Objective: To analyze the nursing care of 54 children with asthmatic suffocating pneumonia, explore the correct and effective nursing methods, and improve the cure rate of children with severe asthmatic suffocating pneumonia. Methods: 54 children with asthmatic suffocating pneumonia were systematically cared. Early treatment with antiviral combined with antibiotics, early oxygen therapy to ensure smooth respiratory tract. Careful observation of vital signs and illness, such as illness changes, should be dealt with in time. Results: All 54 children were cured and discharged. Conclusion: Familiarity with the basic nursing theory of children with asthmatic pneumonia, careful observation of the condition and correct nursing methods can not only shorten the course of disease, but also improve the success rate of children's rescue. Antiviral treatment and psychological nursing of oxygen therapy for children with asthmatic pneumonia is a common disease in infants. Its main pathogen is respiratory syncytial virus, which is mostly related to the low immune function of children. It is more common in children under 2 years old, especially infants from 2 to 6 months old. The main clinical manifestations are cough, wheezing, hypoxia and dyspnea, which are easy to be complicated with important organ dysfunction. Nursing is particularly important during treatment. The nursing experience of 54 children with asthmatic suffocating pneumonia admitted to our department from June 2005 to June 2007 is reported as follows. Materials and Methods General information: From June 2005 to June 2007, 54 children with asthmatic suffocating pneumonia were treated in our department, including 30 males and 24 females. 32 cases were 2 ~ 6 months, 22 cases were 2 years old, 8 cases were common/kloc-0, and 36 cases were severe. Diagnostic criteria: diagnostic criteria are divided into two types: ordinary type: those with mild hypoxia symptoms and signs; Severe: frequent wheezing and dyspnea, and prominent symptoms and signs of hypoxia and heart failure. Observation of illness and respiratory system Most children in this group often have severe cough, paroxysmal dyspnea, paroxysmal dyspnea and shortness of breath, expiratory wheezing, and even obvious nasal fan and depression sign, cyanosis of mouth and lips, which often leads to suffocation or apnea due to phlegm. Therefore, we should pay attention to the changes of children's breathing frequency, rhythm and breathing style. If the baby breathes ≥60 times/minute, the baby breathes >: 40 times/minute, or the breathing rhythm is irregular, and there is conscious obstacle in nodding and breathing, which indicates respiratory failure. Report to the doctor immediately and cooperate with the rescue of the child. Observation of heart rate, pulse rate and blood pressure: Monitor the electrocardiogram, blood pressure and blood oxygen saturation of critically ill children, pay attention to whether the heart rate and rhythm are normal, auscultate whether the heart sounds are abnormal, and be alert to the occurrence of heart failure. When the child's unexplained heart rate increases, that is, the child ≥ 140 beats/min and the baby ≥ 160 beats/min, report to the doctor in time to determine whether there is heart failure. Temperature change: Take temperature 4 ~ 6 times a day, so as to provide the basis for the doctor's condition change and medication rationality. If the body temperature does not drop after 3 days of treatment, or the fever does not drop gradually, it means that the lung inflammation of the child is out of control or the pathogenic bacteria are insensitive, resistant to antibiotics or have complications, so it is necessary to closely monitor the changes of body temperature. Changes in spirit and consciousness: if you can sleep peacefully after playing and nursing after treatment, it means that your condition has improved; Such as fidgeting, crying or drowsiness, it means that the condition is out of control or aggravated, prompting the doctor for further examination. Therefore, we should pay close attention to the changes of children's mental state, consciousness and diet. Treatment principle: drug treatment: early application of ribavirin combined with antibiotics, intravenous administration, to obtain the understanding and cooperation of parents of children. The application of adrenocortical hormone can reduce inflammatory exudation, relieve bronchospasm, improve vascular wall permeability, reduce intracranial pressure and improve microcirculation. Dexamethasone 2 ~ 5 mg is commonly used, 2 ~ 3 times a day, and 3 ~ 5 days is 1 course of treatment. Flushing can occur during the treatment, and the symptoms disappear naturally after stopping the drug. Effective cough suppressants can be used for children with cough. If asthma is serious, besides dexamethasone, salbutamol can be added for atomization inhalation, and salbutamol spray can also be used to relieve spasm and asthma. Oxygen therapy: nasal vestibular catheter is generally used, with oxygen flow of 0.5 ~ 1.0L/min and oxygen concentration less than 40%. Oxygen should be humidified to avoid damaging airway cilia and epithelial cells, resulting in sticky sputum. Those with obvious hypoxia should be given oxygen through the mask, the oxygen flow rate is 2 ~ 4L/min, the oxygen concentration is 50% ~ 60%, and the oxygen is inhaled intermittently at low flow rate. If you have acute pulmonary edema, immediately sit down, droop your legs or repeatedly bind your limbs to reduce blood return to your heart, and use 50% alcohol to inhale oxygen, every time 10 minute, with an interval of 20 ~ 30 minutes 1 time, so as to promote foam rupture in alveoli and improve gas exchange. Nursing methods General nursing of pneumonia: do a good job of respiratory isolation. Attention should be paid to placing the children with acute and recovery period, bacterial infection and virus infection in different wards, regularly opening windows for ventilation, limiting visitors and accompanying personnel, keeping the room temperature at 18 ~ 20℃ and the humidity at 50% ~ 60%. Management of intravenous infusion. Transfusion is a powerful measure to replenish enough heat and water in time to ensure the timely onset of drugs. Especially in children with heart failure or when using phentolamine, we should pay attention to the accurate dosage, strictly control the dripping speed and the total amount of liquid, and maintain uniform drip. The baby had better use the infusion pump. It is necessary to arrange the medication order reasonably, pay attention to the incompatibility between drugs, use antibiotics now, master the skills of intravenous puncture of nurses, effectively fix needles, relieve the pain of children, and reduce the burden of crying on the heart and lungs. Diet care. Reasonable feeding should ensure the nutrition of children. Children with dyspnea, cyanosis and abdominal distension should be picked up obliquely and fed several times to reduce the burden on the heart and prevent food from being inhaled into the trachea and suffocating. Posture often helps children to change their posture, pat their backs, reduce pulmonary congestion, promote inflammatory absorption, and facilitate secretion discharge. Prevent complications. Nursing care of critically ill children keeps respiratory tract unobstructed and prevents hypoxemia. All the children in this group have different degrees of wheezing attacks. During this period, the child will have shortness of breath, painful expression, purple lips, irritability and crying. Chloral hydrate is often used to keep enema for children. In severe cases, hormones are used to reduce airway inflammation and reduce exudation, or phentolamine is added to glucose solution and infused intravenously with a micro-injection pump to reduce airway hyperresponsiveness, relieve airway spasm and achieve the purpose of relieving asthma. Due to the accumulation of respiratory secretions at night, sputum aspiration in the morning is helpful to improve ventilation [1]. In this group 1 47-day-old infants suddenly suffocated, and their breathing and heartbeat were weak. After the medical staff on duty immediately cleared the respiratory secretions and effective cardiopulmonary resuscitation, the child turned to safety. Therefore, it is very important to clear the respiratory secretions in time and keep the respiratory tract unobstructed. Atomizing inhaler atomization. According to the situation of children, ultrasonic atomization or air compression atomization is used for atomization. For children with excessive phlegm and viscosity, physiological saline+chymotrypsin can be used for ultrasonic atomization, 15min/ time, 2-4 times/day, and for children with obvious dyspnea, Pulmicort atomizer (Lingshu)+Bricanyl atomizer and air compressor pump inhalation can be used, 1-2 times/day, which is beneficial to spasmolysis ventilation and expectoration. After atomization, you can pat your back with a hollow fist in cooperation with turning over and patting your back, and both sides alternately promote sputum excretion. Oxygen therapy. Positive correction of hypoxia is the key link of treatment: for mild cases, nasal catheter is generally used to absorb oxygen, and nasal catheter can be inserted into nasal vestibule. The oxygen flow rate is 0.5 ~ 1L/min, and severe children can use mask atomization oxygen inhalation or continuous positive pressure oxygen inhalation, and the oxygen flow rate is 2 ~ 4L/min. Continuous or intermittent oxygen inhalation can be given according to the condition, and the effect of oxygen therapy can be observed at any time to ensure the unobstructed nasal catheter. In addition to the above nursing work, nurses should also establish a high sense of responsibility and compassion, gain the trust and cooperation of parents of children, observe carefully, patiently and accurately, find problems in time, and cooperate with doctors to take effective nursing countermeasures, which is also the key to nursing work. refer to

1 Jin Jinhua, Wei Li, Cai Shufen. Treatment and nursing care of loyal children with asthmatic pneumonia. Guide to traditional Chinese medicine, 2007, 32.

2 Duran Ming, Yan. Nursing experience of heparin sodium atomized inhalation in the treatment of asthmatic pneumonia in children. Journal of Linyi Medical College, 200 1, 0 1.

Zhang Xuehua, Zuo Ling and Yuan Jiuli. Nursing experience of oxygen-driven atomizing inhalation in the treatment of 63 children with asthmatic pneumonia. Shandong Medicine, May 2006.