บทบาทพยาบาลเด็กในการเฝ้าระวังและตอบสนองต่อภาวะหายใจล้มเหลว: จากการประเมินสู่การตัดสินใจทางคลินิก

Phatcharaporn Watcharasin*; Busayamad Kankad; Torkiet Singha; Aungsumalin Pichedboonkiat

Authors

Phatcharaporn Watcharasin* Overbrook hospital, Chiang Rai
Busayamad Kankad Faculty of Nursing, Chiang Rai Rajabhat University
Torkiet Singha Boromarajonani College of Nursing, Nakhon Lampang, Faculty of Nursing, Praboromarajchanok Institute
Aungsumalin Pichedboonkiat Faculty of Nursing, Chiang Rai Rajabhat University

Keywords:

Respiratory failure, Clinical decision-making, Surveillance, Pediatric nursing, Nurse's roles

Abstract

Respiratory failure in children is a severe emergency condition that may lead to death if not assessed and treated promptly. Early surveillance, timely recognition of clinical deterioration, and evidence-based nursing care are essential components of the management of pediatric respiratory failure. This article aims to review the body of knowledge on respiratory failure in children, analyze the nurse's role in the surveillance of and response to this condition, and synthesize evidence-based nursing guidelines for application in the care of pediatric patients. The content covers the pathophysiology, causes, and types of respiratory failure in children, approaches to the assessment of respiratory warning signs, and the nurse's role in the surveillance of critical conditions, particularly the systematic use of assessment tools, namely the pediatric assessment triangle (PAT), the pediatric early warning score (PEWS), assessment based on the airway, breathing, circulation (ABC) approach, and communication. Nurses play a role in the early recognition of warning signs, monitoring respiratory rate, blood oxygen saturation, the use of accessory respiratory muscles, and level of consciousness, as well as positioning, initial airway opening, administering oxygen as indicated, preparing ventilatory support equipment, coordinating with the multidisciplinary team, and supporting families' involvement in observing changes in the child's condition. Systematic surveillance of respiratory failure, together with the use of evidence-based practice and nurses' clinical decision-making, enables the early identification of critical conditions, enhances safety, reduces complications, and effectively promotes the clinical outcomes of pediatric patients.

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