Catheters - Lecture notes 2 PDF

Preview

Summary

…………………………………………………. …………………………………………………. …………………………………………………. …………………………………………………. …………………………………………………. …………………………………………………. …………………………………………………. …………………………………………………....

Description

Urinary bladder catheters （Foley） ） INDICATION        

Management of urinary retention. urine output measurement During surgery prevent bladder overdistention Management of hematuria associated with clots. immobilized patients. neurogenic bladder. Management of open wounds located in the sacral or perineal regions Intravesical pharmacologic therapy (eg, bladder cancer).

CONTRAINDICATIONS  

Absolute： urethral injury / hematuria, which is typically associated with pelvic trauma. Relative： urethral stricture, recent urinary tract surgery, and the presence of an artificial sphincter.

COMPLICATIONS      

urinary tract infection Epididymitis Retained balloon fragments — Spontaneous rupture of the urinary catheter balloon Bladder fistula — The presence of air or feces in the urine of a patient with an indwelling catheter may indicate the formation of a fistula. between the bladder and small intestine, colon, rectum, or vagina. Bladder perforation — Bladder perforation, both intraperitoneal and extraperitoneal, is rare Bladder stone formation — Stones can form in the bladder due to the presence of a foreign body.

central venous catheter (CVC) = Central line * 3 veins can be used : Subclavian V. > Jugular V. > Femoral V.

*2 ～ 4 周左右

*distal tip should lie in the lower superior vena cava, outside the right atrium and above the pericardial reflection. INDICATIONS 

  

Peripherally incompatible infusions – Long-term administration of medications such as vasopressors, chemotherapy, blood product , and Total parenteral nutrition (TPN,全靜脈營養) Prevent vein inflammation (phlebitis) when given through a peripheral intravenous catheter. Hemodynamic monitoring –CVP,central venous pressure, venous oxyhemoglobin saturation (ScvO2), and cardiac parameters (via pulmonary artery catheter). Extracorporeal therapies – Large-bore venous access is required to support high-volume flow required for many extracorporeal therapies, including renal replacement therapy (ie, hemodialysis) and plasmapheresis. placement of other medical devices, including: o Vena cava filters o Venous thrombolytic therapy/venous angioplasty/venous stenting o Pulmonary artery catheters o Pacemakers/defibrillators

CONTRAINDICATION

:

Coagulopathy and/or thrombocytopenia

COMPLICATIONS    

Pneumothorax, Delayed collapsed lung(...