analysis of modified supraclavicular approach of subclavian vein puncture（锁骨下静脉穿刺的改良锁骨上的分析方法）.docVIP

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analysis of modified supraclavicular approach of subclavian vein puncture（锁骨下静脉穿刺的改良锁骨上的分析方法）.doc

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analysis of modified supraclavicular approach of subclavian vein puncture（锁骨下静脉穿刺的改良锁骨上的分析方法）

Analysis of modified supraclavicular approach of subclavian vein puncture [Keywords] subclavian vein; puncture; indwelling; catheter Quickly and efficiently establish intravenous access, hemorrhagic shock is essential for the rescue, rapid and reliable for the study of subclavian vein puncture method, we used modified supraclavicular approach of subclavian vein catheterization to obtain the desired results, are as follows. Clinical data 1.1 General Information Choice in our department underwent emergency surgery in patients with hemorrhagic shock, 59 cases of shock index (SI) 1.0 ~ 1.5, including 28 males and 31 females. Causes were: ectopic pregnancy, bleeding in 27 cases, liver, spleen 12 cases of femoral shaft, pelvis fracture in 13 cases, other causes of bleeding in 7 cases. 1.2 steps Patients were supine, head turned to the left, take the branch outer edge of the right sternocleidomastoid muscle and clavicle clavicle intersection vertex angle of the corner points in the line 0.5 cm from the apex near the needle point, routine disinfection, shop hole towel, 2% lidocaine local anesthesia, and try to 5ml syringe. Improved puncture points: at the left index finger to press down the needle, fully exposed to the sternocleidomastoid muscle, the level of the lower edge of the sternocleidomastoid muscle from the needle point to the sternoclavicular joint, and vascular exploration after 16 G, 6.5 cm long vascular needle probe according to the above was tried on the direction and depth of the puncture, piercing the subclavian vein through a sense of when there are more pits and smooth blood, instruct patient to breath or slow breathing, the guide wire gentle entry into the guide wire, expanded skin, along the guide wire into the indwelling silicone tube into the tube length of about 12 ~ 14 cm. According to the infusion flow rate of uncontrolled smooth, when the water column measured CVP fluctuations up and down with respiration was initially est