Views:3 Author:Site Editor Publish Time: 2020-11-19 Origin:Site
Main points of central venous catheter care
Operations related to central venous catheters should be strictly aseptic: nurses should strictly wash their hands, wear sterile gloves and masks, and carry out care in accordance with standard operating procedures during the nursing process of patients. operating.
Strengthen the care of the puncture site: check the skin around the puncture point daily to observe whether there is redness, swelling, exudation and purulent secretions, etc.; disinfect the puncture point skin with iodophor, and the range should exceed the sterile patch, at least> 10cm; choose ventilation Transparent dressings with good sex and histocompatibility. The puncture points must not be covered so as not to affect the observation. The dressings should be replaced as needed. If there is moisture, seepage, pollution, curling, or looseness, it should be replaced in time.
Strengthen the fixation of the catheter: fix the catheter with double needles during deep venous catheterization. After the disinfectant dries, place the midpoint of the 7 cm×9 cm transparent dressing (IV3000) on the puncture point, and cover the deep venous catheter without tension before shaping For the duct, press the dressing from the center to the periphery to make it fully adhere to the skin, without leaving air in the dressing, take out the exposed duct from the gap, and then take the 6 cm×7 cm duct fixation stick to fix the duct wing to fix it again Then use the tape inside the transparent dressing to mark the date and name of the replacement.
Dedicated tube: total parenteral nutrient solution, vasoactive drugs and central venous piezometer tube should be dedicated to the tube. Vasoactive drugs should be pumped in a separate channel to ensure that the speed of other liquids in the channel is basically uniform, and the speed of intravenous infusion is not less than 5ml/h. It is recommended to use an infusion pump for uniform infusion to avoid rapid volume expansion.
Correctly handle the infusion pipeline: the infusion set should be replaced every day. Some viscous liquids (such as whole blood, platelets, fat emulsion, etc.) are easy to deposit on the tube wall and cause clogging or clotting in the tube, so rinse with normal saline after the infusion catheter.
Seal the tube correctly: Before sealing the tube, use 20ml of normal saline to quickly flush the tube. Do not withdraw the syringe before injecting the heparin saline. The injection of heparin saline is pulsed, and the speed must be rapid. When the heparin saline is injected to reach the mark value (almost while the injection is still in progress), the clamp on the extension tube is quickly clamped to maintain a certain positive pressure in the lumen. The heparin saline reaches the tip of the catheter and prevents blood from returning to the lumen.
Catheter blockage: When the catheter is partially clogged, you can use urokinase 1000IU/ml, 3-5ml to seal the tube for 3-5h, after the thrombus dissolves, pull back forcefully, if you see blood return, discard the blood 3-5ml, connect the infusion needle Flush the tube and do not inject the thrombus into the blood vessel.