Subclavian vein catheter care, 1. Good psychological care to patients and their families to explain, explain precautions to reduce the psychological pressure, to take the initiative to meet. Inform patients of catheter after 2 – 3 days may have local discomfort.
2. Puncture should be closely observed after the success of 2 hours, 30 minutes to observe the requirements of each respiration, pulse 1, asked whether the chest tightness, shortness of breath and so on, while doing chest auscultation, observation of patients without signs of subcutaneous emphysema. After 24 hours, every 4 hours of observation should be asked 1.
3. To prevent infection, maintain clean and dry the skin puncture site, catheter dressing was changed every day after, the local skin and exposed ducts are disinfected with a shy wine, cover the foil. After the dressing was changed 2 times per week, the replacement of heparin cap again. Carefully observe the skin puncture site, if there is a slight redness, the affected area can be used antibiotic ointment, if there is redness, tenderness, around discharge and fever, they should immediately check blood and blood bacterial culture done, one for each day medicine. Accept the subclavian vein catheter in patients Yichuan low collar, loose clothing to avoid rubbing the puncture point.
Subclavian vein catheterization in the care 4. To prevent the catheter slipping. Catheters indwelling governing the use of good or bad is the key to the length of time. Lcm away from the office in addition to suture the puncture point, but also from the puncture point 5 – 6cm to do with plastic sheets at a fixed wing cross in order to improve the fixation of catheters, fixed position to avoid the joints and depression, so as to avoid patient activity, and neck flexion, coughing and movement.
5. Maintain the catheter patency, to prevent clogging. Properly sealed tube: in the patients with normal clotting mechanism, the closure of 10ml of heparin saline control; heparin sodium for allergies, can be sealed tube 20ml normal saline. On the medication order, enter a strong hypertonic or irritating substances, and enter the smaller isotonic or irritating substances. Note that the flush volume can not be too small, the speed can not be too slow to reduce the residual particles in the catheter to avoid catheter blockage. Deep venous catheter through the blood sampling, the acquisition is completed must use 10ml of heparin saline washing pipe, will thoroughly rinse the blood within the lumen to prevent clogging the lumen. Prevention of air embolism. Infusion process, the nurses should step up inspections to prevent drops of liquid air and air to enter.
6. Indwelling tube blockage, avoid violence and impulse control, to avoid being rushed into the intravascular blood clots. Should be drawn with heparin saline syringe withdraw sword first, then slowly push the heparin saline; any blood clots, no longer promote the blood vessels, should dissolve blood clots with heparin saline, and then washed with normal saline control, until smooth so far.
7. Intermittent chemotherapy in patients discharged on or with a catheter, it should explain matters to their attention and catheter maintenance, asked the patients to the hospital on time and dressing, washing pipe. Of patients discharged with a catheter for heparin cap to be taken to the thief-pin sealed connector, the patient with heparin saline per week washing pipe only once.
Subclavian vein catheter care, 8. Indwelling end, extubation should not have too much force, breaking into the blood vessels to prevent the catheter. Should be routine disinfection, removal of stitches, and then reverse direction along the needle extubation and press lightly puncture the skin 10 minutes after the disinfection of pressure bandage, and close observation for 24 hours.
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