Ngozi Dzakabatana Nekuiswa uye Kushandiswa kweCentral Lines
Mutsara wepamusoro ndiwo rudzi rwekateti inowanikwa mumhangura huru iyo inobvumira maruva akawanda emvura kuti apiwe uye ropa rinofanira kuwedzerwa. Kana ichienzaniswa nemutsetse wemuchina, rutivi rwepamusoro hukuru, runogona kugara munzvimbo yakareba kwenguva refu, runogona kununura huwandu hwemvura uye hunoita kuti ropa riwedzere nyore. Mutsara wepamusoro unogona kushandiswawo kuyera kufanana kwehuwandu hwehuwandu hwehuwandu hwehuwandu hwemhepo, uye kubatsira kubvisa kana murwere ane mvura yakasviba kana kuti akagamuchira huwandu hunokwana hwemvura kunotsigira mabasa epanyama.
PICC mutsara , rudzi rwekuwanikwa kweV IV runogona kuchengetwa kwemavhiki nemwedzi, haisi mutsara wepamusoro asi hugovera huzhinji hunhu nehuwandu hweHIV.
Nei Chikuru Chakashandiswa?
Nheyo huru inogona kuiswa kune zvikonzero zvakawanda. Mutsara wepamusoro unogona kusvika kusvika kumagetsi mashanu, ayo ari mazamu ayo mvura inogona kuiswa, ropa rinogona kutorwa kana zviyero zvingatorwa. Kana murwere achida kushandiswa kwemvura, zvinoreva kuti yakawanda yemvura inopisa inofanira kupiwa, iyo inogona kuiswa mukati mokubvumira kushanduka kwemvura kunomhanya nokukurumidza.
Mitsara yeCentral inogona kushandiswa kuisa ropa zvakare. Mune zvimwe zviitiko, zviviri zvechiedza pamusiya wepakati zvinogona kushandiswa kuita dialysis, neine lumen inoshandiswa kutora ropa kubva mumavhesiyumu uye imwe lumen inoshandiswa kudzorera ropa dialyzed kumuviri. Kune varwere vanoda kuwedzerwa ropa vanoenda kunotumirwa ku laboratori, ruzivo rwepamusoro runobvumira kuti ropa riwedzere risina "kuramba rakanamatira" murwere.
Rimwe basa rakasiyana nedzimwe ruzivo rwakakosha ndiko kukwanisa kuisa mukati mekumanikidzwa kwevhu. Ichi chiyero chinopa sangano rehutano hwehutano kunzwisisa kuti inguva yakawanda sei mumvura yevascular, uye kana murwere agamuchira zvakawanda kana zvishoma zvishoma mvura.
Kana rutivi rwakakosha iCenner-Ganz type catheter, chirwere chepineti chinogona kuwanika zvakare, chinogona kuratidza nenzira isina kuratidza kuti kusvibiswa kwero kwemoyo kunoshanda sei.
Kune varwere vane pfungwa dzakakomba dzemwoyo kana kushanda kwemoyo munguva pfupi, ruzivo urwu runogona kuva rukuru kwazvo.
Mutsara wepamusoro unofanirwawo kana chirwere chenguva refu chichitarisirwa, sevhiki vemachina maitiro ekurapa maantibioti, kana kuti mishonga inonyadzisa inodiwa isingagoni kupiwa kuburikidza nehuwandu IV, yakadai sedhemotherapy .
Kuiswa kweCentral Line
Kuti uise mutsara wepamusoro, murwere anofanira kunge akarara pasi, uye nzvimbo yemuviri umo mutsetse wepakati uchanyorwa unoratidzwa. Mitsetse yakawanda inoshandiswa pakuiswa kwepakati pepamusoro inonzi jugular mukati mumutsipa, mutsara we subclavia pedyo ne clavicle, uye mhombwe yevakadzi mumugwagwa.
Murwere anovharwa, kazhinji kubva pamusoro kusvika kunewe, ane bhata rakaoma. Iyo yakagadzirwa yakashata mapepa epurasitiki ine gomba mukati mayo kuitira kuti munhu aise mutsara wepakati kupinda kune mutsva. Iyo yakasvibiswa yakagadzirirwa kubatsira kubatsira kuderedza njodzi yehutachiona, uye zvidzidzo zvakaratidza kuti kufukidza muviri wose, pane kungova nzvimbo iyo iyo kati iyo ichaiswa, ndiyo ndiyo nzira yakanakisisa yekudzivirira utachiona.
Kamwe kana murwere akavharwa, nzvimbo yeganda inocheneswa. Kana murwere akasvinuka, nzvimbo yeganda ingangodaro ichinyatsogadziriswa nehutano hwemunharaunda .
Kushandisa nzira isina kuchena, catheter inovhara inobva yaiswa muhombodo, inowanzoshandisa ultrasound kuti iwane iyo yakakodzera yomuropa. Iyo catheter inogadziriswa panzvimbo, kana chigadziro chinotsigirwa chinoshandiswa kubata catheter ichiri panzvimbo yekuisa nzvimbo.
Nharaunda yacho inobva yashambidzwa zvakare nesiriseptic uye kupfeka kusina kuiswa kunoiswa panzvimbo yekuisa, uye chiedza chinowanikwa. Kuiswa kwecatheter kunofanira kusimbiswa uchishandisa x-ray pamberi pemutsetse wepamusoro unogona kushandiswa, kuti usapinda mungozi kupindira mishonga muviri kana kuti zvisina kunaka mudziyo. Mune zvimwe zviitiko, catheter inogona kunge iri mumudziyo wakakodzera, asi inoda kugadziriswa zvishoma nokuti catheter iri kure kwazvo mumudziyo kana kwete kure zvakakwana.
Central Line-Associated Bloodstream Infection (CLABSI)
Chimwe chezvipingamupinyi zvepakati pekuisa mutsara uye kushandiswa inopa ropa. Kuti ubatsire kudzivirira utachiona , tsika dzakanaka dzakagadzirwa dzakashandiswa. Iyi miitiro inosanganisira yakagadziriswa kupfeka kushanduka kushanduka, kushandiswa kwemuviri wose usina kuchena panguva yekuiswa kwemutsara, kubvisa mutsara pakarepo zvisingachadiwi, uye kungoisa mitsetse mikuru iyo inonyanya kukosha.
Mitsara yeCentral inowanzoiswa kumusoro kwechiuno kana zvichibvira kuderedza ngozi yehutachiona. Mhuri dzevakadzi dzinosangana nehupamhi hwehutachiona. Kupfekedzwa kwakaiswa pamusoro penzvimbo yekuisa iyo inowanzojeka, iyo inobvumira terevhizheni yehutano kutarisa zviratidzo zvehutachiona pasina kuisa nzvimbo yekuisa kune imwe nzvimbo kupfuura zvinonyanya kukosha.
Ngozi dzeCentral Line
Pane zvipingamupinyi zvinosanganiswa nekuiswa kwepakati, iyo inofanirwa kuyerwa pamusoro pekudiwa kwevarwere kwezera. Utachiona ndiyo ngozi yakawanda yepakati, pamwe nedzimwe njodzi dzinosanganisira pneumothorax (kuputika mapapu), kunyanya kana nheyo huru iri kuiswa mumusana we subclavia, iyo inobatwa nebhokisi rebhokisi kana zvichidiwa.
Munguva yekuiswa kweimwe mhando dzemitsara yakadzika, mwoyo unogona kutsamwiswa nehutsika apo mutsara unofamba uchienda mumidziyo yeropa pedyo nemwoyo, zvichiita kuchinja mumhanzi wepfungwa. Izvi zvinowanzogadzirisa nekugadziriswa kwakakodzera kwemutsetse asi zvinogona kudikanwa mishonga kune vamwe vanhu vashoma.
Chimwe chirevo chekupedzisira chemiganhu yepakati inobatana nemhepo, mamiriro apo mweya unopinda maitiro epascular uye unotanga kufamba nemuviri. Ichi chiitiko, icho chakanyanya kuoma, chakanyanyawo kushoma uye zvikuru chinodzivirirwa.
Shoko Rinobva:
Mutsara wepamusoro unobatsira zvikuru apo murwere anorwara, asi haisi pangozi. Kune varwere vazhinji, kubatsirwa kwokusava ne "tsitsi" dzakawanda kweropa kunotora uye kuva nechivimbo chinowanikwa mukati mune nzvimbo chakanyanya kudarika ngozi dzinowanikwa nenzira iyi yekuwana.
Kune vamwe varwere, nheyo yepamusoro inoita kuti zvipatara zvirambe zvichitakura, asi vamwe vasingatambudzi neropa zvinoswededza uye vanosarudza kudzivisa zvinetso zvinogona kuitwa nechepamusoro.
> Kwakabva:
> Central > Line-Associated > Bloodstream Infection. California Department of Health.