1 Material
Cotton thread (the length of about 1.5 times the length of the cleaning of the connecting tube) 2, gauze 1 (8cm * 25cm), 1 scissors, 500ml empty saline bottle 1, can provide tap water tap 1, the need to clean the connecting tube.
2 Methods and steps
(1) Pre-rinse the connecting tube with tap water, which serves to moisten the wall of the tube and pre-clean the foreign body. (2) Introduce the cotton thread into the connecting pipe so that it runs through the entire pipe and exposes both ends. Specific method: tie a knot at one end of a cotton thread, the same point 4 to 5 times, to knot can slide freely in the pipe and the largest possible as good, wet the whole cotton thread, the knot in front of the end of the knot is not knotted part cut off. Put the knot into one end of the connecting tube and feed the cotton thread into it. At this time, the connecting pipe straight, into the end of the line under the tap, the other end is placed in the 500ml empty bottle, while rinsing the pipe with water, while sending the cotton thread into the pipe, relying on the force of the water and gravity, so that the cotton thread into the pipe (the cotton thread at the front end of the knot is equivalent to the front end of the floating catheter, more conducive to the cotton thread into the pipeline) until the entire pipeline is cotton thread through. This process when the bottle is full of water in time to pour. (3) Clean the pipe by tying the cotton thread around the gauze. Cut off the knot at the knotted end and tie the cotton thread entering the pipe and another cotton thread at 1/3 and 2/3 of the long axis of the gauze, respectively. After moistening the gauze, use the cotton thread already in the pipe to pull the gauze into the pipe, use the friction of the gauze on the pipe wall to clean the pipe lumen (at this time, the gauze should be 2/3 of the full length of 25cm, half of which is the thickness of the 4cm wide gauze, and the other half of the 8cm wide gauze) to put the pipe straight so that it's easier to pull the cotton thread and gauze, and at the same time as the gauze is being pulled to clean the pipe lumen, the other cotton thread is being brought into the Pipe lumen, the first cotton thread all pull out, the second also all into the pipe lumen, required to pull out all the gauze, cleaning gauze, and then pull the second cotton thread in the opposite direction, to the pipe lumen again cleaning, and so on, until the wash. (4) After washing, pull out the cotton thread, rinse the lumen with water, and then put it into the disinfectant solution to soak for spare.
3 Precautions
(1) cotton thread thickness is appropriate, too thick is not convenient to operate, too fine strength is not enough; (2) knot size is appropriate, too big too small are not conducive to the water rushed into the tube (too large due to friction with the wall is too large, too small to play the role of the "floatation of the catheter"); (3) gauze should be tied securely to ensure that when pulling the gauze with the cotton thread, it is not possible to use it in the tube, so it is not necessary. Ensure that in the cotton line pull gauze gauze will not fall in the pipe, resulting in the failure of the washing tube; (4) each time a cotton line pull out gauze must be pulled out, in order to facilitate the next pull to make the gauze formation fold, to avoid due to the tie is not secure and the result of gauze falling in the tube; (5) pull the cotton line when the pipeline is straightened, in order to reduce the line and the pipe wall friction.
4 Advantages of the new method
(1) Thorough cleaning of the lumen, to ensure strict disinfection; (2) the method is simple and easy to implement, easy to operate; (3) to save the resources of the suction connecting tube in the medical treatment, which is conducive to the costing of the department and to reduce the economic burden of the patient; (4) can be borrowed from this method to clean other similar pipes.
Introduction of a new method of sputum aspiration
Keywords: sputum aspiration nursing
Sputum aspiration is a therapeutic means of using mechanical suction to aspirate respiratory secretions through the mouth, nose, or artificial airway in order to keep the airway open. Patients in coma and after anesthesia are unable to cough up sputum due to coughing weakness, slow cough reflex or epiglottis insufficiency; or vomitus is mistakenly inhaled into the trachea, which can cause aspiration pneumonia, pulmonary atelectasis, and in severe cases, respiratory distress, cyanosis, and even asphyxiation and death. There are many methods of sputum suction, in the past, clinical teaching, the nurse to the patient sputum suction most of the single operation, our department since May 2004, the use of two people with sputum suction method, sputum suction effect is better than the single operation, the method is introduced as follows:
1 operation method
Before sputum suction, turn over, knocking the back of the first 5 to 10min, knocking the chest and back, with the help of vibration to make the secretion The patient's left side is the most important part of the patient's chest and back. The operator stands on the left side of the patient, increases the oxygen concentration to 2-3L/min to increase the patient's oxygen supply, connects the suction device to get ready for the work, another assistant or family member stands on the right side of the patient, presses the right index finger, middle finger and ring finger to the patient's laryngeal node at the same time, rotates and massages it for several times, and then presses it downward for 1cm, which makes the majority of the patients cough and swallow reflexes, and the epiglottis cartilage opens. At this time, the pharyngeal cartilage is open, and the operator should take this opportunity to insert the suction tube into the trachea smoothly and accurately, rotate it from deep to left and right, and lift the suction tube upward to suction all the sputum.
2 Advantages
The advantages of this method are mainly reflected in the following aspects: (1) The two-player operation is more effective than the traditional single-player method thoroughly, which can suction out all the respiratory secretions and reduce the damage of the respiratory mucosa, which is conducive to safeguarding the patient's breathing and preventing asphyxiation and lung infection. (2) It is conducive to the rehabilitation and treatment of the condition, reduces the pain of the patient and lowers the difficulty of nursing. While the traditional method is a single person operation, due to most of the patients do not cooperate, and the suction tube can not be inserted into the main position, the secretion in the respiratory tract is not easy to be thoroughly suctioned out, and the chance of pulmonary complications is high. (3) This method is highly adaptable to patients with moderate or shallow coma. (4) It effectively avoids tracheotomy due to respiratory secretions that are too much and not easy to be sucked out and respiratory difficulties. Therefore, it reduces the hospitalization cost of the patient.
3 Precautions
When using this method, the following aspects should be noted: (1) the thickness of the suction tube should be appropriate, the suction process should be gentle, not to stimulate back and forth, the negative pressure suction should not be too large, adults are generally 0.04MPa, too large can damage the mucosa of the airway, a suction of sputum is not more than 15s. (2) Massage of the laryngeal nodes should not be too heavy, so as not to damage and oppression of the thyroid cartilage. (3) Hypertension, cerebral hemorrhage patients generally do not use this method, because the stimulation is too large, easy to cause increased intracranial pressure. Elderly people have large brittle blood vessels, which may aggravate the condition, increase the amount of cerebral hemorrhage, and make it easy for cerebral hernia to occur. (4) It is not effective for patients in deep coma.
Suction method
Supplies
One set of suction device. Therapeutic tray: several suction tubes of appropriate thickness, a glass T-tube (connecting the suction tube and suction catheter), several pieces of gauze, cotton swabs, tongue depressors, openers, saline or warm boiled water in a jar with a lid, sterilized tweezers, rinsing solution, syringes, therapeutic towels, and a curved tray.
Methods
1. Before suction, check whether the suction device performance is good, whether the suction catheter is smooth.
2. Prepare all the supplies, set the bedside table, explain to the patient.
3. Tilt the patient's head to one side and slightly backward. Comatose patients can use the tongue depressor to open the mouth, hold the suction tube from the oral buccal inserted into the pharynx, and insert the suction tube into the trachea when the patient inhales. If oral suction is difficult, it can be inserted by the nasal cavity (skull base fracture patients are prohibited); tracheal intubation or tracheotomy patients, can be inserted by the tube or cannula.
4. Before inserting the suction tube, open the suction switch. However, the side hole of the T-tube should be relaxed, and when the suction tube is inserted into the trachea at a certain depth, the side hole can be immediately pressed closed to suction. When suctioning sputum, the suction tube should be lifted up slowly from the bottom and rotated from side to side to suction the sputum. Prevent damage to the mucosa by fixing it in one place or lifting and inserting it up and down to attract sputum. After removing the sputum tube, rinse the sputum inside the tube with water to avoid obstruction. Turn off the suction switch.
5. One suction should not exceed 15s (clean the nose and mouth after suction). At the same time, check the mucous membrane for damage. Each sputum should be replaced with a sterilized sputum tube. Tracheotomy patients should pay more attention to aseptic operation.
6. Increase the concentration of oxygen before and after sputum suction, and observe the vital signs before, during and after sputum suction, and stop the operation if there is any discomfort.
Attention
1. The suction liquid in the reservoir bottle should be poured out in time to avoid the liquid being sucked into the motor and damaging the machine.
2. The suction tube should be used one at a time and should not be reused to avoid infection.
3. The suction material in the treatment tray should be changed once a day.
Phlegm in the infant's throat
is a physical problem.
If the baby does not have a fever \ not coughing \ breathing sound, eat well, play well, sleep well, there must be no problem, do not go to the hospital. Because the doctor will exaggerate and say that this is bronchitis and so on, and then give the injection \ to eat anti-inflammatory drugs and so on, no disease also want to say a little bit of disease so that the child suffered.
First of all, let him drink more water, less bath, wash once every three days can be, and wash fast, but the room do not get too hot; Secondly, as long as the wind is not windy must let the child to play outdoors, so that you can exercise his respiratory system, enhance the resistance. 3, if the child's phlegm is not yellow, the body is not hot can be eaten every day a bit of baby dan or monkey jujube loose, the child phlegm accumulation is not basically a disease, doctors are not the only way to solve the problem, the key to the problem. The only way to solve the problem, the key is still the mother of the child's exercise and attention.
Can often give the child to turn over or pat the back, one is to promote blood circulation in the lungs, the second to make the bronchial phlegm loose and easy to discharge. The method of patting the back is as follows: the sick child lying on the side or holding up the side, parents of five fingers slightly curved into a half-ring, that is, half a fist, patting the sick child's back, alternating between the two sides. Patting force should not be too large, from top to bottom, from outside to inside, in order. Each side patting 3~5 minutes, 2~3 times a day.
Babies due to the lack of ability to expel phlegm, when the little baby coughing you can: 1, will be the little baby horizontal prone in your lap,
and then rhythmically patting his back, not too When he is coughing, try to help him cough phlegm out of the chest cavity. It's OK to let him push. Encourage the child to spit all the phlegm he coughs up into a basin; 2. When he is coughing, make sure he doesn't catch a cold, which may cause bronchitis; 3. If the child has a dry cough, giving him warm boiled water before bedtime can make the child's throat comfortable; 4. The child can be propped up with a couple of pillows while he sleeps to prevent drops of mucus from being secreted down his throat. Infants can put a pillow under the head mattress pad; 5, so that the child has a smoke-free environment;
And waking up from sleep crying may be because of the shock, call the person who will collect the shock to collect a little bit will be fine, or to eat a little pearl powder or monkey jujube loose will be good. I wish your baby a speedy recovery!
Electric sputum aspirator
1. The structure is mainly composed of motor, eccentric wheel, gas filter, pressure gauge and safety bottle and reservoir bottle. The safety bottle and liquid storage bottle are two containers with capacity of 1000ml with 2 glass tubes and rubber tubes connected to each other.
2. Principle of the power supply, the motor drives the eccentric wheel, from the suction holes to suck out the air inside the bottle, and from the exhaust holes, so that the continuous cycle of rotation, so that the bottle produces a negative pressure, the phlegm will be sucked out.
3. The material electric suction device 1, aseptic treatment tray or box with a lid canister 2, each with sterile saline and 12-14 sterilized sputum suction tubes, tracheal intubation prepared for the No. 6 sputum suction tube, gauze, hemostatic forceps, aseptic holding forceps placed in a bottle of disinfectant, multi-head electric plug board, curved plate, necessary to prepare tongue depressor, corkscrew, tongue pulling forceps, the bed rails. A glass bottle with disinfectant is attached to the bedrail. A bucket is placed on the floor to hold the dirty suction tube.
According to the patient's level of consciousness, degree of cooperation and the presence or absence of an artificial airway, choose the appropriate route of suction; sputum suction through the nose, sputum suction through the mouth, sputum suction through the artificial airway.
4. Operation method
(1) Check whether the suction device is well connected and whether there is any air leakage. Turn on the power, open the switch, check the performance of the suction device, adjust the negative pressure. General adult sputum suction negative pressure of about 40-50kPa, pediatric sputum suction of about 13-30kPa, will be placed in the suction tube in the water, test attraction, and rinse the skin tube.
(2) Turn the patient's head toward the nurse and lay a therapeutic towel under the jaw.
(3) Insert the suction tube in the order of oral vestibule → buccal → pharyngeal, and suction all the parts. If oral suction is difficult, it can be inserted from the nasal cavity (prohibited for patients with skull base fracture), and the order is from nasal vestibule → lower nasal passage → postnasal aperture → pharynx → trachea (about 20-25cm), and the secretions will be suctioned out section by section. If there is tracheal intubation or tracheotomy, it can be inserted from the intubation tube or cannula to suction out the sputum. Comatose patients can be used tongue depressor or cotter to open the mouth first, and then suction.