Michael Menna, DO, yog pawg thawj coj saib xyuas kev koom tes nrog tus kws kho mob xwm txheej ceev ntawm Tsev Kho Mob Dawb Plains hauv White Plains, New York.
Lub koob npauj npaim yog ib yam khoom siv los kos cov ntshav los ntawm cov hlab ntsha los yog muab cov hlab ntsha (IV) kho rau cov leeg. Npauj npaim koob tseem hu ua tis infusion teeb lossis lub hau tawv taub hau. Nws muaj ib tug nyias hypodermic koob, ob "tis" saj zawg zog, ib tug saj zawg zog pob tshab raj thiab ib tug connector. Cov khoom sib txuas tuaj yeem txuas nrog lub tshuab nqus tsev lossis lub hnab ntim khoom los kos cov ntshav, lossis mus rau lub twj tso kua mis los yog lub hnab ntim dej ntim cov raj xa dej los yog tshuaj. Cov tshuaj kuj tseem tuaj yeem xa ncaj qha mus rau lub connector ntawm lub syringe.
Npauj npaim koob muaj qee yam zoo dua cov koob ncaj. Piv txwv li, lawv tso cai rau kev tso kawm ntau dua, tshwj xeeb tshaj yog nyob rau hauv cov hlab ntsha uas nyuaj rau kev nkag mus. Txawm li cas los xij, lawv tsis yog qhov kev xaiv zoo tshaj plaws hauv txhua qhov xwm txheej.
Thaum xub thawj siab ib muag, ib rab koob npauj npaim zoo ib yam li Huber koob, thiab nws kuj muaj tis. Txawm li cas los xij, Huber koob tau khoov ntawm 90 degree lub kaum sab xis kom lawv tuaj yeem muab tso rau hauv qhov chaw cog tshuaj khomob.
Cov kws kho mob phlebotomy feem ntau siv cov koob npauj npaim kom tau txais cov ntshav kuaj kom tiav cov ntshav suav (CBC), kuaj cov roj cholesterol, ntsuas ntshav qab zib, kuaj kab mob STD, thiab lwm yam kev kuaj ntshav. Cov koob no kuj tau siv nyob rau hauv cov txhab nyiaj ntshav rau cov neeg uas xav pub ntshav.
Yog tias koj lub cev qhuav dej thiab tsis tuaj yeem haus lossis haus dej txaus los ua kom tsis muaj dej, cov koob npauj npaim tuaj yeem siv los xa cov kua dej hauv cov hlab ntsha. Lawv kuj tuaj yeem siv los xa cov tshuaj (xws li cov tshuaj tua kab mob) ncaj qha rau hauv cov hlab ntsha lossis maj mam txhaj tshuaj IV (xws li tshuaj tua kab mob lossis tshuaj tua kab mob) tso rau hauv cov hlab ntsha.
Txawm hais tias cov koob npauj npaim tuaj yeem nyob hauv cov hlab ntsha li 5 mus rau 7 hnub yog tias muaj kev ruaj ntseg zoo, lawv feem ntau siv rau lub sijhawm luv luv.
Kev tsis tu ncua lossis tas li feem ntau nkag mus los ntawm cov hlab ntsha loj dua los ntawm kab hauv nruab nrab lossis peripheral inserted central catheter (PICC) kab.
Txawm hais tias tag nrho cov koob npauj npaim zoo sib xws hauv kev tsim, lawv tseem txawv. Npauj npaim koob yog ntsuas nyob rau hauv units ntawm specifications, feem ntau nyob rau hauv qhov loj ntawm 18 mus rau 27. Qhov siab dua qhov specification, lub me me koob.
Piv txwv li, 27-gauge koob yog qhov loj me rau kev txhaj tshuaj insulin. Yog hais tias cov tshuaj txhaj tshuaj yog tuab dua los yog cov ntshav tau muab coj los rau hauv cov ntshav, siv ib rab koob me me. Feem ntau cov koob npauj npaim tsis pub tshaj peb-quarters ntawm ib nti (19 hli).
Cov khoom siv IV lossis cov thawv ntim khoom txuas nrog lub raj txuas nrog lub koob, tsis yog rau lub koob. Qhov no yuav pab tau vim yog tias koj raug yanked los yog poob, txoj kev raug mob yuav txo tau.
Qhov loj ntawm cov yeeb nkab yog li ntawm 8 ntiv mus rau 15 ntiv tes (20 mus rau 35 cm). Lub raj luv luv yog siv los kos cov ntshav. Ntev ntev yog siv rau hauv daim ntawv thov IV thiab tej zaum yuav muaj cov menyuam li qub los kho cov dej ntws. Cov raj kuj tuaj yeem ua xim kom tus kws saib xyuas neeg mob paub qhov txawv ntawm kab twg yog siv thaum siv ntau kab.
Qee tus npauj npaim pin connectors muaj qhov chaw nres nkoj "txiv neej" uas tuaj yeem tso rau hauv lub tshuab nqus tsev. Lwm cov khoom sib txuas muaj "poj niam" chaw nres nkoj uas cov koob txhaj tshuaj lossis cov raj tuaj yeem tso tau.
Thaum lub sij hawm venipuncture (lub koob yog muab tso rau hauv cov hlab ntsha), phlebotomist los yog tus nais maum yuav clamp tus npauj npaim koob nrog tis ntawm tus ntiv tes xoo thiab ntiv tes. Vim tias rab koob hypodermic luv luv thiab qhov kev txav deb ntawm qhov luv dua, qhov kev tso ntawm tus npauj npaim koob yog qhov tseeb dua li rab koob ncaj, thiab rab koob ncaj yuav feem ntau yob lossis viav vias ntawm tus ntiv tes.
Ntxig ib rab koob luv luv rau hauv cov leeg ntawm lub kaum sab xis me me. Tom qab txhaj tshuaj, venous siab yuav yuam kom me me ntawm cov ntshav mus rau hauv lub raj pob tshab, paub meej tias rab koob tau muab tso rau kom raug. Thaum rab koob nyob hauv qhov chaw, cov tis kuj tseem siv tau los ua kom lub koob ruaj khov thiab tiv thaiv nws los ntawm dov lossis txav mus.
Thaum siv (kom kos ntshav lossis xa tshuaj), tag nrho cov cuab yeej yuav raug muab pov tseg rau hauv lub thawv ntim cov khoom pov tseg. Tom qab ntawd qhwv lub qhov txhab nrog ib daim ntaub qhwv.
Vim lawv qhov me me (ntau me dua li cov catheters) thiab lub kaum sab xis tsim, cov kab npauj npaim tuaj yeem nkag mus rau cov leeg sab nraud nyob ze ntawm daim tawv nqaij. Qhov no tsis tsuas yog ua rau lawv tsis tshua mob siv, tab sis kuj tso cai rau lawv nkag mus rau cov leeg me me lossis nqaim, xws li cov menyuam mos los yog cov neeg laus.
Npauj npaim koob yog qhov tsim nyog rau cov neeg uas muaj cov leeg me me los yog cov pob qij txha (dov), thiab tuaj yeem muab tso rau hauv cov leeg zoo ntawm ob txhais tes, taw, pob taws lossis tawv taub hau.
Npauj npaim koob yog heev haum rau cov neeg uas tsis kam mus rau koob, vim hais tias lawv tsis tshua hem.
Thaum cov koob raug tshem tawm lawm, lawv kuj tsis zoo li yuav ua rau cov ntshav hnyav, cov hlab ntsha puas, lossis cov hlab ntsha tawg.
Cov qauv tshiab tshiab muaj qhov zawv zawg xauv qhov rooj uas cia li swb hla lub koob thaum nws tawm ntawm txoj hlab ntsha, tiv thaiv kev raug mob ntawm rab koob thiab rov siv cov koob siv.
Yog tias koj tau hais tias koj cov leeg me me thiab muaj teeb meem nqus ntshav yav dhau los, koj tuaj yeem xav thov ib rab koob npauj npaim.
Vim qhov me me ntawm rab koob, cov ntshav sau nrawm feem ntau qeeb. Yog hais tias ib tug neeg yog squeamish los yog thaum muaj xwm txheej ceev uas yuav tsum tau cov ntshav ceev, qhov no yuav ua rau muaj teeb meem nyob rau hauv cov ntshav bank. Hauv qhov no, kev xaiv ntawm rab koob loj yog qhov tseem ceeb.
Txawm tias muaj cov ntshav niaj hnub, yog tias xav tau cov ntshav ntau, qhov koob tsis zoo tuaj yeem ua rau txhaws thiab yuav tsum tau txais ntshav thib ob.
Txij li thaum rab koob siv rau kev txhaj tshuaj yog sab laug ntawm caj npab, tsis yog lub catheter lossis PICC hlau, lub koob npauj npaim tuaj yeem ua rau cov hlab ntsha puas tsuaj yog tias lub cuab yeej rub tawm tam sim ntawd. Txawm hais tias siv rab koob ntawm qhov loj me, yog tias nws tsis muab tso rau kom raug, rab koob tuaj yeem raug thaiv thaum kho.
Sau npe rau peb cov ntawv xov xwm Kev Noj Qab Haus Huv Txhua Hnub kom tau txais cov lus qhia txhua hnub los pab koj ua lub neej zoo tshaj plaws.
Venipuncture txheej txheem. Hauv: Calm. 6th tsab. 2018: 308-318. doi: 10.1016/b978-0-323-40053-4.00024-x
Ohnishi H, Watanabe M, Watanabe T. Npauj Npaim koob txo qhov tshwm sim ntawm cov hlab ntsha raug mob thaum phlebotomy. Arch Pathol Lab Med. 2012; 136(4):352. doi: 10.5858/arpa.2011-0431-LE
Ialongo, C. thiab Bernardini, S. Phlebotomy, tus choj ntawm chav kuaj thiab tus neeg mob. Biochem Med (Zagreb). 2016 Lub Ob Hlis 15; 26(1):17-33. PIB: 10.11613/BM.2016.002.
Volovitz, UA; Beur, P.; Essex, D., thiab lwm yam. Piv nrog rau cov hlab ntsha catheters, kev siv cov koob npauj npaim los kos ntshav yog nws tus kheej cuam tshuam nrog kev txo qis hauv hemolysis. Lub Rooj Sib Tham Txhua Xyoo ntawm Academy of Academic Emergency Medicine; Atlanta, Georgia, Tebchaws USA; Tsib Hlis 2013. DOI: 10.1111/acem.12245.
Post lub sij hawm: Nov-10-2021
