Izingozi ezihambisana nokubekwa nokusetshenziswa kwe-Central Lines
Umgqa oyinhloko wuhlobo lwe-catheter olufakwe emthanjeni omkhulu ovumela amanzi amaningi e-IV anikezwe futhi igazi lidonswe. Uma kuqhathaniswa nomugqa ojwayelekile we-IV, umugqa ophakathi ukhulu kakhulu, ungahlala endaweni ede kakhulu, ungahambisa umthamo omkhulu wamanzi futhi uvumela igazi ukuba ludonse kalula. Umgqa ophakathi nawo ungasetshenziselwa ukukala isimo sevolumu yamanzi, futhi ukusiza ukucacisa ukuthi isiguli siphelelwe amandla noma sithole inani elanele loketshezi ukusekela imisebenzi yomzimba.
Umzila we- PICC , uhlobo lwe-IV ukufinyelela okungagcinwa amasonto nezinyanga, akuyona inkambo ephakathi kepha uhlanganyela ngezici eziningi ngale ndlela yokufinyelela kwe-IV.
Kungani Kusetshenziswe I-Central Central?
Umgqa ophakathi ungafakwa ngezizathu eziningi. Umgqa ophakathi ungaba nezibani ezifika ku-5, okungukuthi yizibuko lapho umthamo ongasetshenziswa khona, igazi lingadonselwa noma izilinganiso zingathathwa. Uma isiguli sidinga ukubuyiselwa kwamanzi, okusho ukuthi kuningi okumele kutholakale amanzi amancane, kufanele kubekwe umugqa ophakathi ukuze uvumele uketshezi luqhume ngokushesha.
Imigqa ephakathi ingasetshenziselwa ukudweba igazi. Kwezinye izimo, izinkomba ezimbili emgqeni ongaphakathi zingasetshenziswa ukwenza i-dialysis, ne-lumen eyodwa esetshenziselwa ukukhipha igazi ngaphandle kwesistimu yezinthambo futhi enye i-lumen esetshenziselwa ukubuyisela igazi elilethwe yisifo se-dialyzed emzimbeni. Kulezi ziguli ezidinga ukwedluliswa kwegazi njalo ukuze zithunyelwe ebhokisithri, umgqa ophakathi uvumela igazi ukuba ludonse ngaphandle kokuphindaphindiwe "ukunamathela" isiguli.
Omunye umsebenzi ohlukile kwezinye imigqa esemaphakathi yikhono lokukala ukucindezela okuphakathi komzimba. Lesi silinganiso sinikeza ukuqondisisa kwethimba lezempilo ukuthi kungakanani uketshezi kuhlelo lwesisulu, futhi uma isiguli sithole amanzi amaningi noma amancane kakhulu.
Uma umugqa ophakathi nendawo ye-Swann-Ganz yohlobo lwe-cathéter, ingcindezi yomgqa yamapayipi ingatholakala, okungabonisa ngokuqondile ukuthi i-atrium yesokunxele senhliziyo isebenza kanjani.
Kulezi ziguli ezinenkinga enkulu yenhliziyo noma ukuhlinzwa kwenhliziyo yakamuva, lolu lwazi lungaba yigugu kakhulu.
Umgudu ophakathi nawo uyadingeka lapho ukwelashwa kwesikhashana eside kulindeleke, njengamaviki e-IV emithi yokwelashwa, noma uma kudingeka imithi yokwelapha engakwazi ukunikezwa nge-standard IV, njenge- chemotherapy .
Ukufaka i-Central Line
Ukuze ufake umugqa ophakathi, isiguli kumele sibe selele phansi, futhi indawo yomzimba lapho umugqa ophakathi uzofakwa khona. Izindwangu ezivame kakhulu ezisetshenziselwa ukubekwa komugqa oyinhloko yi-jugular yangaphakathi entanyeni, i-veclavian vein eduze ne-clavicle, ne-femin vein ekuguleni.
Isiguli sigubungelwe, ngokuvamile kusuka enhlokweni kuya enzwaneni, ngesigqoko esinyumba. I-drape iyiphepha eliphephile elinomgodi kulo ukuze kuvunyelwe ukuthi umuntu abeke umgudu ophakathi kwe-vein. I-drape oyinyumba ihloselwe ukusiza ukunciphisa ingozi yokutheleleka, futhi ucwaningo luye lwabonisa ukuthi oluhlanganisa wonke umzimba, kunokuba nje indawo lapho umgudu ophakathi uzobekwa khona, kuyindlela engcono kakhulu yokuvimbela ukutheleleka.
Uma isiguli sigqokwe, indawo yesikhumba ihlanzwa. Uma isiguli siphapheme, indawo yesikhumba nayo ingabalwa nenani lobuhlungu bokuzibulala .
Esebenzisa amasu oyinyumba, i-catheter engenalutho isuke ifakwe emgodini, ngokuvamile isebenzisa i-ultrasound ukuthola indawo efanelekayo yegazi. I-catheter isuke ishicilelwe endaweni, noma idivayisi yokunamathisela isetshenziselwa ukubamba i-catheter okwamanje endaweni yokufaka indawo.
Indawo iyahlanzwa futhi nge-antiseptic futhi ukugqoka okuyimpoqo kufakwe phezu kwesayithi lokufaka, lapho izibani zifinyeleleka. Ukubekwa kwe-catheter kumele kuqinisekiswe ngokusebenzisa i-x ray ngaphambi komgqa ophakathi, ukugwema ukuphuza imithi ngemithi noma isitsha esingalungile segazi. Kwezinye izimo, i-catheter ingase ibe esitsheni esifanele, kodwa idinga ukulungiswa okuncane ngoba i-catheter ingaphezulu kakhulu emkhunjini noma ayikude kakhulu.
I-Central Line-Associated Bloodstream Infection (CLABSI)
Enye yezingozi zokubekwa komugqa phakathi nokusetshenziswa kuyisifo segazi. Ukuze usize ukuvimbela izifo , imikhuba emihle ehlelekile isetshenziswe. Le mikhuba ihlanganisa izinguquko zokugqoka ezihlosiwe ezihleliwe, ukusetshenziswa komzimba ogcwele oyinyumba ngesikhathi sokubekwa komugqa, ukususa umugqa ngokushesha uma kungasadingeki, futhi kufaka kuphela imigqa esemaphakathi edingekayo.
Imigqa ephakathi imiswe ngokuyinhloko ngaphezu kwesihenqo lapho kungenzeka khona ukunciphisa ingozi yokutheleleka. Izingosi ze-femoral vein zihlotshaniswa namazinga aphezulu okutheleleka. Ukugqoka okubekwa phezu kwesayithi lokufakela isicacile, okuvumela ithimba lokunakekelwa kwezempilo ukuthi lihlole izimpawu zokutheleleka ngaphandle kokudalula isayithi lokufakela ukuhambisa emoyeni ngaphezu kwalokho okudingekile.
Izingozi ze-Central Line
Kunezingozi ezihlobene nokufakwa komugqa ophakathi, okumele ulinganiswe ngesidingo sesiguli somugqa. Ukwelashwa yisengozini enkulu kunazozonke zomgqa ophakathi, nezinye izingozi ezibandakanya i-pneumothorax (ukuphuza amaphaphu), ikakhulukazi uma umugqa ophakathi ubeka emgodini we-subclavia, ophathwa ngethubhu yesifuba uma kunesidingo.
Ngenkathi kufakwe ezinye izinhlobo zemigqa ephakathi, inhliziyo ingacasulwa yinqubo ngenkathi umugqa uhamba phakathi kwemithambo yegazi eduze kwenhliziyo, okwenza ushintsho kwisigqi senhliziyo. Lokhu kuxazululwa ngokubeka ukufaneleka komugqa kodwa kungadinga imithi kwabanye abantu abangavamile.
Enye ingcindezi yokugcina emigqeni ephakathi nendawo yokubumbana emoyeni, isimo lapho umoya ungena khona ohlelweni lwesisulu futhi uqala ukuhamba ngomzimba. Lesi simo, esiyingozi kakhulu, sibuye singavamile kakhulu futhi sivinjelwe kakhulu.
Izwi elivela:
Umgqa oyinhloko uyasiza kakhulu lapho isiguli sigula, kodwa akuyona ingozi. Kuziguli eziningi, inzuzo yokungena "izinti" eziningi zegazi idonsela futhi ukufinyelela kokuthembeka kwe-IV endaweni enkulu kunezingozi ezinikezwe lolu hlobo lokufinyelela.
Kwezinye iziguli, lo mgqa ophakathi wenza ukuba iziguli zibekezeleleke kakhulu, kanti abanye bangakhathazeki ngegazi bese bekhetha ukugwema izinkinga ezingase zilethwe.
> Umthombo:
> Ephakathi > Line-Associated > Bloodstream Infection. UMnyango wezeMpilo waseCalifornia.