Clinical Scenario Daim Ntawv Thov Thiab Kev Ua Haujlwm Yooj Yim Ntawm Intraosseous Koob

Intraosseous koob, raws li cov cuab yeej tshwj xeeb txhaj tshuaj thiab cov twj tso kua mis rau kev nkag mus rau cov hlab ntsha thaum muaj xwm txheej ceev, muaj cov xwm txheej dav dav heev, suav nrog cov tsev kho mob xwm txheej ceev, cov chaw saib xyuas mob hnyav, ua ntej- tsev kho mob thawj zaug, kev cawm dim, kev kho mob kev puas tsuaj thiab kev saib xyuas menyuam yaus. Hauv kev kho mob ib txwm muaj, venous infusion yog txoj hauv kev tseem ceeb ntawm kev xa tshuaj, tab sis nyob rau hauv cov xwm txheej tseem ceeb xws li kev raug mob hnyav, hypovolemic shock, sepsis thiab plawv nres, peripheral venous hlab ntsha tawg sai, thiab qhov ua tiav ntawm cov pa venipuncture yog qhov tsawg heev, uas yuav ncua sij hawm cawm tau zoo tshaj plaws. Intraosseous infusion technology zoo kawg nkaus daws qhov mob qhov mob no, thiab cov koob intraosseous tau dhau los ua cov cuab yeej tseem ceeb hauv kev kho mob xwm txheej ceev.

Hauv cov xwm txheej kho mob hauv menyuam yaus, 1.5cm 15G pediatric intraosseous koob daws qhov kev lag luam mob ntawm qhov nyuaj venipuncture hauv cov menyuam yaus. Cov menyuam yaus muaj cov hlab ntsha nyias nyias, kev ua haujlwm ntawm lub cev thiab kev sib koom tes tsis zoo, thiab rov ua venipuncture yog ib qho yooj yim ua rau cov ntaub so ntswg puas thiab kev ntxhov siab hauv cov menyuam yaus. Cov menyuam yaus- tshwj xeeb koob luv luv lub cev yog tsim los rau cov menyuam yaus hnub nyoog qis dua 40kg, nrog qhov tseeb qhov tob thiab siab ib - lub sijhawm ua tiav, uas tuaj yeem tsim kom muaj cov dej ntws sai sai, txo qis kev ua haujlwm dua, thiab txhim kho kev ua tau zoo thiab kev nyab xeeb ntawm kev kho mob thaum muaj xwm txheej ceev. Nws yog dav siv nyob rau hauv cov menyuam yaus poob siab, mob hnyav, lub cev qhuav dej thiab lwm yam kev kho mob tseem ceeb.

Hauv daim ntawv thov kev kho mob rau cov neeg laus, 2.5cm pa intraosseous koob yog haum rau feem ntau cov tub ntxhais hluas thiab cov neeg laus cov neeg mob, npog cov neeg coob coob tshaj 40kg thiab tsis- cov neeg laus rog. Nws yog thawj zaug - cov cuab yeej pab rau cov neeg laus cawm thaum muaj xwm ceev. Rau cov neeg laus rog rog uas muaj lub cev tshwj xeeb, cov neeg ua haujlwm kho mob tuaj yeem xaiv cov tswv yim ua haujlwm hloov pauv raws li qhov xwm txheej tiag tiag: thaum tus neeg mob lub tibial tuberosity palpable thiab subcutaneous rog txheej tsis tuab heev, cov koob 2.5cm yog siv tau rau tibial intraosseous infusion; Rau cov neeg mob rog rog nrog cov roj tuab thiab cov pob txha tsis paub meej, 4.5cm ntev intraosseous koob yog sib npaug los xyuas kom meej qhov ua tau zoo thiab ruaj khov infusion.

Qhov kev hloov pauv hloov tau siv hom ntawm ntau qhov tshwj xeeb zoo heev txhim kho qhov hloov pauv ntawm cov koob intraosseous hauv cov xwm txheej kho mob nyuaj. Txawm hais tias nws yog menyuam yaus thaum muaj xwm txheej ceev, cov neeg laus niaj hnub pab thawj zaug lossis tshwj xeeb kev pabcuam tus neeg mob rog, cov khoom siv koob txhaj tshuaj serialized tuaj yeem muab cov kev daws teeb meem raug. Nyob rau tib lub sijhawm, kev sib koom ua ke 15G caliber ua kom muaj kev sib raug zoo ntawm cov raj xa dej thiab cov khoom siv, txo cov kev ua haujlwm nyuaj ntawm cov neeg ua haujlwm kho mob, thiab tsim nyog rau kev ua haujlwm ceev hauv siab -xwm txheej xwm txheej ceev, uas yog vim li cas serialized intraosseous koob tau dav lees paub los ntawm kev lag luam kho mob xwm txheej ceev thoob ntiaj teb.