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22 cases of sudden death in psychiatric patients and nursing care data analysis

Chinese papers League finishing. Key words mental illness; sudden death; antipsychotics, [Abstract] Objective To understand the perspective from the psychiatric care of patients and the nursing of the causes of sudden death. Methods Retrospective chart review method, according to pre-established research project, carried out in 22 cases of deaths in each registration. Results All cases of death by the nursing staff found. Discovery and rescue of nurses in the process of sudden death in patients give adequate weight plays a role. Patients were receiving prior to the onset of different types of antipsychotic medication dose, combined application of two antipsychotic drugs first place, to take drugs or phenothiazines chlorpromazine second. In addition to 4 deaths in this group a clear reason, the remaining 18 deaths were likely to infer that the application with the antipsychotics on. Conclusion In addition to sudden death and sudden death related to their physical condition, the various psychotropic drugs on sudden death, direct or indirect relationship. Of all hospitalized patients received drug treatment, early treatment should be carried out in close observation. Especially for young first hospitalization, elderly and frail, suffering from cardiovascular and cerebrovascular disease, or high dose combination of two antipsychotic drugs patients should be highly valued. [Key words] mental illness; sudden death; antipsychotics psychiatric patients during hospitalization, sudden death caused by taking antipsychotics reported more recent years, some patients in the hospital soon then sudden death. Although the proportion of such deaths is not high, and its very serious nature of the event, rescue little chance of success should lead to medical attention and vigilance. To this end, 26 years from 95 cases of hospital deaths, 22 cases of sudden death in which to analyze the data and cause of death from the perspective of nursing and nursing of a preliminary analysis, in order to provide a theoretical basis for clinical care in order to take effective scientific preventive measures,[link widoczny dla zalogowanych], as much as possible to reduce the incidence of sudden death. 1 Materials and Methods 1.1 General Information all the information from May 1, 1979 ~ Dec. 2005 30 hospitalized patients in Japan and 26 years for various reasons, 95 patients died of medical files. 1.2 Methods 22 cases of sudden death, according to the survey outline pre-established, one by one retrospective registration method, and item by item analysis. 26 years, 26,651 cases were treated in various types of patients, hospital mortality rate was 0.36% over the same period patient died of sudden death cases accounted for 23.2% of the constituent ratio. 2 results 2.1 Gender and age 22 cases, 10 males and 12 females, slightly more than women men. The majority of young patients, the youngest 21 years old, maximum of 60 years, average 37.2 years old. 2.2 inpatient diagnosis and course of mental illness 15 patients diagnosed with schizophrenia, schizophreniform psychosis in 2 cases, chronic alcohol toxicity of mental disorders in the 2 cases of psychomotor excitement state of 2 cases mania in 1. The shortest duration of 2 weeks, up to 12 years, average 3.4 years. Less than 1 year of which 11 cases, 2 to 5 years in 6 cases, 6 to 10 years in 4 cases, 1 case of 10 years. 2.3 times and the second inpatient hospital stay more patient for the first time, the group of 14 patients hospitalized for the first time, the second hospitalization in 4 cases, the third hospital in 3 cases, more than 3 times in 1 case. The shortest length of hospital stay 1 day, up to 237 days. Which died within 15 days of admission, 17 cases died within 1 month in 2 cases, 1 patient died on day 42, the first 237 days and 1 died. 2.4 Physical Diseases and examination findings The hospital found that 7 cases of physical disease and complications, and the remaining 15 cases were not aware of any physical disease. 12 patients with various tests of the blood, urine and liver function tests were within normal range report, 1 WBC 12 × 109 / L, 1 patients had fever, throat congestion, WBC 22 × 109 / L, due to length of stay short, while the return of laboratory results in 8 cases. 8 patients had ECG report, 2 of which were normal, 6 cases of sinus tachycardia. 1 case with myocardial insufficiency. 2.5 Therapeutic Use all cases since the first day of admission are accepted until the death of all kinds of different doses of antipsychotic medications. Because in the acute phase, in order to manage the psychiatric symptoms, more treatment within 1 week to increase the amount of high doses, more drugs are combined. Antipsychotic combination therapy in two ranks first (9), to taking phenothiazine drugs that followed chlorpromazine (8 cases). And method of administration is via: a single oral treatment with chlorpromazine in 8 cases, a single oral treatment with clozapine in 2 cases, a single oral treatment with Tai Erdeng 2 cases, combined oral administration of haloperidol, chlorpromazine intravenously for 7 cases of oral chlorpromazine clozapine treatment in 1 case combined oral dose of 400 mg / d and 50 mg / d. Clozapine treatment of oral combined intravenous haloperidol in 1 case, haloperidol 20 mg intravenous injection 15 mg and stability combined in 1 case.