tailieunhanh - Access for Dialysis: Surgical and Radiologic Procedures - part 10

Bệnh nhân này phần nào suy nhược đến cho vị trí truy cập vĩnh viễn. Về việc loại bỏ các mặc quần áo bao gồm các ống thông Tesio này là những gì nó trông giống như (Hình ). Không có dấu hiệu nhiễm trùng, và ống thông đã chỉ làm việc tốt cho bây giờ gần một năm. | Appendix I Fifty Case Reports Work in Progress 381 Fig. . I AI Case Scenario 44 Poor Catheter Care This somewhat debilitated patient came for placement of permanent access. On removing the dressing covering the Tesio catheters this is what it looks like Fig. . No signs of infection and the catheter has worked just fine for now almost one year. Fig. . 382 Access for Dialysis Surgical and Radiologic Procedures AI Comments The author thinks it makes common sense for the dialysis unit may it be the nephrologist RN DON technician to change check the catheter dressing clean the area including the catheter sutures should be removed 10-14 days after catheter placement. Case Scenario 45 Malplaced Dual Lumen catheter These two elderly ladies share a few problems in addition to advanced age Fig. . Both have left subclavian vein cuffed tunneled catheters that are nonfunctioning lady in Fig. also has a gastrostomy feeding tube . Catheter Fig. . Appendix I Fifty Case Reports Work in Progress 383 in Figure is a split ash poorly primed blood in the red port same dialysis unit as cases 43 and 44 and catheter in Figure is an OptiFlow sutured to the wing. The long scar leading up to the exit site suggests some unusual surgical technique at time of placement Fig. . The main problem with these examples is low and poorly positioned exit sites. This suggests inability to access the central vein or in this case being occluded due to sucking against the lateral SVC wall Fig. . I AI Fig. .