血管通路器材选择课件

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,MC-PP-349,BAS Confidential and Proprietary.For Internal Educational Purposes Only,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,推进人类健康事业的进步,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,An Overview of,Vascular Access,Devices,And Early Assessment,血管通道器材概述以及合理选择,巴德 宁海燕 新疆区域大客户经理,An Overview of Vascular Access,Types of Venous Catheters,静脉导管类型,PIV:peripherally intravenous catheter,Very short term(days),外周静脉导管,短期（天）,Midline catheterLonger term than PIV(weeks),中线导管,长于,PIV,（周）,Peripherally inserted central catheter:PICC(up to one year),外周插管的中心导管：,PICC,（最长,1,年）,Centrally inserted central venous catheter:CVC or CICC,中心插管的中心静脉导管：,CVC,或者,CICC,Long term(years):Tunneled,cuffed,Short term(days to weeks):Non-tunneled,“acute”CVC,non-cuffed,长期（年）：隧道式，套袖式,短期（数日至数周）：无隧道，“短期”,CVC,，无套袖,Types of Venous Catheters静脉导管,General Overview:Types of Devices,概览：产品类型,PIV,外周静脉导管,No BAS direct products,BAS,没有相关产品,PICC Lines,经外周植入的,PICC,导管,Triple,Power,Valved,Non-Valved,Silicone,Polyurethane,三腔，耐高压注射，有瓣膜，无瓣膜，硅胶，聚氨酯,CVC,中心静脉导管,Hickman*,Groshong*,Broviac*,PowerLine*,and PowerHohn*Catheters,PORTs,植入式输液泵型中心静脉导管,Chest,Double,Single,Arm,Power,胸部，双腔，单腔，手臂，高压注射,General Overview:Types of Dev,Complications of PIVs,Bleeding,Vein injury,Nerve injury,Infiltration,Phlebitis,Thrombosis,Infection,外周静脉导管的并发症,出血,静脉损伤,神经损伤,渗液,静脉炎,血栓形成,感染,Complications of PIVsBleeding,Peripheral IVs:Poor Outcomes,外周静脉导管：效果差,Peripheral IVs:Poor Outcomes外,Midline Catheters,Overview,概要,Placed in the upper arm or antecubital fossa,置于上臂或肘窝,Tip resides in peripheral vein,usually the axillary vein,and does not enter the central vasculature,头端位于外周静脉，一般为腋静脉而不可使其进入中心血管,NOT a central line,不是中心静脉导管,中线导管,Midline CathetersOverview概要中线导,Midline Catheters,Advantages,Longer dwell than PIV,No chest x-ray required,Complications,Occlusion,Phlebitis,DVT,Identification of complications may be delayed,Often confused for a central line,Less hemodilution,not appropriate for pH extremes or hyperosmolar solutions,中线导管,优势,留置时间长于外周静脉导管,无需进行胸片检查,并发症,导管堵塞,静脉炎,深静脉血栓形成,可能延迟的并发症诊断,常被误用作中心静脉导管,血液稀释作用轻微，不适用于极端,pH,值和高渗的静脉输液,Midline CathetersAdvantages中线导,Peripherally Inserted Central Catheter(PICC),Call Point,IV/PICC Nurse,Interventional Radiologist(IR),ICU,Insertion,Upper arm preferred,Bedside or IR,U/S and MST are best practice,BAS products,Per-Q-Cath*PICC,Poly Per-Q-Cath*PICC,Poly RadPICC*catheter,PowerPICC*catheter,PowerGroshong*PICC,Groshong*PICC,PowerPICC SOLO*catheter,使用者,IV/PICC,护士,放射,介入医师（,IR,）,重症监护室,插管,优先选择上臂,床旁或放射介入科置管,U/S,和,MST,是最佳方法,BAS,产品,Per-Q-Cath*PICC,Poly Per-Q-Cath*PICC,Poly RadPICC*,导管,PowerPICC*,导管,PowerGroshong*PICC,Groshong*PICC,PowerPICC SOLO*,导管,Peripherally Inserted Central,Overview:PICC LinesPICC,导管概述,PICC,:Peripherally Inserted Central Catheter,PICC,：外周插管的中心静脉导管,IS a Central Line,属于中心静脉导管,Can be used for delivery of any infusate,including those intended for central venous delivery,能够用于输送任何药物，包括那些需经中心静脉输送的药物,incompatible medications,不相容的药物,pH extreme medications,极端,pH,值的药物,Hyperosmolar medications,高渗性的药物,Vesicant and irritant meds,发泡剂及刺激性的药物,Reliable means for blood sampling,可靠的采血方法,Can be placed by a nurse at the bedside,可由护士在床旁放置,Overview:PICC LinesPICC导管概述P,优势,途径可靠,可在床旁放置,并发症,阻塞,感染,机械性静脉炎,血栓,Peripherally Inserted Central Catheter(PICC),Advantages,Reliable access,Can be placed at bedside,Complications,Occlusion,Infection,Mechanical Phlebitis,Thrombus,Central Venous Injury,优势Peripherally Inserted Centra,Central Venous Catheters:CVCs,中心静脉导管,Overview,概要,Inserted percutaneously by MDs,possibly RNs in the future,由医生经皮插管，可能未来由,RN,执行,Placed in internal jugular,subclavian or femoral vein,可放置在颈内静脉、锁骨下或股静脉,Intended for short term dwell(7-10 days),适用于短期使用（,7-10,天）,CRBSI rates vary by site of placement,在所有,VAD,中的,CRBSI,率最高,Commonly placed in ICU/CCU with complex,critically ill patients,多用于,ICU/CCU,中病情危重患者,Can be placed emergently,可急性放置,Central Venous Catheters:CVCs,Complications,并发症,Insertion related:,植入相关：,Pneumothorax,气胸,Arterial puncture,误穿动脉,Nerve damage,神经损伤,Post insertion:,植入后,Infection,感染,Accidental removal,意外脱出,B