目的讨论二级医院急诊留观患者潜在的风险及对策。方法通过对二级医院急诊科工作现状的分析,大部分急诊科无重症监护病房,观察室也无各项监护设备,人员少、工作量大是二级医院急诊护理工作中普遍存在的问题,急诊留观患者的病情交织着各种复杂的因素,随时可能出现不可预知的病情变化,使我们的医疗护理行为具有高风险性。因此急诊患者在留观输液的过程中潜在着各种风险如使用降压药硝酸甘油未及时测量血压的风险、腹痛患者未明确诊断掩盖病情的风险、醉酒患者呕吐物未及时清理造成窒息的风险、“三无”患者未及时做各项检查耽误病情的风险、车祸打架的患者漏诊、误诊的风险、心脏病患者突发猝死的风险、老年患者跌倒摔伤的风险等进行讨论分析,探讨规避风险的各种措施,培养慎独精神,为患者进行详细体检,及时巡视,及时发现病情变化及时处理,审慎与病情有关的蛛丝马迹,避免误诊、漏诊的发生;腹痛患者及时行各项相关检查明确诊断;高血压患者选用欣康等降压效果比较缓和的药物;同时履行告知义务,对拒绝住院拒绝做检查的患者,要告知病情的严重性,作好健康教育;醉酒患者及时清理呼吸道防止窒息的发生;同时完善各项记录,依法行医,6h内据实补齐各项抢救记录;建立完善的医疗急救体系,对“三无”人员认真做好交接登记,及时进行各项检查等等。结果及时杜绝各种潜在风险的发生,规避风险,保障急诊留观患者的医疗安全,提高医疗护理质量。结论二级医院急诊留观患者虽然存在着很多潜在的风险,但只要我们本着认真负责的原则,培养慎独精神,履行告知义务,完善各项记录,详细体检、认真观察、及时处理,很多风险是可以避免的。 Objective To discuss the potential risks and countermeasures of emergency patients in secondary hospitals. Methods Based on the analysis of the current situation of emergency department in secondary hospitals, most of the emergency department without intensive care unit and observation room also lack of monitoring equipment, less staff and heavy workload are common problems in secondary care of secondary hospitals, The patients with emergent patients are intertwined with a variety of complicated factors. Unpredictable changes may occur at any time, posing a high risk to our medical nursing behaviors. So emergency patients in the process of viewing the infusion of potential risks such as the use of antihypertensive drugs nitroglycerin not timely measure of blood pressure, abdominal pain patients did not clearly diagnose the risk of disease cover, drunk patients vomit was not promptly cleared the risk of suffocation, “Three no ” patients do not promptly do the risk of the inspection delay, the accidental misdiagnosis of patients in the car accident, the risk of sudden cardiac death in patients with heart disease, the risk of falls and falls in elderly patients were discussed and discussed to explore Avoid risk of various measures to cultivate the spirit of cautiousness for patients with detailed physical examination and timely inspections, timely detection of changes in the disease in a timely manner, cautious and clues to the disease, to avoid misdiagnosis, missed diagnosis; abdominal pain patients in a timely manner the relevant clear examination Diagnosis; hypertensive patients with Xinkang and other antihypertensive drugs more relieved; at the same time fulfill the obligation to inform refusal to refuse to do hospital inspection, to inform the seriousness of the disease, make good health education; drinkers promptly clean the respiratory tract to prevent suffocation The occurrence of; at the same time improve the records, according to the law practice, within 6h actually fill the rescue record ; Establish and improve the emergency medical system, the “three noes ” the transfer of the registration staff do a good job, in a timely manner the examination and so on. The results in a timely manner to eliminate the occurrence of a variety of potential risks, to avoid risks, to ensure the safety of emergency patients with medical observation and improve the quality of medical care. Conclusions Although there are many potential risks in patients with emergency observation in secondary hospitals, as long as we cultivate the spirit of cautiousness, fulfill the obligation of disclosure, improve the records, conduct detailed medical examination, observe carefully and handle in time, many risks are serious It can be avoided.