1. Local skin care
In addition to close observation of the local skin for inflammatory reactions such as redness, swelling, heat and pain, daily disinfection of the puncture point with iodine, alcohol, to be evaporated and dried, plus povidone-iodine, because of the gradual release of iodine, can play a role in the continuous sterilization. In addition, there is a layer of dark brown thin crust formed on the local skin where povidone-iodine is applied, which can play the role of covering the skin entrance of the catheter, and has a definite therapeutic effect on preventing bacteria from traveling into the bloodstream along the sinus tract next to the catheter. Then use 3M transparent film to cover the puncture point and catheter, because it has good air permeability, sterile, not easy to cause the capping site skin excreta can not volatilize and lead to infection. These may be the main reasons for the occurrence of no infection in this group. Another need to closely observe the temperature changes, body temperature is an important indicator of monitoring the occurrence of infection in the process of central venous catheter indwelling, when the patient suddenly appeared chills and fever, body temperature suddenly increased, and clinically can not find other reasons, should be considered for catheter-related infections.
2. Anti-embolism care
The end of the indwelling catheter is connected to a heparin lock, which prevents blood coagulation in the catheter and reduces the possibility of bacterial intervention. The scalp needle is inserted into the heparin lock for infusion, and 3 ml (125 U/ml) of heparin solution is injected through the scalp needle at the end of the infusion every day at a slow speed, and care is taken to withdraw the scalp needle to leave only the tip of the needle, so as to ensure that the heparin solution fills up the entire lumen, thus avoiding blockage caused by the relatively lower concentration of heparin solution. When connecting the scalp needle daily, take care to withdraw blood to determine whether the catheter is patent; if blood return is not seen, it should be determined whether the catheter is dislodged or whether the blood returned to the catheter is coagulated. Air embolism often occurs in deep venous placement, and if prompt action is not taken, the patient will die of air embolism within minutes. This group of patients are prepared before puncture infusion pump device, according to the function of the infusion pump to set the alarm program, such as the occurrence of blockage, air, infusion is complete, etc., to ensure that the fluid into the body smoothly and avoid accidents.