IABP导管置入流程.ppt

IABP导管置入流程 物品准备 消毒物品：碘酒、酒精、无菌手套 局部麻醉物品：麻醉药 无菌洞巾及无菌单 IABP导管 压力传导组 肝素生理盐水 输血加压袋 ARROW IABP导管 Insertion Kit（穿刺包） IAB Catheter Kit（IABP导管） Adapter Air Hose(For Datascope or Bard Mechine)（配其他IABP机器用氦气管） 去掉止血鞘 插入球囊 将导丝从球囊尾端露出 将IABP导管送置左锁骨下动脉开口远端２cm处 取出导丝，接上15cm长短管，冲洗中央腔 将保护套与鞘连接 H.E.A.R.T. CHECK-LIST H – Helium E – ECG A – Arterial R – Right Trigger T - Timing 固定导管 缝合固定穿刺鞘或止血鞘 缝合固定氦气管之Y型端 Commence Pumping IABP导管拔除流程 停止IABP泵，拆除固定缝合线 缓缓向后抽出IABP导管，直到抽不出有阻力时停止 将IAB导管及穿刺鞘/或止血装置一起拔出 按一般动脉止血方法，按压穿刺点止血 注意：反搏过程中发现 IABP导管氦气管内有血液，请立即取出IABP导管，勿再反搏 Catheter tray contains Pre-wrapped IAB catheter gas line tubing with appropriate volume coded connector 6” pressure tubing with stopcock extra pressure tubing 50/60cc syringe with slip-fit tip one-way valve This MUST be done to prevent IAB from prematurely unwrapping. Attach one way valve to short end of gas tubing Pull negative pressure until resistance is met Remove syringe leaving one way valve intact One way valve should be maintained until full placement in aorta is achieved Without removing the label, remove balloon assembly from the tray by gently pulling the balloon out of the retaining sleeve Catheter MUST be removed straight out and not bent during removal as this may damage the catheter Maintain the one-way valve This can damage the catheter, central lumen, or membrane itself. To maintain central lumen patency, flush with 3-5cc of heparinized saline just PRIOR to insertion The hemostasis device is only used with sheathless insertion if required to help control post insertion bleeding. It must be removed if sheathed insertion is employed. Pass balloon onto guidewire Insert the balloon into the sheath Wetting the membrane with saline may help reduce the friction coefficient and facilitate easier insertion Some IABs have a hydrophilic coating which can be activated by wetting the tip of the catheter Advance the balloon over the guidewire and position 2cm distal to the left subclavian artery * 导管部分 穿刺部分 穿刺部位准备: 1.