Cateterizarea Venoasa Essay

2847 words - 11 pages

UMF "Iuliu Haţieganu" Cluj-Napoca Caiet de demonstraţii practice ATI, anul IV MG Catedra ATI II Caiet de demonstraţii practice ATI, anul IV MG UMF "Iuliu Haţieganu" Cluj-Napoca Catedra ATI II
Cateterizarea venoasăAbordul venos perifericPuncţia venoasă periferică este o manoperă elementară pe care orice medic, indiferent de specialitate şi orice asistent medical trebuie să şi-o însuşească.Abordul venos periferic poate să aibă două scopuri:recoltarea de sânge;administrarea de medicamente sau soluţii perfuzabile.Când este necesar un abord venos de scurtă durată (recoltarea de sânge), acesta se poate realiza cu ajutorul unui ac după care acul este retras.Dacă este necesar un abord venos mai îndelungat acesta se va realiza prin montarea unui cateter venos periferic (CVP): canulă de plastic cu mandren metalic care va fi retras după pătrunderea în venă, rămânând pe loc doar canula de plastic, canulă care poate fi menţinută chiar şi 2-3 zile în anumite condiţii (în funcţie de calitatea canulei: PVC, teflon, poliuretan) (Fig.1).CVP pot fi de diferite dimensiuni existând un cod de culoare în funcţie de grosimea cateterului. Dimensiunea canulei care urmează a fi montată va fi corespunzătoare calibrului venei.Cel mai frecvent abord este la nivelul membrelor superioare. Abordul la nivelul membrelor inferioare este utilizat în special la copil şi mai rar la adult datorită riscului de tromboflebită. Un abord deloc de neglijat şi extrem de util în urgenţă când nu se reuşeşte canularea venelor de la nivelul membrelor este cel de la nivelul venei jugulare externe. Poziţia Trendelenburg crescând presiunea venoasă în teritoriul cav superior permite o mai bună vizualizare a venelor jugulare externe (jugularele devin turgescente).La nou-născut abordul venos periferic se poate face uşor la nivelul venelor epicraniene. De asemenea în urgenţă abordul intraosos la nivelul tibiei poate fi folosit pentru resuscitare volemică până la montarea unui CVP.Fig.1. Cateterul venos periferic (CVP)Materiale necesare pentru puncţia venoasă periferică:tampoane sterile cu alcool sanitar;garou;ac de puncţie sau CVP, sterile;benzi adezive pentru fixarea canulei;ser heparinat pentru spălarea cateterului (10-20 ui heparină/ml ser fiziologic).Tehnica puncţiei venoase perifericepacientul va fi poziţionat în decubit dorsal;medicul va fi echipat cu mănuşi sterile;membrul ce urmează a fi puncţionat va fi poziţionat decliv (gravitaţia va accentua staza venoasă);se aplică garoul aproape de locul puncţiei. Plasarea garoului la...

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