支氣管鏡檢查須知(Flexible Bronchoscopy)
【Learning Points】
- Before removing the catheter, your doctor and nurse practitioner will assess whether you are at high risk for bleeding.
- It is essential lie flat in bed for two hours and avoid strenuous exercise.
- Do not take a bath within 24 hours (you can use a sponge to bathe)
- Do not lift or carry heavy objects with the affected limb for the first three days.
- If bleeding, local redness, swelling, cold limbs, numbness, or tingling occur within three days, please inform your nurse to evaluate appropriate treatment.
I.What are the common types of blood vessel access?
In clinical settings, common types of blood vessel access include peripheral arterial catheter, pulmonary artery catheter, intra-aortic balloon pump(IABP),pediatric Hickman catheter, dual-lumen catheter for blood dialysis, adult or pediatric peripherally inserted central catheter(PICC),central venous catheter, and implantable port(port-A)
II.Precaution Before Blood Vessel Access Removal:
- Before catheter removal, the doctor and nurse will assess whether you are at a high risk of bleeding, such as if you are taking anticoagulant medications or blood-thinning drugs. Depending on your condition, the doctor will decide whether to postpone catheter removal or if additional pressure should be applied to the removal site to ensure proper hemostasis.
- After catheter removal, to prevent bleeding, oozing, or hematoma, formation, please pay careful attention to and adhere to the following measures:（refer to Figure1.2）
- For patients undergoing catheter removal on the same day or upon discharge, once hemostasis is confirmed ,vital signs are stable and there are no significant problems, discharge can be arranged. However , if there is leakage or severe bleeding from the catheter site, the extremities of the limbs are cold ,or there is numbness and tingling ,immediate follow-up should be sought.
III.Conclusion:
Vascular access is an indispensable means in clinical treatment, To ensure safe removal of vascular access, precautions must be taken to prevent complications such as bleeding , oozing, and hematoma, Proper application of pressure and post-removal care measures for the catheter site can help prevent delayed bleeding and maintain the safety and quality of your vascular access.
（ Figure1）
（Figure2）
IV.References:
- 陳憬儀、曾士芬、張奕文、吳振誠、曹祐慈、陳素里、鄭舒倖、徐永年（2020）。血管通路之病人安全異常事件：某區域醫院四年經驗分享。醫學與健康期刊，9(1)，73-82。https://www.airitilibrary.com/Publication/alDetailedMesh?DocID=23046856-202003-202003180009-202003180009-73-82
- Morgan, B. 與倫敦健康科學中心。手術：切除中心靜脈導管（頸靜脈、鎖骨下靜脈、股靜脈）。https://www.lhsc.on.ca/ritic-care-trauma-centre/procedureremoval-of-central-venous-catheters-jugular-subclavian#i (2020)
- 移除血液透析中心靜脈導管 (HD-CVC) 當地侵入性手術安全標準 (LocSSIPs) 標準操作程序。https://secure.library.leicestershospitals.nhs.uk/PAGL/Shared%20Documents/Haemodialysis%20Central%20Venous%20Catheter%20-%20Removal%20UHL%20Renal%20LocSSIP.pdf(2019)
Blood Vessel Access Removal Care and Precautions
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