Ina roa te wā e tango ana koe i te rongoā, inā koa me werohia ki roto i te uaua, he tino whakarihariha te wero i ngā ngira ki roto i ō uaua i ia rā, kāore? I ētahi wā he uaua ki te kimi i tētahi uaua, ā, ki te werohia tonutia e koe ngā ngira ki roto i ō uaua, ka taea e koe te pakaru. Nō reira, i tēnei rā kei te kōrero tātou mō tētahi taputapu motuhake ka tino āwhina i ngā tūroro me ngā tākuta i roto i ngā āhuatanga pēnei. Koinei te mea e kiia nei e tātou he raina pokapū, he CVC rānei.
He aha tonu te rārangi pokapū (CVC)?
He whakarāpopototanga noa iho, he ngongo angiangi, roa, ngāwari te aho pokapū e whakaurua ana ki roto i tētahi uaua nui o tō tinana. I te nuinga o te wā ka whakaurua ki roto i tētahi uaua nui i tō kaki, i tō uma, i tō hope, i tō ringa rānei, ā, ko te pito kē atu o te ngongo ka mirohia ki roto i te uaua matua e kawe ana i te toto ki te ngākau (te 'vena cava').
Whakaarohia he 'huarahi' motuhake kua whakanohoia ki roto i ō toto. Mā tēnei 'huarahi', ka taea e ngā tākuta me ngā nēhi te uru atu ki ō toto.
E rua ngā momo o te wāhanga e pupū ake ana o tēnei ngongo:
1. Hei pū: Koinei te wāhanga e kitea ana mā roto i tō kiri. Koinei te wāhi e hono ai ngā mea pēnei i te ngongo tote e hoatu ana ki a koe he rongoā.
2. Hei pūaha: He taputapu iti tēnei, he rite te rahi ki te moni, ka whakaurua ki raro i te kiri. He tapahi iti noa iho i te kiri ka kitea. Ina hiahiatia he rongoā, ka whakaurua he ngira motuhake mā roto i taua tapahi ka uru ki roto i te kiri.
Ko te painga nui o tēnei, ina werohia, ka taea e koe te mahi i ngā mea maha pēnei i te tango rongoā, te tango toto, me te hoatu tote, me te kore e hiahiatia he ngira i ia wā mō te wā roa .
He aha te rerekētanga i waenga i te raina pokapū me te cannula noa (Peripheral IV)?
E toru ngā rerekētanga matua i waenga i te cannula (e kiia ana ko te 'catheter') e whakamahia ana i te hōhipera me tēnei raina pokapū. Ka mārama ngāwari koe ina tirohia tēnei ripanga.
| Te take mō te huringa | Raina Waenga (CVC) | Cannula noa (IV ā-taha) |
|---|---|---|
| Te wāhi e whakauruhia ai ki roto i te tinana | Ka werohia ki roto i tētahi uaua nui, hōhonu i te kaki, i te uma, i te hope, i te ringa o runga rānei. | I te nuinga o te wā ka werohia ki roto i tētahi uaua iti e kitea ana i runga ake i te kiri, i te ringa, i te ringaringa rānei. |
| Rahi me te roa | He tino roa, he matotoru hoki tēnei ngongo. Me roa hoki nā te mea me tata ki te ngākau. I ētahi wā, e rua, e toru rānei ngā ngongo (lumens) e whakamahia ana hei hoatu i ētahi momo rongoā i te wā kotahi. | He poto, he mārie hoki tēnei. He poto noa te tawhiti ka uru ki roto i te uaua. |
| Te roa o te wā e taea ai te pupuri i roto i te tinana | I runga i te momo, ka taea te pupuri mō ngā wiki, ngā marama, tae noa ki ngā tau . | I te nuinga o te wā me huri i ia torutoru o ngā rā . |
Ko wai e hiahia ana ki tēnei raina pokapū?
He maha ngā wā ka whakatau ngā tākuta ki te whakatakoto i tētahi raina pokapū pēnei ina hiahia te tūroro ki te maimoatanga mō te wā roa. Hei tauira:
- Mō ngā tūroro matepukupuku: Me haere tonu te tuku i te chemotherapy.
- Mō ngā tūroro whatukuhu: Hemodialysis hei pure i te toto.
- Mō te hunga e tango ana i ngā paturopi ā-uaua mō te wā roa: Ko ētahi mate kino e hiahia ana kia maha ngā wiki o te rongoā.
- Mō te hunga e hiahia ana kia tangohia he tauira toto i ngā wā katoa: Me tango tauira toto i ngā wā katoa mō te hunga he mate toto tō rātou.
- Mō te hunga kāore e taea te kai mā te pūnaha nakunaku: Me whāngai tika ētahi tūroro ki roto i ngā uaua.
- I roto i tētahi āhuatanga ohorere: I roto i ngā āhuatanga pēnei i te "hypovolemic shock", ina hiahiatia he nui te wai, te toto rānei e hoatu tonutia ana i muri i tētahi aituā nui.
- Mō te hunga e whiwhi maimoatanga ana i te kāinga: Mā tēnei ka māmā ake te whiwhi maimoatanga mai i te kāinga.
He aha ngā momo rārangi pokapū kei reira?
Mā tō tākuta e whiriwhiri te momo e tika ana māu i runga i tō āhua hauora me te roa o te wā e hiahia ana koe ki te pupuri. He maha ngā momo matua.
| Ingoa momo | Whakaahuatanga (Me pēhea te mahi?) | Te wā e whakamahia ana i te nuinga o te wā |
|---|---|---|
| Te Tātari Uaua Waenga Kore-Ture | Ka werohia tika tēnei ki roto i tētahi uaua i te kaki, i te uma, i te hope rānei. Ka whakamahia i ngā wā ohorere, me ngā matea poto hoki. | I raro iho i te 2 wiki |
| Raina PICC (Te Kātene Waenga i Whakauruhia ki te Taha) | Ka whakaurua tēnei mā roto i tētahi uaua i te ringa o runga, ka tukuna ki te ngākau. Nā te mea kei roto i te ringa, he māmā ake mō ngā mahi o ia rā. | Mai i ētahi wiki ki ētahi marama |
| Te Tātaritanga Uaua Waenga kua Rungahia | Ka mahia tēnei mā te pokanga iti. E rua ngā wāhi e whakaurua ai te ngongo ki roto i te uaua, ā, e rua hoki ngā wāhi e puta atu ai i te kiri. Ka puta te ngongo mā roto i tētahi "kauhanga" iti i raro i te kiri. Mā tēnei ka whakaiti i te tūponotanga o te mate. (Tauira: Broviac®, Hickman® ) | Mō ētahi marama, neke atu rānei |
| Putanga Kiri-ā-roto (Putanga Whakatō) | He taputapu tēnei e huna katoatia ana i raro i te kiri. Ka whakaurua mā te pokanga iti. Kāore he mea e kitea mai i waho. Ka whakaurua he ngira ki runga ake i te kiri ina hiahiatia he rongoā anake. Kāore he herenga mō te kaukau, te kaukau rānei. (Tauira: Port-a-Cath ) | Mō te whakamahinga roa rawa, neke atu i te 3 marama |
Me pēhea te tāuta i tēnei raina pokapū?
Mā te tākuta kua whiwhi whakangungu motuhake mō tēnei kaupapa tēnei tikanga e whakahaere. Tērā pea ka rerekē te tikanga i runga i te momo CVC kei a koe.
He aha te mea ka tupu i mua i te whakatakotoranga o te rārangi pokapū?
Mā tō tākuta koe e whakamārama i te tikanga, tae atu ki ngā painga me ngā mōrearea. He wā pai tēnei ki te pātai i ō pātai. Kātahi ka whiwhi koe i tō whakaaetanga. Mēnā he āhuatanga ohorere, kāore pea he wā mō tēnei kōrero. Ka whakanohoia koe ki te tūranga (te tikanga ka takoto koe) ka honoa ki ngā taputapu aroturuki hei aroturuki i tō tere o te manawa me tō toto toto.
Ka aha koe ina whakakakahu koe i tēnei?
I te nuinga o te wā, ka hoatu he rongoā whakangāwari kia kore ai koe e mamae. Tērā pea ka whakamoea koe (whakamoe). Ko te tikanga o te tikanga penei:
1. Ka horoia rawatia te kiri e werohia ai te ngira, ā, ka patua kia kore e pangia.
2. Ka werohia e rātou he rongoā hei whakangoikore i te wāhi.
3. Kātahi, mā te āwhina o te matawai ultrasound, ka kitea tika te uaua, ā, ka werohia he ngira ki roto.
4. Ka tukuna he waea angiangi (waea ārahi) mā te ngira ki roto i te uaua.
5. Ka whakanuia ake te wāhi i werohia ki tētahi mata iti, ā, ka whakamahia he taputapu e kiia nei ko te dilator hei hanga wāhi mō te ngongo CVC.
6. Kātahi ka tukuna mārire te ngongo CVC mā runga i te waea ki roto i te uaua, ka mutu ina tae ki te tūranga tika e tata ana ki te ngākau.
7. Hei whakamutunga, ka tuia te wāhanga e kitea ana o te ngongo ki te kiri, ā, ka tāpirihia he takai hei pupuri i te wāhi kia ma.
Ka whakatakotoria he CVC me te putanga kua whakakōpikopikotia mā te whakamahi i tētahi tikanga pokanga iti. Mēnā he putanga, ka hangaia he 'pōkete' iti i raro i te kiri, ka whakatakotoria te putanga ki roto, ā, ka tuia te kiri kia kati.
Ka aha koe i muri i te whakakakahu?
Kia oti te mahi, ka tangohia he hihi-X o te uma hei tirotiro kei te tika te tūnga o te ngongo CVC, ā, kāore he raruraru kē atu. Mēnā kei te pai ngā mea katoa, ka hoatu he tohutohu ki a koe mō te wā ka taea e koe te hoki ki te kāinga, me pēhea hoki te tiaki i te kāinga.
He aha ngā painga o te whakauru i tētahi rārangi waenga?
- Ka whakaiti i te auau o ngā werohanga ngira: Ka whakaitihia te kino o ō uaua. Ka whakakorea hoki te wehi me te kore whakamarie o ngā werohanga ngira.
- He iti ake te mamae: Ka taea e ētahi rongoā te whakapūpū i te mumura me te mamae i roto i te uaua ina hoatu mā te cannula noa. He iti ake te mamae o tēnei uaua me te CVC.
- Te whakamahinga mō te wā roa: Kāore e hiahiatia kia whakawhitihia te cannula i ia rā e te hunga e whiwhi maimoatanga tonu ana.
He tūponotanga kei roto?
Pērā i ngā tikanga hauora katoa, he iti noa ngā mōrearea, engari kāore i te tino puta pinepine.
Ko te mōrearea matua, ko te mōrearea tino kitea ko te mate urutā . Ka kiia tēnei e mātou ko te '(Catheter-Related Bloodstream Infection - CRBSI)'. Mēnā kāore te wāhi e puta mai ai te ngongo i te kiri e horoia ana, ka taea e ngā iroriki te tomo mai.
Hei tāpiritanga, he maha atu anō ngā raruraru ka puta ake i te wā e whakatakoto ana i te aho, i muri rānei i te whakatakoto:
- Te toto.
- Te pakaru o te pukahukahu (pneumothorax).
- Te kino ki ngā uaua, ki ngā uaua rānei.
- Te toto totoka i roto i te uaua (thrombosis).
Ka whakapau kaha tō tīma hauora ki te whakaiti i ēnei mōrearea, ā, ko te mea nui rawa atu māu ko te pupuri i te wāhi CVC kia tino ma, me te whai i ngā tohutohu a tō tākuta.
Āhea koe me waea atu ki tō tākuta tonu
Ki te kite koe i tētahi o ngā tohu i raro nei i a koe e noho ana i te kāinga, me waea atu koe ki tō tākuta i taua wā tonu . He tohu pea ēnei nō te mate pāwera.
| Ngā tohu mōrearea - kia aro tonu atu | |
|---|---|
| - Te kirika. | - Te mamae, te ngaungau rānei i te wāhi i werohia ai te CVC, i te taha rānei o taua wāhi. |
| - He whero, he whero rānei ngā ira huri noa i te kiri. | - Te pupuhi o te kiri e karapoti ana, te mahana rānei ina pā atu. |
| - Kei te turuturu te wai, he rite ki te pupuhi, he kōwhai, he kakariki rānei. | - Mena kei te puta te ngongo CVC ki waho (tērā pea kei te wetekina). |
Waihoki, ki te puta katoa mai tō CVC i te tūponotanga, me toro atu ki te tākuta tonu.
Karere Tangohia ki te Kāinga
- He taputapu tino nui te raina pokapū (CVC) hei āwhina i ngā tūroro kia whiwhi maimoatanga ngāwari me te haumaru, kia kore ai e hiahiatia he ngira ia rā i ngā maimoatanga roa.
- Mā tō tākuta e whakatau te momo CVC e tika ana māu i runga i ō hiahia.
- Ko te mate te tino mōrearea o tēnei, nō reira he mea nui kia tino ma te kiri i roto, i te taha hoki o te CVC.
- Ki te kite koe i ētahi tohu o te mate pāwera, pērā i te kirika, te whero, te pupuhi, te mamae, te pupuhi rānei, me kōrero tonu atu ki tō tākuta.
- Mena he pātai, he ruarua rānei āu mō tēnei mea, tēnā kōrero ki tō tākuta.
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