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 Posted: Mon 2:56, 28 Feb 2011 Post subject: asics shoes online Peripheral inserted central cat |
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Peripheral inserted central catheter (PICC) and the clinical application of catheter care
Measurement: From the pre-extension of vein puncture to the right chest, and then lock down to the third intercostal joints. Middle upper arm circumference measurements, the establishment of the sterile field. Open the PICC catheter bags,[link widoczny dla zalogowanych], sterile gloves, ready to heparin cap, pumping saline, heparin saline. The first piece of cloth pads to the patient treatment arm, in accordance with the principles of sterilization aseptic puncture point,[link widoczny dla zalogowanych], the scope of lOcm ~ lOcm, first with alcohol and iodine to be at. Replacement of sterile gloves, shop towel, flush catheter with heparin saline, assistant to the bar on the upper arm tourniquet, the venous filling. The protection cover removed from the needle on, the implementation of venipuncture. The angle is about 15-3O °, perpendicularly blood vessels, once back to the blood, and immediately lower the puncture point of view, promoting guided tube into the vein. Remove the casing from the guide pin through the side. Left index finger fixed guide tube to prevent displacement, the middle finger tip pressure in the casing in which the blood vessels, reducing blood flow. Assistant to release the tourniquet from the guide sleeve in the needle out, clamp the clamp tip, gradually began to give as gifts venous catheters,[link widoczny dla zalogowanych], forced even slow. When the tube is inserted about 15cm or so, the equivalent of the shoulder, the needle will urge patients to head to the side, shoulder to prevent the lower jaw close to the jugular vein catheter is a dangerous thing. Expected length of the tube inserted, you can exit the leaders sheath. Refers to the pressure casing side vein, stable catheter exit from the intravenous tube, confirmed the intravascular catheter. Hand fixed catheter in one hand and remove the guide wire, gentle movements. Back to the blood with normal saline syringe pump, and saline injection to determine whether smooth or positive heparin cap connecting joints, heparin saline pressure sealed tube, fixed tube, sterile dressing covered in puncture a small piece of gauze placed on top of , absorption bleeding, careful not to cover the puncture point, covered with transparent film post and the puncture site in the catheter, pressure paste, by x ray film to determine catheter tip position. 2 explain to the patient care operation 2.1 to obtain the consent of the patient by the physician responsible for patient informed consent, the patients in a relatively relaxed state, to avoid uncomfortable emotional stress increase the intubation. 2.2 familiar with the anatomy of local patients should be aware of before puncture static Jiang Yueqiu Mudanjiang 157009 pulse conditions to avoid scars and venous valve at the puncture, puncture positioning accuracy, reduce the pain of the patients, strict implementation of aseptic technique, the puncture to a certain depth into the still no return to the blood should be returned to the subcutaneous needle, and then change the angle of the needle. Must not be allowed back to the blood when the needles in the absence of left and right, could easily lead to vessel wall injury, the formation of hematoma. Patients with bleeding tendency of pressure to stop bleeding, catheter replaced within 24 hours after post film, and observe the local hemorrhage, after appropriate 1-2 times a week, dressing changes direction along the catheter thrown off by a transparent dressing-down , local iodophor disinfection, replacement of sterile gauze to keep the local dry and the prevention of infection and effective measures for phlebitis. 2.3 Use the correct sealed tube technology is a catheter tube seal key to success, the method should be properly, each infusion, the sealed tube Do not withdraw blood by syringe pump over 1O ml of normal saline 10-20 ml way to pulse impulse control, and pressure sealed tube. When the tube is clogged, use of urokinase per ml 5000u pull side approach to push side,[link widoczny dla zalogowanych], dissolved the clot catheter, is strictly prohibited blood clot pushing people, prohibited the use of less than 1O mL syringe, or in case of catheter obstruction can result in catheter rupture. 2.4 The regular inspection head positioning catheter catheter, flow properties and fixed the situation, try to avoid catheter limb blood pressure measurement, appropriate activities, arms, shall not be lifting heavy puncture side of the arm. 2.5 Prevention of complications and the use of PICC catheter common complications of phlebitis, the puncture point bleeding, edema, skin infections orifice,[link widoczny dla zalogowanych], catheter obstruction, catheter ectopic and so on. Air embolism is less common, the reason usually done by unskilled and improper care, and only skilled nursing PICC catheter methods and techniques to prevent complications. 3 If students clinical application of irritating drugs, especially cancer chemotherapy drugs or long enough to require transfusion therapy to maintain intravenous access, infusion of hypertonic or given a higher viscosity liquid. Required repeated blood transfusion, or blood products or blood of patients. Washed prior to use normal saline infusion tube, and quickly lost after washing pipe to reduce the physical component attached to maintain catheter patency, parenteral nutrition, and lack of supportive care drugs in patients with vascular channels, or inclination, or the application of infusion pump pressure infusion therapy can be used PICC catheter. In the absence of life-threatening complications, such as blood, pneumothorax, perforation of large vessels quickly and easily, and intubation, the nurse to operate. Venous injury and after extubation, by nursing peers recognized. In the clinical application of multi-exploration, technology is improving daily, representing a lock to wear safe, convenient, fewer complications, reduce patient suffering, improve the efficiency and quality.
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