Ubungakanani beCannula ye-IV yabantu abadala: Ungayikhetha njani efanelekileyo?

Intshayelelo

Ukukhetha i-IV cannula sisakhono esibalulekileyo kwindlela yokwenza unyango esichaphazela ngokuthe ngqo iziphumo zesigulana, intuthuzelo, kunye nokusebenza kakuhle konyango. Kwizigulane ezindala, ukukhetha ubungakanani be-cannula efanelekileyo kuxhomekeke kwizinto ezininzi kubandakanya ubungakanani bemithambo yegazi, imeko yezonyango, kunye nenjongo yokukhupha i-cannula. Esi sikhokelo sinika iingcali zezempilo ulwazi olubalulekileyo malunga nobukhulu be-IV cannula yabantu abadala, amazinga okuhamba kwegazi, kunye neendlela zokukhetha ezisebenzayo.

Ubungakanani beCannula eqhelekileyo kunye neenkcukacha

Inkqubo yokulinganisa ilinganisa ububanzi be-IV cannula, amanani aphantsi abonisa ii-cannula ezinkulu ezinika amazinga aphezulu okuhamba kwamanzi. Nazi iisayizi eziqhelekileyo ezisetyenziswa kwizigulane ezindala:

 
Ukuqonda Amanqanaba okuhamba

Izinga lokuhamba kwamanzi limela umthamo wolwelo olunokudlula kwi-cannula ngomzuzu, olulinganiswa ngee-milliliters ngomzuzu (mL/min). Ubungakanani begeyiji buchaphazela ngokuthe ngqo umthamo wokuhamba kwamanzi—iigeyiji ezinkulu zibonelela ngamanani aphezulu okuhamba kwamanzi. I-cannula ye-gauge eyi-14 inokukhupha malunga ne-240 mL/min, ngelixa i-gauge eyi-22 ikhupha i-35 mL/min kuphela. Olu lwalamano lulandela umgaqo wokuba ububanzi be-catheter obukhulu bukhokelela kwizinga lokuhamba kwamanzi elonyukayo, nto leyo ebalulekileyo ekuqondeni ukusetyenziswa kweklinikhi.

Amanqanaba okuhamba kwamanzi achatshazelwa zizinto ezongezelelweyo ezingaphaya kobukhulu begauge, kubandakanya ukuphakama okumiselweyo kokufakwa, uhlobo lolwelo, kunye noxinzelelo lwegazi lomguli. Umzekelo, ulwelo oluninzi oluqinileyo olufana ne-hetastarch lubonisa amazinga okuhamba kwamanzi aphantsi xa kuthelekiswa nezisombululo ze-crystalloid ezifana ne-saline eqhelekileyo.

Izicelo zeKlinikhi kunye neMigqaliselo yoKhetho

Iimeko ezingxamisekileyo nezeNgxaki

Ii-cannula ze-14-gauge zezona zikhethwayo kwiindawo ezingxamisekileyo nakwiindawo ezenzakalayo apho ukuvuselelwa kolwelo ngokukhawuleza kubaluleke kakhulu. Ezi cannula zinkulu zivumela amazinga aphezulu okuhamba kwegazi, ziququzelela ukuhanjiswa ngokukhawuleza kweemveliso zegazi, amayeza kunye nezisombululo ze-crystalloid ngexesha leemeko ezinzima.

Utyando kunye noNyango oluBalulekileyo

Ii-cannula ze-16-gauge kunye ne-18-gauge ziyacetyiswa kwiindawo zotyando kunye nezononophelo olunzulu. I-16-gauge inika amandla okutshintsha umthamo ngokukhawuleza ngesantya sokuhamba se-180 mL/min, ngelixa i-18-gauge inika indlela elungeleleneyo ngesantya sokuhamba se-90 mL/min, efanelekileyo kokubili ekunikezelweni kolwelo kunye notofelo-gazi.

Utofelo-gazi

Ii-cannula ze-18-gauge ukuya kwi-20-gauge zikhethwa kakhulu xa kufakwa igazi ukuthintela i-hemolysis nokuqinisekisa ukuhamba kakuhle kwegazi. I-18-gauge yeyona ifanelekileyo xa kufuneka ukufakelwa igazi ngokukhawuleza, ngelixa i-20-gauge isamkelekile xa kufakwa igazi rhoqo ngokwemigaqo yesikhungo.

Ukusetyenziswa Kwesi sibhedlele rhoqo

Kwiimeko eziqhelekileyo zesibhedlele ezifuna ulungelelwano phakathi kokuhanjiswa kolwelo kunye nokuthuthuzelwa sisigulana, ii-cannula ze-18-gauge okanye ze-20-gauge ziyindlela eqhelekileyo yokukhetha. Ezi sayizi zilungele uninzi lwamayeza e-IV kunye nolwelo oluqhelekileyo ngelixa zinciphisa ukungonwabi kwesigulana kwaye zinciphisa umngcipheko weengxaki.

Izigulane zemithambo yegazi ekhulileyo nebuthathaka

Ii-cannula ze-22-gauge kunye ne-24-gauge ziyacetyiswa kwizigulane ezindala ezinemithambo ebuthathaka okanye enzima ukuyifumana. Ezi gauge zincinci zinciphisa ukwenzakala kwemithambo kunye neengxaki, nto leyo ezenza zibe zilungele abantu abadala, nangona zinciphisa amandla okuhamba kwegazi xa kuthelekiswa nobukhulu obukhulu.

Indlela yokukhetha i-IV Cannula efanelekileyo

Ukukhethwa kwee-cannula ngokufanelekileyo kufuna uvavanyo lwezinto ezahlukeneyo zonyango:

Uvavanyo lweMithambo yesigulana:Hlola ubungakanani bemithambo, imeko, kunye nokufikeleleka. Imithambo emikhulu nebonakalayo inokukwazi ukwamkela ii-cannula ezinkulu, ngelixa imithambo emincinci okanye ebuthathaka ifuna ubungakanani obuncinci.

Imeko yezonyango:Cinga ngokuxilongwa kwesigulana kunye nongxamiseko lonyango. Iimeko ezingxamisekileyo zifuna iigeyiji ezinkulu ukuze zisetyenziswe ngokukhawuleza, ngelixa izigulana ezizinzileyo zinokusebenzisa ubungakanani obuncinci.

Injongo Ecwangcisiweyo:Qinisekisa ukuba i-IV yeyesiqhelo na, ukuvuselelwa kolwelo, iimveliso zegazi, okanye ukunikezelwa kokungafani. Utofelo-gazi kunye nezifundo zokungafani zihlala zifuna ii-cannulas ze-18-20 gauge.

Ubudala besigulana kunye nemeko yempilo:Izigulane ezindala, ezo zineengxaki ezingapheliyo, okanye ezo zifumana iinzame ezininzi zokufaka i-IV ziyazuza ekukhethweni ngononophelo kwegeyiji ukunciphisa umonakalo wemithambo.

IiProtokholi zeZiko: Soloko uqinisekisa ubungakanani kunye nezikhokelo ze-IV ezikhethwayo zesikhungo sakho, njengoko iiprotokholi zahlukile phakathi kwamaziko.

Izinto eziqwalaselwayo kwiKliniki

Inkqubo yokubhala imibala isebenza njengophawu olubalulekileyo lokhuseleko, oluvumela ababoneleli bezempilo ukuba bachonge ngokukhawuleza ubungakanani be-cannula kwaye banciphise umngcipheko weempazamo kwiindawo zonyango. Olu hlengahlengiso luphucula ukusebenza kakuhle komsebenzi kwaye luxhasa ukwenziwa kwezigqibo ngokukhawuleza kwiimeko ezinobuzaza ngexesha.

Ukukhetha ubungakanani obuchanekileyo be-IV cannula kuqinisekisa iziphumo ezilungileyo zeklinikhi, kuphucula intuthuzelo yesigulana, kunciphisa iingxaki, kwaye kuxhasa ukunikezelwa konyango okusebenzayo. Nokuba kukwimisebenzi eqhelekileyo okanye kwiimeko ezingxamisekileyo, ukuqonda ngokufanelekileyo kunye nokusetyenziswa kwemigaqo yokukhetha i-IV cannula kudlala indima ebalulekileyo ekunyamekeleni isigulana ngempumelelo.

Iingcali zonyango kufuneka ziphinde zihlolisise le migaqo kunye neenkqubo zesikhungo ukuze zigcine ubuchule ekukhetheni nasekubekeni i-IV cannula.