跳到主要內容

[Clinical] Endotracheal Intubation\LMA\Central Venous Catheterization

Endotracheal Intubation
Purpose:build a liable airway for supplying air to patients' Lung.
Contraindication:
step1: call patient's name and then check conscious, airway, breathing.
step2(Give some air): 口咽撐開器+mask+ambu bag

LMA


Central Venous Catheterization
Purpose:build a liable tube to monitor vital signs and give some medicine or the entrance of operation.
Contraindication:Infection, thrombosis
step1: wear aseptic dress, operative glove.
step2: disinfect and set aseptic package.
step3: find the trangle circled by the Sternoclavicle muscle.vein is outside, and artery is inside.(at Femor, vein is inside) Put the needle at the lateral side of the middle form the line of ear and sternum.
step4:

留言

這個網誌中的熱門文章

外科腸胃道疾病照護

手術前 NPO 手術後 減壓引流管 Decompression - NG decompression  pressure:? - J-P drain - Hemovac drain 引流管 - Foley-sump drain:一般不用負壓引流,採free drainage     臨床經驗,負壓引流無特別情況, 術後照護重點: 1. 適當引流及腸胃道減壓 2. 營養建立:需長期靜脈營養? 七天以上無法給予腸胃道。                         PPNLP\PPNNP\TPN

[Phsiology] 溶液滲透度osmolaluty & osmolarity

Osmolarity is a measure of the osmoles of solute per liter of solution, while the osmolality is a measure of the osmoles of solute per kilogram of solvent . from http://en.wikipedia.org/wiki/Osmolarity Plasma osmolality Plasma osmolality is a measure of the concentration of substances such as sodium , chloride , potassium , urea , glucose , and other ions in human blood . It is calculated as the osmoles of solute per kilogram of solvent. Normal osmolality in plasma is about 280 - 303 milli-osmoles per kilogram. It is affected by changes in water content. To calculate plasma osmolarity (osmolality) use the following equation: P osm = 2[Na + ] + [Glucose]/18 + [ BUN ]/2.8 The above equation holds true if the glucose & ureas blood chemistry units are given as: mg/dL. If the units are given as: mmol/l; then the calculated osmolality is given by: P .OSM = 2[NA] + 2[K+] + [Urea] + [Glucose] Osmolality can be measured on an analytical instrument called an Osmometer.

[Gastroenterology] 消化道疾病與內視鏡手術

本文內容: (1)整個內視鏡之診療 (2)上消化系統內視鏡 A 食道 B 胃 C ERCP (3)大腸鏡 (4)腹腔鏡 (5)小腸鏡 (6)內視鏡超音波EUS (7)出血Hemostasis (a)急性非曲張性出血Acute nonvariceal bleeding(潰瘍性) (b)肝門脈高壓性出血Portal hypertensive bleeding(高壓性) (8)消化道擴張和固定GI tract dilatation and stent insertion (9)Enteral Access (10)ERCP (11)Tumor resection --------------------------------------------------- 上消化系統內視鏡手術 UGI System Endoscopy 定義 Def :從嘴巴>食道>胃>十二指腸第二段(肝胰壺腹) by Harrison 食道Esophageal Varices GERD Esophageal Varices GERD Los Angeles Classification (1) Grade A, one or more mucosal breaks no longer than 5 mm, none of which extends between the tops of the mucosal folds; (2) Grade B, one or more mucosal breaks more than 5 mm long, none of which extends between the tops of two mucosal folds; (3) Grade C, mucosal breaks that extend between the tops of two or more mucosal folds, but are not circumferential; (4) Grade D, one or more circumferential mucosal breaks. Grade A 單個或多個長度<5mm div="