Objective:To investigate the application effect of medical failure modes and effects analysis(FMEA)in reducing the inci-dence rate of catheter dislodgement in patients in the post-anesthesia care unit(PACU).Methods:A retrospective study was con-ducted among 469 PACU patients in our hospital from January 2023 to June 2024.According to the application time of FMEA,the pa-tients were divided into routine group(234 PACU patients who did not receive FMEA from January to June 2023)and FMEA group(235 PACU patients who received FMEA from July 2023 to June 2024).The two groups were compared in terms of the incidence rate of catheter dislodgement,risk priority number(RPN)coefficients(including professional knowledge,risk awareness,and intervention guidance),the quality of recovery of consciousness(including the time to complete recovery of consciousness and the length of stay in the PACU),and the degree of satisfaction with nursing(including risk management,nursing services,and nursing techniques).Results:The FMEA group had a significantly lower incidence rate of catheter dislodgement than the routine group[0.43%(1/235)vs.2.99%(7/234),the difference was statistically significant(χ2=4.604,P=0.032)].Compared with the routine group,the FMEA group had significantly lower RPN coefficients of risk awareness t=52.518,professional knowledge t=49.641,and intervention guidancet=61.592(P<0.001).Compared with the routine group,the FMEA group had significantly shorter time to complete recovery t=18.087 of consciousness and length of stay in the PACUt=15.710(P<0.001).The FMEA group had a significantly higher degree of satisfaction with nursing than the routine group in terms of risk management t=19.794,nursing services t=10.825,and nursing techniques t=14.555(P<0.001).Conclusion:The application of FMEA manage-ment in PACU patients can reduce the incidence rates of catheter dislodgement and risk events and improve the quality of recovery of consciousness and the degree of satisfaction with nursing,and there-fore,it has important clinical significance.

OBJECTIVETo compare the ventricular-dynamic parameters and thoracic aorta tension induced by two septic shock models in rats.

METHODSSeptic shock models were induced by cecal ligation or puncture (CLP) and intraperitoneal injection of lipopolysaccharide (LPS) in rats. The carotid artery was cannulated and connected to a pressure transducer to determine mean arterial blood pressure (MABP). Ventricular dynamic parameters, including heart rate (HR), left ventricular developed pressure (LVDP) and maximal rise/fall velocity of ventricular pressure (± dP/dtmax) were determined. Isolated thoracic rings were mounted on an organ bath and the tension of the vessel was recorded.

RESULTThe mortality was 65.2% in CLP shock rats, but no death in LPS shock rats. The MABP and HR of CLP rats were decreased more prominently than those of LPS rats (P < 0.01). Contraction induced by high K(+) (60 mmol/L) or 10⁻⁶ mol/L phenylephrine (PE) in endothelium-intact and endothelium-denuded aortic rings was all attenuated, but in LPS rats it was more prominent (P < 0.01).

CONCLUSIONTwo rat septic shock models can decrease ventricular-dynamic parameters and vasoconstriction responsiveness of aorta. The ventricular-dynamic parameters decrease more prominently in CLP model, while vasoconstriction responsiveness of aorta changes more in LPS model.

Animals ; Cecum ; surgery ; Disease Models, Animal ; Hemodynamics ; Ligation ; adverse effects ; Lipopolysaccharides ; toxicity ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Shock, Septic ; etiology ; physiopathology ; Vasoconstriction ; Ventricular Pressure ; physiology