想了很久才記起來～以前我都叫它Double lumen，在這是Venous catheter 這照片是我同事在拔管的時候，拉出了三公分之後就整個卡住，我也不敢硬扯怕大噴血，最後只好打電話跟洗腎室護理長求救，因為周遭只有我拔過ven cath，連我都不敢用力拉，真的也沒人敢了，還好阿長很快就下來救火，乾淨俐落的咻咻就拔出來了～趕快拍張照做紀念 XD 在這裡很多我們所認知的進階技術都是由RN做的，當然是要有醫生醫囑先啦～像是拔CVC, ICC (chest tube), Pacing wires, Bellovac drain, 拆線等等，在ICU連Endo也是RN拔，非常酷，一開始上班的時候，小編還傻傻的，醫生說可以拔管，我還備好料要給醫生用，後來是我同事說～這些都是自己要拔的...........我嚇呆了！！！！只好先看醫院的protocol，再請同事帶我做一次，後來...........我愛上了拔管這個動作，連病人都感覺的出來我很興奮，甚至還有不少人稱讚我綁線拆線的技術很有當surgeon的潛力 哈哈 澳洲賦給RN很多權力，當然相對的責任也比較大。醫生病人相信你的能力，自然就會給你更多的尊重，也會放心把責任交給你。但有時候他們已經對我放心到～看完我的病人之後的下一句是：You know what to do, right :) ＯＫ～廢話到此....還是要介紹一下 Venous catheter A venous catheter is a tube inserted into a vein in the neck, chest, or leg near the groin, usually only for short-term hemodialysis. The tube splits in two after the tube exits the body. The two tubes have caps designed to connect to the line that carries blood to the dialyzer and the line that carries blood from the dialyzer back to the body. A person must close the clamps on each line when connecting and disconnecting the catheter from the tubes. If kidney disease has progressed quickly, a patient may not have time for placement of an AV fistula or AV graft before starting hemodialysis treatments. Venous catheters are not ideal for long-term use. With a venous catheter, a patient may develop a blood clot, an infection, or a scarred vein, causing the vein to narrow. However, if a patient needs to start hemodialysis right away, a venous catheter will work for several weeks or months until a surgeon can perform a long-term access surgery and the AV fistula or AV graft has time to mature. Venous catheters are the most likely to cause infection and clotting problems. If these problems develop, medication may help. Antibiotics are medications that fight bacteria that can cause infection. Blood thinners such as warfarin keep blood from clotting. If these treatments fail, a nephrologist or an interventional radiologist will need to replace the catheter.
Posted on: Tue, 16 Sep 2014 11:10:01 +0000
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