Txawm hais tias koj tsuas yog sim cais cov leeg ntawm koj cov tawv nqaij lossis kawm rau kev kuaj mob lossis ntawv pov thawj ultrasound, koj yuav tsum muaj peev xwm sib txawv ntawm cov hlab ntsha thiab leeg. Yog tias koj tab tom saib ntawm koj cov tawv nqaij, koj muaj hmoo: cov leeg yog qhov yooj yim heev rau pom. Lawv yog cov xim xiav thiab nce me ntsis ntawm cov tawv nqaij thaum cov hlab ntsha zoo li yuav tob dua hauv qab daim tawv nqaij. Koj tseem tuaj yeem cais cov hlab ntsha nrog lub tshuab ultrasound, thiab cais lawv los ntawm cov leeg ntshav raws li lawv lub zog thiab kev coj ntawm cov ntshav ntws. Yog saib cov duab, muaj ntau qhov sib txawv uas koj yuav pom ntawm phab ntsa thiab qhov loj ntawm cov leeg thiab cov leeg.
Cov kauj ruam
Txoj Kev 1 ntawm 3: Txheeb Ntshav Los Ntawm Qhov Muag
Kauj Ruam 1. Txheeb xyuas caj npab, ceg, lossis caj dab kom pom cov leeg ntshav ze ntawm daim tawv nqaij
Muaj cov hlab ntshav thoob plaws koj lub cev, tab sis nws tuaj yeem yog qhov nyuaj rau nrhiav cov hlab ntshav ntawm cov tuab tuab ntawm lub cev. Pib nrog lub caj dab, lossis rub caj npab lossis txhais ceg txhawm rau nrhiav cov leeg. Lawv zoo li yuav tsum tau tsa thiab pom hauv ntu ntawm lub cev nrog cov nqaij rog tsawg.
- Thaum nws zoo kawg nkaus los ntshav los ntawm cov leeg, koj yeej tsis xav kos ntshav los ntawm cov leeg ntshav. Cov hlab ntshav nqa ntshav mus rau lub plawv, thaum cov hlab ntshav xa nws tawm, thiab koj tsis xav kom lub plawv ntawm cov ntshav rov qab mus rau lub ntsws thiab aortas.
- Koj tsis tuaj yeem pom pom cov hlab ntsha zoo li koj tuaj yeem pom leeg. Cov hlab ntshav sib xyaw rau ntawm daim tawv nqaij vim tias lawv tsis nyob ze rau ntawm daim tawv nqaij. Lawv kuj tsis tau tsa rau ntawm daim tawv nqaij li txoj hlab ntshav, uas ua rau lawv nyuaj rau pom yog tias koj tab tom saib nrog qhov muag liab qab.
Tswv yim:
Feem ntau cov hlab ntsha los kos cov ntshav los ntawm yog cov hlab ntshav nruab nrab nruab nrab, uas nyob hauv lub qhov taub ntawm lub luj tshib, qhov twg nws taug kev ntawm lub nqes nqes los ntawm cov hlab ntsha basilica mus rau qhov nruab nrab cephalic leeg. Qhov no yog cov hlab ntshav feem ntau vim tias nws loj thiab yooj yim mus nrhiav.
Kauj Ruam 2. Tshawb xyuas daim tawv nqaij sab caj npab, ceg, lossis caj dab kom pom txoj kab xiav
Tuav ntu ntu ntawm daim tawv nqaij uas koj tab tom tshuaj xyuas tas li thiab ua tib zoo saib saum nplaim dej. Saib rau cov xim ntsuab-ntsuab, kwv yees li 1-2 hli (0.039–0.079 hauv) hauv qhov dav khiav hla cov tawv nqaij. Ntau cov hlab ntshav khiav ntsug thiab nqes nqes thiab caj dab, tab sis koj yuav tsum muaj peev xwm ua kom ob peb leeg me me txuas rau cov leeg loj hauv caj npab, txhais tes, ceg, thiab caj dab.
Koj yuav muaj lub sijhawm yooj yim nrhiav cov leeg ntshav rau saum txhais tes yog tias koj tsis tuaj yeem pom lawv nyob qhov twg lwm qhov
Kauj Ruam 3. Hnov lub ntsej muag ntawm daim tawv nqaij kom pom tias nws nce siab thiab paub meej tias cov leeg
Ntawm tus kheej lossis cov neeg uas ua haujlwm tawm, koj yuav tuaj yeem hnov cov hlab ntsha nthuav tawm ntawm daim tawv nqaij me ntsis. Khiav koj txhais tes maj mam hla ntawm cov leeg. Yog tias nws zoo li nce siab, koj twv yuav raug hu muaj leeg ntshav. Yog tias koj muaj teeb meem hnov cov hlab ntshav thiab nws nyob hauv caj npab, qhwv cov ncig ncig saum cov hlab ntshav kom txwv cov ntshav ntws thiab nce cov leeg ntshav.
- Kev ncig ncig yog roj hmab lossis ntaub ntaub ntev ntawm cov khoom uas koj khi nruj nreem saum cov hlab ntshav kom txwv tsis pub cov ntshav ntws mus rau tus ceg. Qhov no ua rau kom lub siab nyob hauv cov leeg, ua rau nws pom tau yooj yim dua.
- Tsis txhob qhwv ib ncig ncig ncig ib tus neeg lub caj dab.
- Tourniquets kuj tseem tuaj yeem siv los tiv thaiv ib tus neeg los ntawm ntshav tawm. Lawv yog qhov zoo uas yuav tau dag ib ncig yog tias koj yog EMT, kws saib xyuas neeg mob, lossis kws kho mob.
Txoj Kev 2 ntawm 3: Siv Vascular Ultrasound
Kauj Ruam 1. Nug tus neeg koj tab tom sim tshem tawm cov hniav nyiaj hniav kub lossis khaub ncaws hauv cheeb tsam
Koj tuaj yeem nqa lub vascular ultrasound, tseem hu ua Doppler ultrasound, ntawm ib feem ntawm lub cev. Nug tus neeg uas koj tab tom sim tshem khaub ncaws ntawm 6-12 ntiv tes (15-30 cm) ntawm lub cev uas koj tab tom sim. Thov kom lawv tshem tawm cov hniav nyiaj hniav kub uas nyob ze thaj tsam ib yam, vim tias cov hniav nyiaj hniav kub tuaj yeem cuam tshuam nrog kev sim.
Lub vascular ultrasound xa suab nthwv dej hla ib ntu ntawm lub cev thiab siv lub suab nthwv dej los tsim cov duab ob sab ntawm cov hlab ntsha thiab leeg
Tswv yim:
Thaum koj tuaj yeem pom cov leeg ntshav hauv ultrasound, koj yuav tsum muaj lub sijhawm yooj yim cais cov leeg ntshav los ntawm kev saib cov ntshav ntws thaum koj tig lub thawv xim rau. Cov hlab ntsha ntws tawm ntawm lub plawv, thaum cov hlab ntsha ntws mus rau nws. Koj kuj tseem yuav pom cov hlab ntsha sib cais nyob hauv qab ntawm daim tawv nqaij txij li koj tuaj yeem pom lawv ua pa.
Kauj Ruam 2. Rub cov dej-soluble gel rau ntawm qhov chaw ntawm lub transducer lub sensor
Koj xav tau lub tshuab hluav taws xob ultrasound kom tuaj yeem txav tau lub tshuab hloov pauv ib puag ncig kom tau txais cov duab huv. Cov roj nplua nyeem tseem yuav tsim kev sib txuas ntawm cov tawv nqaij thiab cov hloov pauv, tso cai rau lub suab tsis dhau ntawm daim tawv nqaij. Muab ob lub hnab looj tes looj thiab siv lub qhov taub nyem los thov gel rau lub ntsuas. Rub cov gel nyob ib ncig ntawm lub ntsuas kom txog thaum nws tau npog tag nrho.
- Lub ntsuas cua yog lub npog ib nrab tiaj ntawm qhov kawg ntawm lub transducer, rov qab ntawm kab.
- Ua kom ntseeg tau tias lub tshuab hloov pauv tau ua kom tsis muaj menyuam thiab ntxuav kom huv ua ntej siv rau ntawm ib tus neeg.
- Siv cov gel ntau li qhov tsim nyog los npog tag nrho cov transducer. Nws yuav txias rau tus neeg uas koj tab tom tshuaj xyuas, tab sis nws yuav tsis tsim teeb meem muaj txiaj ntsig yog tias koj siv cov gel ntau dhau.
Kauj Ruam 3. Qhib lub tshuab ultrasound thiab hloov chaw
Qhib lub tshuab ultrasound, thiab ua raws cov lus qhia tsim nyog kom teeb tsa lub tshuab rau "teeb tsa" teeb tsa. Hloov zaus mus rau 5.0 MHz rau cov duab vascular los ntawm nias lub pob lossis tig lub xov tooj. Tig qhov kev siv txhua txoj kev nqes mus rau qhov chaw qis tshaj thiab ua haujlwm los ntawm qhov ntawd.
- Lub ultrasound yuav tsum tau teeb tsa rau "txuas ntxiv mus" yog tias koj xav tau cov duab zoo ib yam thiab tsis yog sim ua ib daim duab nkaus xwb.
- Yog tias thaj chaw tau kub hnyiab lossis o, tig lub taub hau kom sov kom tsis txhob hloov pauv kom txias yog tias nws muaj lub taub hau ua kom sov.
- Qhov zaus ntawm lub tshuab ultrasound tau hloov pauv raws li qhov koj xav pom sab hauv ntawm tus neeg koj tab tom sim. Piv txwv li, koj yuav siv 2.5 MHz rau cov duab thaij duab, tab sis 15 MHz rau cov pob txha lossis cov leeg. Koj yuav tsum tau hloov kho qhov zaus me ntsis raws li tus neeg koj tab tom tshuaj xyuas.
Kauj Ruam 4. Khaws tus hloov pauv mus rau thaj chaw uas koj tab tom sim thiab saib rau cov hlab ntshav
Muab tus transducer tso rau ntawm daim tawv nqaij uas koj tab tom nrhiav ntshav. Tsiv tus hloov pauv ib puag ncig kom kis tau cov gel hla thaj chaw uas koj tab tom saib. Cov hlab ntsha feem ntau yuav zoo li lub raj yas lossis khoob vim koj tsis tuaj yeem pom ntshav hauv daim duab dub-thiab-dawb ultrasound.
- Cov leeg yuav dawb/txho thiab zoo saib. Cov hlab ntsha yuav tsum tsis muaj xim nyob hauv. Yog tias ua tau, sim kho qhov zaus kom txog thaum cov hlab ntsha zoo li hollow.
- Yog tias koj saib ntawm txhais caj npab lossis txhais ceg ntawm lub kaum sab xis uas koj tab tom saib mus rau hauv cov hlab ntsha lossis leeg, koj yuav pom tsuas yog lub voj voos.
Kauj Ruam 5. Qhib qhov ntsuas cua sov kom saib xyuas cov ntshav ntws
Txij li cov ntshav yog qhov kub sib txawv dua li lub cev tas li, thiab vim tias nws txav mus los, koj yuav tsum tuaj yeem pom tias cov ntshav ntws los txwv lossis pub dawb hauv cov hlab ntshav los ntawm kev hloov qhov ntsuas kub ntawm koj lub transponder. Koj yuav tuaj yeem pom cov ntshav ntws los ntawm cov hlab ntsha hauv lub thawv xim ntawm koj lub vijtsam.
- Qhov ntau los ntawm qhov zoo 27 cm/s txog -27 cm/s yuav tsum yog cov khoom ruaj khov rau sau cov ntaub ntawv ntawm cov ntshav ntws hauv cov hlab ntshav.
- Yog tias koj tab tom tawm tsam kom pom cov leeg ntshav, sim ua raws qhov chaw khoob ntawm kab rov tav kom pom yog tias koj tab tom saib ntawm ib qhov ntev ntawm qhov khoob.
- Yog tias koj tsis tuaj yeem pom ib qho ntshav ntws ntawm koj lub vijtsam thiab koj tau hloov kho koj cov teeb tsa ntau zaus (thiab koj tsis tau sim lub cadaver), koj feem ntau yeej tsis tau saib ntawm cov hlab ntshav.
Kauj Ruam 6. Txheeb xyuas seb lub lumen pulses thaum hloov pauv los qhia cov leeg ntshav los ntawm cov leeg
Thaum saib cov duab nyob, yog tias koj tab tom saib 2 lub lumens thiab tab tom sim txiav txim seb qhov twg yog cov leeg ntshav thiab uas yog leeg ntshav, nug tus neeg mob kom yoog lawv cov leeg. Raws li cov hlab ntsha thiab cov hlab ntshav cog lus, cov hlab ntshav yuav kaw thiab qhib tau zoo, thaum cov hlab ntsha yuav pulsate me ntsis. Koj kuj tseem tuaj yeem pom tias cov hlab ntshav kaw qeeb dua li cov leeg.
- Qhov kev tawm suab no yuav zoo li zoo li me ntsis tshee. Lub lumen yuav qhib thiab kaw ntau zaus thaum nws yuam cov ntshav hla.
- Koj tseem tuaj yeem ntxiv qhov siab ntxiv rau tus hloov pauv kom ua rau cov hlab ntsha tawg thaum cov hlab ntsha nyob qis.
- Lub lumen yog lub sijhawm kho mob rau lub hollow, raj zoo li cov qauv uas pom hauv cov leeg thiab cov hlab ntsha.
- Qee cov hlab ntsha yuav tsis kaw hlo li. Cov leeg yuav ib txwm kaw txawm hais tias.
Txoj Kev 3 ntawm 3: Txheeb Xyuas Cov Duab ntawm Cov Voj Vias thiab Cov Hlwb
Kauj Ruam 1. Sib piv qhov ruaj khov thiab tuab ntawm phab ntsa
Yog tias koj tab tom saib cov duab me me lossis cov duab cua sov ntawm cov hlab ntsha lossis cov leeg, pib los ntawm kev saib ntawm phab ntsa ntawm lub lumens, uas yog cov raj hollow hauv tib neeg lub cev. Cov hlab ntsha muaj cov phab ntsa nyias dua li cov hlab ntsha, thiab cov hlab ntsha phab ntsa feem ntau muaj cov kab nyob ib puag ncig ntawm qhov qhib. Thaum saib ntawm ib khub, cov hlab ntsha yog ib qho nrog cov phab ntsa tuab, du dua.
Cov hlab ntsha yuav luag ib txwm me me me dua cov hlab ntshav ze tshaj plaws ib yam
Kauj Ruam 2. Saib rau lub lamina ywj kom paub txog cov hlab ntsha
Cov hlab ntsha muaj qhov sib txuas ntawm cov xov paj ywj ywj khiav raws ib puag ncig ntawm nws lub lumen. Qhov no zoo li tsis zoo li txheej txheej ntawm cov ntaub, teeb tsa hauv cov qauv accordion. Cov kab hauv qab no hu ua lub lamina ywj, thiab nws tsuas yog muaj nyob hauv cov hlab ntsha. Yog tias koj pom cov yas lamina, koj yuav tsum tau saib ntawm cov hlab ntsha.
Tswv yim:
Cov hlab ntsha zoo li muaj zog dua li cov leeg, yog li sab hauv sab hauv ntawm cov hlab ntshav muaj txheej ntxiv. Qhov no yog vim li cas cov yas lamina muaj nyob hauv cov hlab ntsha thiab tsis leeg.
Kauj Ruam 3. Tshawb xyuas qhov chaw nruab nrab ntawm phab ntsa thiab cov leeg kom pom cov leeg
Thaum saib cov duab hluav taws xob lossis duab me me ntawm cov hlab ntsha, tshuaj xyuas qhov chaw nruab nrab ntawm ntug ntawm cov hlab ntshav ntawm cov leeg thiab cov leeg, uas yuav yog hlua thiab cov ntawv. Yog tias qhov chaw no tsis muaj kev ntxhib los mos thiab feem ntau yog du thiab nyias, koj tab tom saib cov leeg.
- Tshooj ntawm cov hlab ntshav no hu ua tunica media.
- Cov ntu sib thooj ntawm cov hlab ntsha zoo li taw tes thiab cov ntawv, zoo ib yam li cov ntaub pua tsev nyuaj siab.
Lub tswv yim
Cov hlab ntsha ib txwm muaj cov xim xiav thiab cov hlab ntsha tsis pom rau qhov muag liab qab. Cov ntshav yog ib txwm liab txawm tias nws nyob hauv cov leeg lossis leeg
Lus ceeb toom
- Tsis txhob khi ib lub tourniquet rau hauv lub hauv caug. Hloov chaw, quav 2 qhov ntev dua ib leeg zoo li koj tab tom pib khi koj nkawm khau thiab rub lawv kom nruj. Yog tias koj khi hlua thiab qee yam tsis raug, koj yuav tsum siv sijhawm ntau los kho qhov pob, uas tuaj yeem ua rau muaj teeb meem.
- Yog tias koj tab tom kuaj ntshav thiab koj tab tom tawm tsam kom pom cov leeg ntshav, sab laj nrog lwm tus kws kho mob phlebotomist. Nws tsis ncaj ncees rau tus neeg mob kom zaum ntawd lo lawv nrog rab koob ntau zaus thiab lub qhov muag tshiab yuav pab.
- Tsis txhob kos ntshav los ntawm cov hlab ntshav tshwj tsis yog koj tab tom kuaj xyuas cov roj ntshav ntshav lossis lwm qhov chaw kuaj tshwj xeeb uas xav tau.
