0.424).Conclusions The stage management can significantly reduce the pain of primipara during delivery and improve their comfort .