MC-PP-349BASConfidentialandProprietary.ForInternalEducationalPurposesOnlyAnOverviewofVascularAccessDevicesAndEarlyAssessment血管通道器材概述以及合理选择巴德宁海燕新疆区域大客户经理TypesofVenousCatheters静脉导管类型•PIV:peripherallyintravenouscatheter–Veryshortterm(days)外周静脉导管—短期（天）•Midlinecatheter—LongertermthanPIV(weeks)中线导管—长于PIV（周）•Peripherallyinsertedcentralcatheter:PICC(uptooneyear)外周插管的中心导管：PICC（最长1年）•Centrallyinsertedcentralvenouscatheter:CVCorCICC中心插管的中心静脉导管：CVC或者CICC–Longterm(years):Tunneled,cuffed–Shortterm(daystoweeks):Non-tunneled,“acute”CVC,non-cuffed–长期（年）：隧道式，套袖式–短期（数日至数周）：无隧道，“短期”CVC，无套袖GeneralOverview:TypesofDevices概览：产品类型•PIV外周静脉导管–NoBASdirectproducts–BAS没有相关产品•PICCLines经外周植入的PICC导管–Triple,Power,Valved,Non-Valved,Silicone,Polyurethane–三腔，耐高压注射，有瓣膜，无瓣膜，硅胶，聚氨酯•CVC中心静脉导管–Hickman*,Groshong*,Broviac*,PowerLine*,andPowerHohn*Catheters•PORTs植入式输液泵型中心静脉导管–Chest,Double,Single,Arm,Power–胸部，双腔，单腔，手臂，高压注射ComplicationsofPIV’s•Bleeding•Veininjury•Nerveinjury•Infiltration•Phlebitis•Thrombosis•Infection外周静脉导管的并发症•出血•静脉损伤•神经损伤•渗液•静脉炎•血栓形成•感染PeripheralIVs:PoorOutcomes外周静脉导管：效果差MidlineCatheters•Overview概要–Placedintheupperarmorantecubitalfossa置于上臂或肘窝–Tipresidesinperipheralvein,usuallytheaxillaryvein,anddoesnotenterthecentralvasculature头端位于外周静脉，一般为腋静脉而不可使其进入中心血管–NOTacentralline不是中心静脉导管中线导管MidlineCatheters•Advantages–LongerdwellthanPIV–Nochestx-rayrequired•Complications–Occlusion–Phlebitis–DVT–Identificationofcomplicationsmaybedelayed–Oftenconfusedforacentralline–Lesshemodilution,notappropriateforpHextremesorhyperosmolarsolutions中线导管•优势–留置时间长于外周静脉导管–无需进行胸片检查•并发症–导管堵塞–静脉炎–深静脉血栓形成–可能延迟的并发症诊断–常被误用作中心静脉导管–血液稀释作用轻微，不适用于极端pH值和高渗的静脉输液PeripherallyInsertedCentralCatheter(PICC)•CallPoint–IV/PICCNurse–InterventionalRadiologist(IR)–ICU•Insertion–Upperarmpreferred–BedsideorIR–U/SandMSTarebestpractice•BASproducts–Per-Q-Cath*PICC–PolyPer-Q-Cath*PICC–PolyRadPICC*catheter–PowerPICC*catheter–PowerGroshong*PICC–Groshong*PICC–PowerPICCSOLO*catheter•使用者–IV/PICC护士–放射介入医师（IR）–重症监护室•插管–优先选择上臂–床旁或放射介入科置管–U/S和MST是最佳方法•BAS产品–Per-Q-Cath*PICC–PolyPer-Q-Cath*PICC–PolyRadPICC*导管–PowerPICC*导管–PowerGroshong*PICC–Groshong*PICC–PowerPICCSOLO*导管Overview:PICCLinesPICC导管概述•PICC:PeripherallyInsertedCentralCatheter•PICC：外周插管的中心静脉导管•ISaCentralLine•属于中心静脉导管•Canbeusedfordeliveryofanyinfusate,includingthoseintendedforcentralvenousdelivery•能够用于输送任何药物，包括那些需经中心静脉输送的药物–incompatiblemedications不相容的药物–pHextrememedications极端pH值的药物–Hyperosmolarmedications高渗性的药物–Vesicantandirritantmeds发泡剂及刺激性的药物•Reliablemeansforbloodsampling•可靠的采血方法•Canbeplacedbyanurseatthebedside•可由护士在床旁放置优势–途径可靠–可在床旁放置•并发症–阻塞–感染–机械性静脉炎–血栓PeripherallyInsertedCentralCatheter(PICC)Advantages–Reliableaccess–Canbeplacedatbedside•Complicati...
