Usayizi We-Cannula Ye-IV Yabantu Abadala: Ungayikhetha kanjani efanele?

Isingeniso

Ukukhetha i-cannula ye-IV kuyikhono elibalulekile ekusebenzeni kwezokwelapha elithinta ngqo imiphumela yesiguli, induduzo, kanye nokusebenza kahle kokwelashwa. Ezigulini ezindala, ukukhetha usayizi we-cannula ofanele kuncike ezintweni eziningi kufaka phakathi usayizi wemithambo yegazi, isimo sezokwelapha, kanye nenhloso yokukhipha i-cannula. Lo mhlahlandlela unikeza ochwepheshe bezempilo ulwazi olubalulekile mayelana nosayizi we-cannula ye-IV yabantu abadala, amazinga okugeleza, kanye nezindlela zokukhetha ezisebenzayo.

Ubukhulu kanye Nemininingwane Ye-Cannula Ejwayelekile Ye-IV

Uhlelo lokulinganisa lulinganisa ububanzi be-cannula ye-IV, kanti izinombolo eziphansi zibonisa ama-cannula amakhulu aletha amazinga aphezulu okugeleza. Nazi osayizi abajwayelekile abasetshenziswa ezigulini ezindala:

 
Ukuqonda Amanani Okugeleza

Izinga lokugeleza limelela umthamo woketshezi olungadlula ku-cannula ngomzuzu, olulinganiswa ngamamililitha ngomzuzu (mL/min). Usayizi wegeji uthonya ngqo umthamo wokugeleza—amageji amakhulu aletha amazinga okugeleza aphezulu kakhulu. I-cannula engama-gauge angu-14 ingaletha cishe ama-240 mL/min, kuyilapho i-gauge engama-22 iletha ama-35 mL/min kuphela. Lobu budlelwano bulandela isimiso sokuthi ububanzi be-catheter obukhulu buholela ekwandeni kwamazinga okugeleza, okubalulekile ekuqondeni ukusetshenziswa kwemitholampilo.

Amazinga okugeleza nawo athintwa yizici ezengeziwe ezingaphezu kosayizi wegeyiji, okuhlanganisa ukuphakama okubekwe ekufakweni, uhlobo loketshezi, kanye nomfutho wegazi wesiguli. Isibonelo, uketshezi oluningi oluqinile njenge-hetastarch lubonisa amazinga okugeleza aphansi uma kuqhathaniswa nezixazululo ze-crystalloid ezifana ne-saline evamile.

Izicelo Zemitholampilo kanye Neziqondiso Zokukhetha

Izimo Eziphuthumayo Nezimo Ezibuhlungu

Ama-cannula angu-14-gauge ayisinqumo esikhethwayo eminyangweni yezimo eziphuthumayo nasezindaweni zokulimala lapho ukuvuselelwa koketshezi ngokushesha kubaluleke kakhulu. Lawa ma-cannula amakhulu avumela amazinga aphezulu okugeleza kwegazi, okwenza kube lula ukunikezwa okusheshayo kwemikhiqizo yegazi, imithi, kanye nezixazululo ze-crystalloid phakathi nezimo ezibucayi.

Ukuhlinzwa Nokunakekelwa Okubucayi

Ama-cannula angu-16-gauge kanye nama-gauge angu-18 anconywa ezindaweni zokuhlinzwa kanye nokunakekelwa okujulile. I-gauge engu-16 inikeza ikhono lokushintsha umthamo ngokushesha ngesilinganiso sokugeleza esingu-180 mL/min, kuyilapho i-gauge engu-18 inikeza indlela elinganiselayo ngesilinganiso sokugeleza esingu-90 mL/min, esifanele kokubili ukuhanjiswa koketshezi kanye nokumpontshelwa igazi.

Ukumpontshelwa Igazi

Ama-cannula angama-gauge angu-18 kuya kwangu-20 akhethwa kakhulu ekumpompelweni kwegazi ukuze kuvinjelwe i-hemolysis nokuqinisekisa ukugeleza kwegazi okuphumelelayo. I-gauge engu-18 ingcono kakhulu uma kudingeka ukumpontshelwa okusheshayo, kuyilapho i-gauge engu-20 isamukeleka ekumpompelweni kwegazi okuvamile ngokwemigomo yezikhungo.

Ukusetshenziswa Kwesibhedlela Okuvamile

Ezimweni ezijwayelekile zasesibhedlela ezidinga ibhalansi phakathi kokulethwa koketshezi kanye nenduduzo yesiguli, ama-cannula angu-18-gauge noma angu-20-gauge ayizinketho ezijwayelekile. Lawa masayizi amukela imithi eminingi ejwayelekile ye-IV kanye noketshezi ngenkathi enciphisa ukungakhululeki kwesiguli futhi enciphisa izingozi zezinkinga.

Iziguli Ezikhulile Nezibuthakathaka Zemithambo Yemithambo

Ama-cannula angama-22-gauge kanye nama-24-gauge anconywa iziguli ezindala ezinemithambo ebuthakathaka noma okunzima ukuyifinyelela. Lawa ma-gauge amancane anciphisa ukulimala kwemithambo kanye nezinkinga, okwenza kube kuhle kubantu asebekhulile, yize enciphisa amandla okugeleza kwegazi uma kuqhathaniswa nosayizi omkhulu.

Indlela Yokukhetha I-IV Cannula Efanele

Ukukhetha i-cannula efanele kudinga ukuhlolwa kwezici eziningana zezokwelapha:

Ukuhlolwa Kwemithambo Yesiguli:Hlola usayizi wemithambo, isimo, kanye nokufinyeleleka kalula. Imithambo emikhulu negqamile ingamukela ama-cannula amakhulu, kuyilapho imithambo emincane noma ebuthakathaka idinga osayizi abancane.

Isimo Sezokwelapha:Cabanga ngokutholakala kwesiguli kanye nokuphuthuma kokwelashwa. Izimo eziphuthumayo zidinga ama-gauge amakhulu ukuze kunikezwe ngokushesha, kuyilapho iziguli ezizinzile zingasebenzisa osayizi abancane.

Inhloso Ehlosiwe:Nquma ukuthi i-IV ingeyemithi ejwayelekile, ukuvuselelwa koketshezi, imikhiqizo yegazi, noma ukuphathwa kokungafani. Ukumpontshelwa igazi kanye nezifundo zokungafani ngokuvamile kudinga ama-cannula angu-18-20 gauge.

Iminyaka Yesiguli kanye Nesimo Sempilo:Iziguli esezikhulile, lezo ezinezimo ezingamahlalakhona, noma lezo ezama kaningi nge-IV ziyazuza ekukhethweni ngokucophelela kwegeji ukuze kuncishiswe umonakalo wemithambo yegazi.

Izimiso Zezikhungo: Njalo qinisekisa ubukhulu be-IV obukhethwa yisikhungo sakho kanye neziqondiso, njengoba izimiso ziyahlukahluka phakathi kwezikhungo.

Izinto Ezicatshangelwayo Zomtholampilo

Uhlelo lokubhala imibala lusebenza njengesici esibalulekile sokuphepha, okuvumela abahlinzeki bezempilo ukuthi babone ngokushesha ubukhulu be-cannula futhi banciphise ingozi yamaphutha ezindaweni zemitholampilo. Lokhu kulungiswa kuthuthukisa ukusebenza kahle komsebenzi futhi kusekela ukwenza izinqumo ngokushesha ezimweni ezibucayi ngesikhathi.

Ukukhetha usayizi we-IV cannula ofanele kuqinisekisa imiphumela emihle yezokwelapha, kuthuthukisa induduzo yesiguli, kunciphisa izinkinga, futhi kusekela ukulethwa kokwelashwa okuphumelelayo. Kungakhathaliseki ukuthi kusemsebenzini ojwayelekile noma ezimweni eziphuthumayo, ukuqonda kahle kanye nokusetshenziswa kwezimiso zokukhetha i-IV cannula kudlala indima ebalulekile ekunakekelweni kwesiguli okuphumelelayo.

Ochwepheshe bezokunakekelwa kwempilo kufanele babuyekeze njalo lezi ziqondiso kanye nezinqubo zezikhungo ukuze balondoloze ikhono ekukhetheni nasekubekeni i-IV cannula.