1. Drug extravasation: If drug extravasation occurs during injection, the alarm system of micropump will not reflect it, and serious consequences will be caused if active and correct measures are not taken in time.
2. Phlebitis and venous sclerosis: Generally, indwelling needle puncture is carried out when micro-pump is administered, and the drug concentration is relatively high, so the risk of phlebitis and venous sclerosis is also high.
3. Venous blood return is related to factors such as slow speed, long or folded extension tube and simultaneous injection of two channels.
4. Needle blockage: Because the extension tube has certain elasticity and large capacity, after the needle is blocked, the micropump continues to deliver the liquid medicine, but the liquid medicine does not enter the blood vessels, but accumulates in the extension tube. When the pressure of the extension pipe increases to a certain limit, the micropump will give an alarm, which is unfavorable to critically ill patients.
5. Micro-pump speed adjustment error: because the operator is not familiar with the speed setting key, or the speed is not changed in time after dressing change, or in some cases, the speed setting is inadvertently touched by others and the speed is changed, so that too much drugs or drugs do not enter the body, leading to adverse consequences.
6. Micro-pump failure: inaccurate speed, exhausted battery, improper maintenance, careless cleaning of micro-pump, especially high-viscosity liquid medicine sticking to the friction between propeller and guide rail, which affects the accuracy of speed.
7. It is very common to insert 2 ~ 3 channels from heparin cap of venous indwelling needle in clinic, so that patients can avoid the pain of venipuncture again. However, somatostatin can not be combined with other drugs, which will reduce the curative effect.
8. The indwelling time of venous indwelling needle is too long. Due to the long course of treatment of acute pancreatitis, in the process of using micropump, the indwelling time of intravenous indwelling needle is too long, which leads to phlebitis for more than 7 days.
Nursing countermeasures:
1. strengthen patrol observation: closely observe the local reaction of drugs, whether there is extravasation, especially when it is imported from central vein, and closely observe the local skin color and whether there is swelling. Once drug extravasation is found, stop injection immediately, re-select veins and do local treatment.
2. Explain the usage, therapeutic purpose and precautions to patients and their families to prevent self-adjustment.
3. Before using the micropump, select the blood vessels first, and generally select the upper limb parts with thick and straight blood vessels, which are easy to fix and observe for venipuncture. Slow venous return and semi-sitting position determine more phlebitis during lower limb infusion, because liquid and liquid medicine stay in lower limb vein for longer than upper limb vein during infusion. In addition, low immunity is an important factor of phlebitis, because immunity is obviously reduced. The repair ability of vein wall trauma caused by puncture and the anti-inflammatory ability of mechanical stimulation (caused by indwelling catheter), chemical stimulation (caused by liquid medicine and liquid) and local inflammation caused by bacteria are also reduced. Phlebitis is more likely to occur when using peripheral venous indwelling needle, so try to avoid puncture and infusion in lower limbs. Micro-pump infusion is a special channel, so try not to use a vein with other drugs. The indwelling needle is usually replaced once every five days to avoid phlebitis and local inflammation caused by long-term infusion.
4. When injecting drugs with a micropump, the effects and reactions of drugs should be closely observed. If the blood pressure and heart rate change greatly without obvious reasons, the extension tube of the micropump should be disconnected from the scalp needle joint to observe whether the blood vessels are unobstructed.
5. Strengthen the sense of responsibility, standardize the operation, be familiar with the performance of the micro-pump, correctly master the use method and the settings of each key, understand the matters needing attention, and have a high understanding of common problems. Clean up the dirt and residual liquid on the pump surface in time, collect and sort out the machine to prevent corrosion, and keep it by special personnel after use.