留置胃管技术.pptxVIP

留置胃管技术;主要内容 一、目的 二、适应症 三、禁忌症 四、准备 五、用物 六、操作程序 七、注意事项 八、并发症;是指经一侧鼻腔插入胃内，用于胃肠减压或灌注（食物、水、药物等）以达到治疗目的。;;鼻饲 洗胃 胃肠减压 施压 pH值监测或胃液分析 ;二、适应征;Contraindications;Preparation;All necessary equipment should be prepared, assembled and available at the bedside prior to starting the NG tube. Basic equipment includes: Personal protective equipment NG/OG tube Catheter tip irrigation 60 ml syringe Water-soluble lubricant, preferably 2% Xylocaine jelly Adhesive tape Low powered suction device OR Drainage bag Stethoscope Cup of water (if necessary)/ ice chips Emesis basin pH indicator strips ;车上层治疗盘内： 胃管包1个（内有胃管1根，一次性手套1副，液状石蜡油棉球） 弯盘、治疗碗（内置压舌板1个） 50ml注射器1个 治疗巾、胶布、棉签 快速手消毒液 一次性手套 必要时：备听诊器，手电筒 汽油或松节油、酒精、清洁纸巾 车下层： 医用垃圾桶 生活垃圾桶;备物 Gather equipment. 不需要戴无菌手套 Don non-sterile gloves 查对、评估、解释 Explain the procedure to the patient and show equipment 如果可能，采取患者坐位（抬高床头30度至45度） If possible, sit patient upright for optimal neck/stomach alignment 检查并清洁鼻腔，铺治疗巾，置弯盘于近下颌处 Examine nostrils for deformity/obstructions to determine best side for insertion;测量胃管拟插入长度 Measure tubing from bridge of nose to earlobe, then to the point halfway between the end of the sternum and the navel 标识长度 Mark measured length with a marker or note the distance 润滑胃管 Lubricate 2-4 inches of tube with lubricant (preferably 2% Xylocaine). ;传统置入长度：45-55cm 即 ＋鼻部 8cm ＋咽喉 12cm ＋食管25-30cm 前额发迹到剑突的距离 或鼻尖到耳垂再到剑突的距离 ;第一刻度45cm，表示胃管达贲门;插管 先稍向上而后平行再向后下轻缓经鼻插入，至14～15cm(咽喉部)时，嘱病人做吞咽动作，当病人吞咽时顺势将胃管向前推进，直至预定长度。 Pass tube via either nare posteriorly, past the pharynx into the esophagus and then the stomach. Instruct the patient to swallow (you may offer ice chips/water) and advance the tube as the patient swallows. Swallowing of small sips of water may enhance passage of tube into esophagus. Advance tube until mark is reached. If resistance is met, rotate tube slowly with downward advancement toward closes ear. Do not force. Withdraw tube immediately if changes occur in patient‘s respiratory status, if tube coils in mouth,