I-Catheter Ephakathi Yemithambo
Izici Zomkhiqizo
● I-clamp eshukumayo ivumela ukunamathela endaweni yokubhoboza kungakhathaliseki ukujula kwe-catheter, okunciphisa ukulimala kanye nokucasuka endaweni yokubhoboza.
● Ukumaka ukujula kusiza ekubekweni kahle kwe-catheter yemithambo ephakathi kusukela kumthambo we-subclavian noma we-jugular wesokudla noma kwesobunxele.
● Iphuzu elithambile linciphisa ukulimala komkhumbi, linciphisa ukuguguleka komkhumbi, i-hemothorax kanye ne-cardiac tamponade.
● I-lumen eyodwa, ephindwe kabili, ephindwe kathathu iyatholakala ukuthi uyikhethe.
Imiyalelo yokusebenzisa
UKULUNGISELELA KWANGAPHAMBILI KWENQUBO
● Ukuhlolwa Kwesiguli: Qinisekisa inkomba kanye nokuqina kwemithambo yegazi (kunconywa i-ultrasound).
● Imishini: Ikhithi ye-CVC ehlanzekile (i-catheter, i-guidewire, i-dilator, i-sutures), umshini we-ultrasound, ama-drapes ahlanzekile, i-antiseptic (i-chlorhexidine/utshwala), i-local anesthetic (1–2% lidocaine).
INKQUBO YOKUFAKA
● Ukubeka Nokubulala Inzalo: Beka isiguli eTrendelenburg (esifubeni/esingaphansi kwesikhumba) noma silale phansi (esifubeni), bulala inzalo esikhumbeni nge-chlorhexidine engaphezulu kuka-0.5%.
● Ukufinyelela Emithanjeni: Sebenzisa indlela ye-Seldinger eqondiswa yi-ultrasound.
① Faka inaliti, ukhiphe igazi ukuze uqinisekise umthambo.
② Faka ucingo oluqondisa intambo, susa inaliti.
③ Vula umgudu, hambisa i-catheter ngentambo.
④ Susa ucingo, qinisekisa ukubuya kwegazi.
● Ukuvikela Nokubopha: Faka i-catheter yokuthunga + faka i-dressing esobala engenamagciwane. Qinisekisa ukuthi ibekwe nge-CXR (ithiphu ekuxhumaneni kwe-SVC/RA).
UKUNAKEKELWA NGEMVA KOKUFAKWA
● Ukuhlanza: Usawoti we-Heparinized (wokusetshenziswa ngezikhathi ezithile). Usawoti ongu-0.9% (ukufakwa okuqhubekayo).
● Ukushintsha Izingubo Zokugqoka: Njalo ezinsukwini eziyi-7 (ezikhanyayo) noma ezinsukwini ezi-2 (i-gauze).
● Ukuqapha Izinkinga: I-Pneumothorax, ukutheleleka, i-thrombosis.
Isicelo somkhiqizo
● Ukunakekelwa Okubucayi: Ukunikeza imithi, uketshezi, noma ama-vasopressor emayunithi okunakekelwa okujulile (ama-ICU).
● Ukwelashwa ngamakhemikhali: Ukuletha imithi yamakhemikhali noma eminye imithi yesikhathi eside.
● Ukudla Okunomsoco Kwabazali: Ukunikeza ukwesekwa kokudla okunempilo kweziguli ezingakwazi ukudla.
● I-Hemodialysis: Isebenza njengokufinyelela kwesikhashana kwemithambo yegazi ukuze kuhlanjululwe igazi (isib., ama-CVC angagoqelwanga).
● Ukuqapha: Ukulinganisa umfutho wegazi ophakathi (i-CVP) ezigulini ezigula kakhulu.
Imininingwane kanye namamodeli
| I-Single Lumen Catheter | I-Catheter Ephindwe Kabili Ye-Lumen | I-Catheter ye-Lumen Ezintathu | |||
| Inombolo Yomkhiqizo | Imodeli | Inombolo Yomkhiqizo | Imodeli | Inombolo Yomkhiqizo | Imodeli |
| 021001 | 20G | 022001 | 4F | 023002 | 5.5F |
| 021002 | 18G | 022002 | 5F | 023003 | 7F |
| 021003 | 16G | 022003 | 7F | 023004 | 8.5F |
| 021004 | 14G | 022004 | 8F | ||
Imininingwane Yomkhiqizo