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Thoracentesis is an operation in which a sterilised needle from China factory is used to puncture through the skin, intercostal tissue and mural pleura into the pleural cavity. In clinical work in pulmonary medicine, thoracentesis is a relatively common, convenient and easy method of diagnosis and treatment.
When it comes to thoracentesis, many patients feel scared. It is not as easy to accept a decompression needle in the buttocks as it is to pierce the chest cavity, where the heart and lungs are located. It is important to know what the patient should be aware of and how to cooperate well. The danger can be said to be almost non-existent when operating according to the protocol. Therefore, we believe that thoracentesis is safe and there is absolutely nothing to fear.
What should the operator be aware of? This is a question that every one of us should have a good grasp of, the indications for thoracentesis, the operational essentials, and in particular the fact that the China decompression needle must be introduced at the upper edge of the rib cage and never at the lower edge of the rib cage, otherwise the blood vessels and nerves along the lower edge of the rib cage will be accidentally injured. The patient must be carefully disinfected and the operation must be absolutely sterile. Do a good job with the patient, avoid anxiety and nervousness and obtain close cooperation with the doctor. If necessary, stop the operation and take immediate bed rest for resuscitation.
What should the patient be aware of? Firstly, the patient should be prepared to work closely with the doctor and eliminate fear, anxiety and nervousness. Secondly, the patient should not cough and should rest well in bed beforehand. If he/she is unwell, he/she should explain this to the doctor so that he/she can consider what to pay attention to during the operation or to suspend it. Thirdly, the patient should lie still for about two hours after the thoracentesis.
A final mention of lung puncture, which is actually a deeper penetration of the thoracic cavity, where the decompression needle is passed through the pleural cavity and through the dirty pleura into the lung. Its purpose is also twofold: primarily to perform a biopsy of the lung parenchyma, to aspirate fluid from the cavity or bronchial cavity for further examination and to clarify the diagnosis, and secondly to treat certain diseases through lung puncture, such as aspiration of pus from poorly drained cavities and, if necessary, injection of drugs for therapeutic purposes. However, lung puncture is demanding and the operation should be carried out more carefully, carefully and quickly to minimise time. The patient should cooperate more closely, should breathe steadily and should not cough, and should receive a detailed examination before the puncture so that the doctor can position the puncture correctly and improve the success rate of the puncture.
Therefore, as long as the doctor follows the procedure and operates carefully, the patient eliminates his fears and cooperates closely with the doctor. Thoracentesis is very safe and there is absolutely nothing to fear.
The whole process:
1. Ask the patient to take a sitting position facing the back of the chair with both forearms on the back of the chair and the forehead resting on the forearms. If you cannot get up, you can sit in a semi-sitting position, with the affected forearm raised on the occiput.
2. The puncture point is chosen at the most obvious part of the chest with solid percussion sounds. The puncture point is marked on the skin with a cotton swab dipped in methyl violet (gentian violet).
3. Routinely disinfect the skin, wear sterile gloves and cover with a sterile cavity wipe.
4. Local infiltration anaesthesia is applied with 2% lidocaine from the skin to the pleural wall layer at the puncture site on the upper edge of the next rib.
5. The operator fixes the skin at the puncture site with the index finger and middle finger of the left hand, and with the right hand turns the tee bolt of the puncture decompression needle to close with the thoracic cavity, then slowly punctures the decompression needle at the anaesthetic site. When the feeling of resistance of the needle blade suddenly disappears, the tee bolt is turned to open it to the thoracic cavity for aspiration. The assistant assists in securing the puncture needle with haemostatic forceps to prevent damage to the lung tissue from penetrating too deeply. When the syringe is full, the tee is turned to open it to the outside world and the fluid is drained.
At the end of the aspiration, the decompression needle is removed, covered with sterile gauze, compressed with a little pressure for a few moments, fixed with adhesive tape and then the patient is asked to lie still.
Stretchers were invented in practice by ancient working people. They are relatively simple and single. With the development of science and the progress of society, according to the situation of different patients and the position of patients, unique stretchers for various patients were invented through continuous research and improvement. Next, let's talk about shovel stretchers.
The scoop stretcher is composed of left and right two aluminium alloy plates. Unlike a regular stretcher, it can insert two vessels under the patient's body and lift it after buckling. The multifunctional scoop folding stretcher is a novel, convenient and efficient rescue stretcher integrating a folding stretcher, shovel stretcher, wheeled stretcher and ambulance stretcher bed.
The scoop stretcher belongs to a detachable rescue stretcher, which is mainly used for battlefield rescue and transfer of fractured and seriously injured patients; characterized by: two ends of the stretcher are provided with hinged clutch devices, which can separate the stretcher into left and right parts; without moving the patient, the patient is quickly placed in the stretcher and transported to the operating table or hospital bed, and then the stretcher is drawn out from under the patient's body. The length of the stretcher can be adjusted according to the patient's size.
Easy to use and easy to master. The stretcher surface does not need to be removed from the whole body during patient handling, thereby saving the workforce, being safer, reducing complications in the handling process, and having various functions such as folding, separating, pushable, dripping, surgery, convenient X-ray irradiation, etc.
The scoop stretcher is convenient to carry and place, can quickly transfer the injured, quickly rescue, minimize the secondary injury caused to the patient during handling, and significantly improve the rescue efficiency. It is worth clinical promotion and use.
The scoop stretcher has clutch devices at both ends, which can be divided into left and right parts; the patient can be quickly shovelled without moving the patient to avoid secondary injury to the patient; the length of the stretcher can be adjusted according to the actual height of the patient, and it can be folded; it is mainly used in ambulances, hospitals and emergency centres.
Detachable design with clutch devices at both ends can split the stretcher into left and right parts and quickly scoop the patient in or pull the stretcher out from under the patient without moving the patient. The grooves at the head end are adjusted to keep the patient's spine aligned.
1. Retractable design: The length of the stretcher can be adjusted according to the person's size; there are 3 positions suitable for patients of any body type and height.
2. The product is equipped with a seat belt to ensure the patient's safety.
3. Scoop stretcher can be used with head guard.
4. The specifications and parameters of the three scoop stretcher are as follows:
1)
Material: aluminium alloy
Model Number: DW-SC003
Size: 167*43*6cm,
Unfold 203*43*6cm,
Folded: 120*43*9cm
Advantages: Affordable, hot selling model
2)
Material: PE plastic
Model Number: DW-SC004
Size: 162*44*7cm,
Folded: 120*45*9cm
Advantages: the patient's body temperature is not too cold or too hot compared to metal stretchers
3)
Material: carbon fibre
Model Number: DW-SC006
X-ray transparency, CT nuclear magnetic resonance
Size: 167*43*6.7 cm,
Unfold: 205*43.7*6.7cm
Folded: 120*43*9cm
Advantages: low-temperature resistance, high-temperature resistance, acid and alkali resistance, lightweight, long service life
1. Before using the scoop stretcher to carry the injured person, check the vital signs of the injured person and the injured part. According to the injury, check whether the injured person has any trauma to the head, spine and chest, especially the cervical spine.
2. Before handling, the injured must be prepared and adequately handled. First, the respiratory tract of the injured person must be kept open to avoid suffocation, and then stop bleeding, bandaging and fixing the wounded part of the injured person. After handling it, it can only be carried out.
3. Do not carry the injured person until the personnel, scoop stretcher, etc., are out of order. When handling overweight or unconscious wounded, careful consideration should be given to preventing accidents such as falls and falls.
4. During the handling process, observe the changes in the condition of the injured person at any time, pay attention to the breathing, mind, etc. of the wounded person etc., and keep warm, but do not wrap the head and face too tightly, so as not to affect breathing. In an emergency during handling, such as suffocation, respiratory arrest, convulsions, etc., stop handling immediately and carry out first aid treatment directly.
5. On particular sites, handling should be carried out according to unique methods. At the fire scene, the wounded should be bent over or prostrate forward in heavy smoke; at the site of toxic gas leakage, the porter should first cover his mouth and nose with a wet towel or use a gas mask to avoid being fumigated by the poison gas.
6. When carrying the injured person with spinal or spinal cord injury, the injured person should be placed flat on the rigid board spade stretcher. The body should be fixed with a triangle towel or other cloth band together with the stretcher, especially the cervical spine injury, sandbags, pillows, clothing, etc. must be placed on both sides of the head and neck to fix, limit the movement of the cervical spine in all directions, and then use triangular scarves, etc. Fix it, and then use a triangle towel, etc., for the whole body with a shovel. Stretchers are enclosed together.
According to its structure, function and material characteristics, it can be divided into three categories: simple stretchers, general stretchers, and special purpose stretchers.
Fast, timely, and correct. Improper ambulance stretchers from manufacturer handling can delay the time for the injured and sick to obtain further examination and treatment in a timely manner, and severe cases can worsen the condition and cause irreparable consequences.
During the handling process, the movement should be light, and unnecessary vibration should be minimized, so as not to increase the pain of the injured and sick.
1. Before carrying the wounded, check the vital signs and injury site of the wounded, focusing on whether the injured person has trauma to the head, spine, and chest, especially whether the cervical spine has been damaged.
2. The wounded must be properly handled. First of all, the respiratory tract of the wounded should be kept open, and then the injured part of the injured person should be stopped from bleeding, bandaged, and fixed in accordance with the technical operation specifications. It can only be moved after proper handling.
3. Do not carry personnel, stretchers, etc. when they are not properly prepared.
4. Observe the worsening condition of the wounded at any time during the handling process. Focus on breathing, mind, etc., and keep warm, but don't cover your head and face too tightly so as not to affect breathing. once
In the event of an emergency on the way, the handling should be stopped and emergency treatment should be carried out immediately.
5. At special sites, handling should be carried out according to special methods.
1. Changes in the state of consciousness
2. Changes in respiratory pulse and vital signs
3. The extent of bleeding, etc.
4. Emergency treatment if necessary
1. Supine position: This position can be used for all seriously injured people.
2. Side lying position: After eliminating the neck injury, the side lying position can be used for the wounded with impaired consciousness. To prevent food from being sucked into the trachea when the injured person vomits. When the injured person is lying on his side, a pillow can be placed on his neck to maintain a neutral position.
3. Semi-lying position: For wounded people with only chest injuries, breathing difficulties are often caused by chest pain, blood pneumothorax.
4. Sitting position: Suitable for patients with pleural effusion and heart failure.
1. In general, let the wounded lie on their back or side and carry them on a stretcher.
2. Use a professional strap to fix the traumatist on the stretcher to prevent the injured person's limbs from sticking out of the stretcher.
3. When the stretcher is carried, the injured person's feet are in front and the head is behind, and the head is raised first, then the foot is lifted, and the foot is placed first when it is lowered, and the stretcher should be at a consistent pace. When lifting to a height, the injured person's head is facing forward and his feet are facing back (such as going up a step or crossing a bridge). The stretcher in front should lower the stretcher and raise the back so that the patient can stay level. The opposite is true when you step down the stairs.
4. When getting on the stretcher, the injured person should be on the head first and on the back of the foot.
5. Place the stretcher carrying the wounded on the stretcher truck and pull up and fix the protective rods on both sides.
1. For acute patients, it is better to lie flat, so that the whole body can be stretched and the upper and lower limbs are straightened; according to different conditions, make some appropriate adjustments; for patients with high blood pressure and cerebral hemorrhage, the head can be properly raised to reduce blood flow to the head.
2. If you are unconscious, you can deflect your head to one side so that vomit or sputum dirt can flow out and not be inhaled.
3. Patients with traumatic bleeding in a state of shock can lower their heads appropriately.
4. For heart disease patients with heart failure and difficulty breathing, they can take a sitting position to make breathing smoother.
It depends. Infusion is not necessarily required for 3 days, but depends on the specific condition and cannot be generalized. Firstly, if there are clear indications for infusion, such as high white blood cell, neutrophil, lymphocyte or mononuclear granulocyte counts in routine blood count and C-reactive protein, or high C-reactive protein index, infusion can be given in case of upper respiratory tract infection or respiratory disease caused by viral infection. If the body temperature is not high or if the temperature is consistently within 38℃, you can switch to oral medication after the symptoms improve after 1 day of infusion. Second, if there is a significant increase in blood count in routine blood tests and it is accompanied by severe hyperthermia or other organ and systemic diseases, such as abdominal pain or the presence of obvious cough, sputum and chest pain, infusion can usually be given for about 3 days. Thirdly, if there are clear pulmonary infections, urinary system infections and abdominal infections, infusion is usually required for more than 5-7 days.
The rate of intravenous infusion by a China IV stand, usually for adults, is usually around 40-60 drops per minute. Children and elderly people, due to incomplete organ development or reduced cardiopulmonary function, usually infuse at a slower rate. The clinical infusion speed is usually related to many factors such as the patient's age, weight, physical condition, and the nature of the drug. Patients with cardiopulmonary and renal diseases, or patients with a weaker constitution, should also have a slower infusion speed.
For drugs with more severe vascular irritation, or drugs that require continuous infusion in small doses, the infusion rate is generally slower. There are also drugs that require rapid infusion to achieve therapeutic effects, and the final infusion rate should be carried out according to the doctor's orders.
Usually the infusion of anti-inflammatory fluid by a IV stand can go down in about 3-7 days, but the exact time varies from person to person. Some people may take 7-10 days or even longer for the inflammation to go down, which needs to be judged according to the severity of the condition.
If there is inflammation in the body, you need to seek prompt medical examination to understand the severity of the inflammation. If the condition is mild and only a bacterial infection occurs without other complications, recovery can usually be faster by way of infusion, and the symptoms of the disease can be effectively relieved in 3-7 days. However, if the condition is more serious and complications arise after bacterial infection, such as the development of pneumonia and other lung infections, it may take 7-10 days for the infusion to reduce inflammation.
If the inflammation is caused by bacterial infection, it is generally recommended to first treat with antibiotic drugs such as cefazolin sodium and amoxicillin under the guidance of a doctor. If the infection is also complicated by a virus, it should also be treated with antiviral drugs, such as acyclovir and valacyclovir, under the guidance of a doctor. In mild cases, oral medication will be administered in a timely manner and the patient will gradually recover after a period of time. If the disease is more serious, then infusion therapy is recommended and is relatively more effective.
During the process of inflammation treatment, it is important to take good daily care and try not to go to crowded places frequently. It is also necessary to keep the air circulating in the room and pay attention to rest to help the condition recover.
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