Carrying punctures

August 12, 2017 17:50 | Paramedic

abdominal puncture (paracentesis)

Apply with ascites.

the following tools: a scalpel, a needle holder, skin needle, silk №4 (1 ampoule), surgical tweezers, the trocar, a rubber catheter, 3-4 gauze balls, scissors, oilcloth apron.The patient is seated on a stool so that his back rested against the dressing table.Around the waist at the level of the inguinal folds tie oilcloth apron, covering the legs of the patient.The edges of the skirt should hang down to the pelvis, the substituted at the patient's feet.

Prepare the surgical site on the patient's abdomen.The surgeon, treating the hand, produces a local anesthetic and then a scalpel incision in the skin puncture site alleged.

produce puncture trocar consisting of a metal tube, which slides a steel rod with a sharp tip.After puncture stylet removed, slowly releasing the fluid, approximately 1 ml in 5 minutes, to periodically cover this ball on the surgical tweezers exterior orifice tube.Upon termination of the fluid discharge check whether the hol

e has not closed the gut or a strand of omentum for this use a soft rubber catheter.After extraction the surgeon places the two tubes silk suture with skin, imposes little napkin after processing seams.

Puncture of the pleural cavity (thoracentesis)

Tools: two 20 mL syringe, one with a 0.5% solution of novocaine, the second - is empty, needle punctures with a rubber tube and cannula hemostat.The patient sits leaning slightly forward, raised on the side of the hand held puncture nurse.Preparation of the surgeon and the surgical field conventional arms.After a local anesthetic Novocain surgeon picks up a puncture needle with a tube clamp clamped, and the dotted line the pleural cavity.It then passes into the hands of the sisters dressing clip lying on the handset.This clip opens sister at the time of suction surgeon fluid and air from the pleural cavity and closes it to provide the surgeon.Evacuate fluid should be slow (1 liter per 15 minutes), occasionally suspending aspiration.After removing the needle puncture site yodinolom processed and carefully glued.

Constant thoracostomy with pneumothorax.Tools: a syringe with a 0.5% solution of novocaine, trocar, PVC drain pipe length of 20-25 cm, with numerous holes for 8-10 cm, a scalpel, a needle holder, skin needle, silk №4 (1 USD), three hemostaticclamps, scissors.The patient is lying on the dressing table, face up, arms stretched along the body, preparing the operating field and the surgeon conventional arms.At the end of vinyl chloride tube impose hemostat.After a local anesthetic in the region II intercostal space novocaine solution surgeon makes a puncture of the skin with a scalpel, from the corners of the puncture imposes two silk suture skin, taking them to the clip number 2, and through this incision into the pleural cavity holds the trocar.By removing the stylet trocar the surgeon covers the finger with a sterile cloth hole in the tube trocar forceps sister delivers drainage overlaid with the terminal number 1. The surgeon holds fast drainage into the pleural cavity, remove the trocar tube and intercepting clip number 3 so that it may not remainan open, locks the drainage to two cash advance skin seams.After processing yodinolom drainage circle in his place standing glued to the cut half a small napkin.

puncture pericardium

patient is laid horizontally on the back, raising the head end of the dressing table.Under the back on the lower level of the ribs enclose a small roller.Prior to puncture the patient through a tube empty stomach.After processing the surgical field surgeon takes a 20 ml syringe filled with 0.5% solution of novocaine.Fine needle anesthesia the surgeon makes the skin at the base of the xiphoid process, takes a needle length of 10-12 cm and a diameter of 1-1.5 mm and with a syringe promotes it on a back surface of the sternum, predposylaya novocaine solution.After going 2-3 cm, the needle punctures the pericardium and into the syringe starts flowing blood or exudate.Aspirate exudate produced slowly, usually 100-400 ml of liquid is removed.The puncture site is treated with antiseptics and glued kleolom.

poisoning novocaine.After 30-40 seconds after injection, the patient feels unwell, feeling cold, dizziness, appear cold sweat, shortness of breath.Sometimes the confusion and excitement.Intramuscularly or subcutaneously necessary to introduce caffeine kordiamin give oxygen inhalation ammonia.