Ina kī atu te tākuta me whakauru he 'raina pokapū', tera pea ka mataku koe. Ina rongo tātou i te kupu 'raina', ka whakaaro tātou ki tētahi cannula e hoatu ana ki a koe he saline noa. Engari he mea rerekē tēnei, he mea motuhake. Engari kāore he take e mataku ai koe. He nui ngā whai wāhitanga e tukuna ana e ia ki a koe. I tēnei rā, kia kitea e tātou he aha te raina pokapū, te CVC rānei.
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He aha te rārangi pokapū (CVC)?
Ko te raina pokapū, ko te Central Venous Catheter (CVC) rānei, he taputapu motuhake e āwhina ana ki te rongoā i ngā momo mate hauora. He mea hanga ki tētahi ngongo angiangi, ngāwari, roa hoki. Ka whakaurua tēnei ngongo ki roto i tētahi uaua i roto i tō tinana. Kātahi ka haere te ngongo ki raro i te uaua kia tae rā anō tētahi pito ki roto i te uaua toto matua (te vena cava) e kawe ana i te toto ki tō ngākau.
Tērā pea kei te piri mai te pito o tēnei ngongo i tō kiri, i te taha matau o tō uma. Ko te wāhanga e piri mai ana i tō kiri ka kiia he 'hub'. Koinei te mea ka kitea e koe, ka rongohia hoki. I ētahi wā kei raro i tō kiri te pito kē. Ka kiia tēnei he 'port'. Kātahi ka taea e koe te rongo i te mea he puku iti i raro i tō kiri, engari kāore i te tino kitea. Ka whakamahia tēnei 'hub', 'port' rānei mō ngā mea pēnei i te hoatu rongoā me te tango toto.
Ko te painga matua o tēnei ko te ngāwari o te uru atu o ngā tākuta ki roto i ō toto me te kore e hiahiatia kia werohia ngā ngira. Nō reira, he tino whai hua tēnei mō te hunga e hiahia ana ki te tango rongoā mō te wā roa, ki te whiwhi tote, ki te tango toto, ki te koha toto rānei.
He aha te rerekētanga i waenga i te cannula noa (peripheral IV) me te raina pokapū?
E mōhio ana tātou katoa ko te cannula noa ((Peripheral IV)) me tēnei aho pokapū e whakamahia ana hei whakarato maimoatanga. Engari e toru ngā rerekētanga matua i waenganui i ngā mea e rua. Kia tirohia tātou he aha rāua.
| Te take mō te huringa | Raina Waenga (Raina Waenga/CVC) | Cannula noa (IV ā-taha) |
|---|---|---|
| Ko te uaua e tomo ana ki te tinana | I ngā wāhi pēnei i te kaki, te uma, me te umaKa werohia ki roto i tētahi uaua nui, hohonu. | Ka werohia ki roto i tētahi uaua iti e tata ana ki te kiri i te mata o te ringa, o te pūkahukahu rānei. |
| Rahi | Roa, matotoru. I ētahi wā he nui atu i te kotahi te ngongo ("(rua/toru ngā lumen)") ka taea te hoatu i ngā momo rongoā maha i te wā kotahi. | He poto, he angiangi, ā, kotahi te ngongo. |
| Te roa o te wā e taea ai te pupuri i roto i te tinana | Ka roa pea mō ngā wiki, mō ngā marama, ā, ka roa ake pea. | He torutoru noa ngā rā e roa ana. Kātahi ka hiahiatia kia whakawhitia. |
Ko wai e hiahia ana ki tētahi raina pokapū?
He āwhina tēnei i te hunga whai momo mate hauora. Hei tauira:
- Whiwhi rongoā chemotherapy mō te wā roa mō ngā tūroro matepukupuku.
- Mō te hunga e purea ana te toto ((Hemodialysis)) nā ngā raruraru o te whatukuhu.
- Mō te hunga e hiahia ana ki te tango i ngā paturopi ā-uaua mō te wā roa.
- Mō te hunga e hiahia ana kia tangohia he toto mō ngā whakamātautau toto auau.
- Mēnā ka puta he āhuatanga ohorere (te ohorere hypovolemic), hoatu tonutia te tote, te toto rānei.
- Whiwhi toto, koha pereti rānei.
- Ina kore e mahi tika te pūnaha nakunaku, me whakarato tika te kai mā roto i tētahi uaua.
- Mō te hunga e hiahia ana ki te whiwhi rongoā werohanga ā-uaua 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 ō hiahia me te roa o te wā e hiahia ana koe ki te whiwhi maimoatanga. He maha ngā momo matua.
- CVC kore-pūwero: He pai tēnei mō te whakamahinga poto (iti iho i te rua wiki). Ka whakaurua tika ki roto i te uaua, pērā i te kaki, i te uma rānei.
- Raina PICC (Peripherally Inserted Central Catheter): Ka whakamahia hoki tēnei mō te wā poto. Heoi, kāore e whakaurua mā te kaki, mā te uma rānei, engari mā te ringa o runga. Mai i reira, ka whakaurua te ngongo ka mirohia ki tētahi uaua nui e tata ana ki te ngākau.
- CVC kua whakakōpikopikohia: He pai tēnei mō te whakamahinga roa (neke atu i te rua wiki). I konei, he iti te tawhiti i waenganui i te wāhi e whakaurua ai te ngongo ki roto i te uaua me te wāhi e puta mai ai i te kiri. I tēnei wā, kei raro i te kiri te ngongo.Ka haere pērā i te kauhanga. Ka whakaitihia te tūponotanga o te mate. Ko Broviac® me Hickman® ngā waitohu rongonui o tēnei momo.
- Putanga i raro i te kiri (whakatōngia): Koinei te kōwhiringa pai rawa atu mō ngā wā roa atu i te toru marama . I konei, kāore he wāhanga o te ngongo e kitea ana mā roto i te kiri. Ka whakaurua te taputapu katoa ki raro i te kiri mā roto i tētahi tapahi iti. Ina hiahiatia he rongoā, ka whakaurua he ngira motuhake ki roto i te 'putanga' i raro i te kiri, ā, ka hoatu te rongoā. Ka kiia hoki tēnei he "Port-a-Cath".
He aha te tukanga mō te tāuta i tēnei?
Ehara tēnei i te pokanga nui, nō reira kaua e wehi. Mā te tākuta kua whiwhi whakangungu motuhake mō tēnei kaupapa e mahi.
1. Tuatahi, horoia rawatia te kiri ki te wāhi e whakamahia ai te raina.
2. Kātahi ka whakangāwarihia te wāhi kia kore ai koe e mamae. Mēnā e tika ana, ka hoatu pea he rongoā whakangāwari ngawari hei pupuri i a koe kia marino.
3. Muri iho, ka whakamahia e te tākuta he ngira hei whakauru i te uaua e pā ana. Tērā pea ka whakamahia he mīhini ultrasound hei kimi tika i te uaua.
4. Ka tukuna he waea angiangi rawa ("(waea ārahi)) mā te ngira ka uru ki roto i te uaua.
5. Kātahi ka tangohia te ngira, ka whakaurua he taputapu iti (whakawhānui) hei waihanga wāhi mō te whakauru i te aho, ā, ka tukuna mārire te ngongo aho waenga ki runga i te waea ki roto i te uaua.
6. Kia tika te tūnga o te pito o te ngongo e tata ana ki te ngākau, ka tangohia te waea.
7. Hei whakamutunga, ka herea te wāhanga e kitea ana o te aho ki tētahi tuitui iti, ki tētahi pāreti motuhake rānei hei ārai i te mirimiri ki te kiri, ā, ka pania he takai hei pupuri i tōna ma.
Ka whakapau kaha mātou kia kore ai koe e mamae i tēnei tukanga katoa, nō reira kāore he take e mataku ai.
Mena kei te whakatakotoria he CVC, he putanga rānei kua whakakōpikopikotia, hei tāpiri atu ki ēnei mahi taketake, me tapahi iti hei tuku i te ngongo ki raro i te kiri, hei whakanoho rānei i te putanga.
He aha ngā raruraru pea (ngā mōrearea)?
Pērā i ngā tikanga hauora katoa, he iti noa ngā tūponotanga. Ko te mea nui ko te tūponotanga o te mate . Ka taea e tēnei te arahi i ngā iroriki ki roto i te toto mā te taura (arā, te mate toto e pā ana ki te catheter - CRBSI). Koia te mea nui kia tino ma te wāhi i whakaurua ai te taura.
Hei tāpiritanga, he tino onge te puta o te toto, te pakaru o te pukahukahu (pneumothorax), te toto toto rānei (thrombosis). Engari ka whakapau kaha ngā tākuta ki te ārai i ēnei mea.
Āhea koe me toro atu ki te tākuta i te wā e taea ai?
Mena he raina pokapū tōu, me tino tupato koe ki ngā tohu o te mate. Mena kei a koe tētahi o ngā tohu e whai ake nei, me waea atu koe ki tō tākuta tonu atu .
- Ki te pāngia koe e te kirika .
- Mena he mamae, he whero, he pupuhi rānei te wāhi i whakatakotoria ai te aho.
- Mena ka mahana te kiri o taua wāhi ina pā atu.
- Mena ka puta mai he wai rite ki te pupuhi kōwhai, kakariki rānei i te rārangi.
- Mena he roa ake te āhua o te wāhanga o te rārangi e kitea ana i mua (tērā pea kei te puta mai i roto).
Ki te kite koe i tētahi mea pēnei, me whakamōhio tonu atu ki tō tākuta. Ki te mea he āhuatanga ohorere, haere ki te Wāhanga Maimoatanga Ohotata (ETU) o te hōhipera tata.
Karere Tangohia ki te Kāinga
- He ngongo motuhake te raina pokapū (CVC) hei āwhina i a koe ki te whiwhi maimoatanga mō te wā roa, hei karo hoki i te werohanga pinepine o te ngira.
- He rerekē ngā momo raina pokapū i runga i ō hiahia. Mā tō tākuta e whiriwhiri te mea e pai ana māu.
- Kāore tēnei e mamae ina whakaurua. Ka mahi tonu mātou i ngā mahi e tika ana kia kore ai koe e mamae.
- Ko te mate urutā te tino mōrearea, nō reira ko tō kawenga kia noho ma tonu te wāhi e kuhua ana te aho.
- Ki te kite koe i ngā tohu o te mate pēnei i te kirika, te mamae, te whero, te pupuhi rānei, me whakamōhio tonu atu ki tō tākuta.
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