重症病患动脉导管监测教材课程.pptVIP

The nurse caring for a patient with an arterial line must be able to obtain(獲得) blood samples(血液檢體) from the arterial catheter using the needless system. After the arterial catheter is removed pressure(加壓) will be held directly over the site for 10 minutes. The nurse with document(文件) all pertinent(相關的) information on the flow sheet and clinical record. Indications for arterial blood pressure measurements When accuracy(準確) in blood pressure measurement is needed Frequency(持續)of blood pressure is needed Some of those are as follows Gradual (漸進的 )or acute hypotension or hemorrhage. Circulatory or cardiac arrest(暫停). Hypertensive crisis(危象). Sepsis are respiratory failure. Neurologic injury. Post-operative complications. When the patient is on vasoactivedrugs (血管作用藥物) such as dopamine, nitroglycerin, The arterial line may also be used when the patient requires frequent ABGs or other blood work. Limitations of arterial lines The arterial line pressures should be 5 to 20 mmHg higher(較高) then cuffed measurements. If the arterial line pressure cuff pressure reading or 5-20 mmHg over cuff pressure measurement, one of the following is occurring: cuff is too small for the p’t arm, will read high. cuff is too large for the p/t arm, will read to low. Equipment malfunction(發生故障 ). in severe shock, or hypothermia, occlusive peripheral vascular disease. Potential(潛在的 )complications. Hemorrhage. Air emboli. Equipment malfunction. Inaccurate pressures. Dysarhythmias. Infections.. Tubing separation. Altered skin integrity. Impared circulation to extremities. Altered hemodynamics. 導管的插入與部位 插管部位 說明 橈動脈 (radial artery) 易插入，有尺動脈側支循環，對末梢循環影響的機會較小，表淺近骨突處所以傷口較易止血，在臨床上最常用。 臂動脈 (brachial artery) 易插入，易影響肢體活動，須注意影響前臂血流，若血腫可能壓迫到正中神經，在臨床上常見。 股動脈 (femoral artery) 休克時較其他部位易插入，較易感染，可能影響下肢血流。 足背動脈 (dorsalis pedis artery) 血管管徑較小，較易影響末梢血循，離心較遠使數據偏高，通常是其他部位無法插入時考慮使用的部位。 EQUIPMENT 500 mls Heparinize Normal Saline ( premixed) Pressure Bag 2 x 5 ml. syringes Surgical mask S