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The role and characteristics of the tourniquet
Data: 2022-04-14
ApplytourniquetThe purpose is to increase the local filling of the vein and facilitate puncture. The application position of the pulse belt should be 7.5~10cm above the puncture point, and the time should be less than 1 minute. When the blood collection time exceeds 1 minute, the pulse belt should be untied and used after 2 minutes. If the pulse belt is used for too long, it will cause local blood concentration, increased blood pressure in mao fine blood vessels, and reduced blood flow. Persistent venous hypertension reduces the reflux of water and electrolytes in the tissues, increases the concentration of proteins and protein conjugates. After pressing the tourniquet for 3 minutes, albumin, serum iron, serum calcium, alkaline phosphatase, aspartate aminotransferase, and cholesterol increased by 5% to 10%, and serum potassium increased more obviously. At the same time, with the increase of oxygen consumption, anaerobic glycolysis is strengthened, lactic acid is increased, and blood pH value is reduced. Within 1 minute after using the pulse band, there was no significant change in the blood sample indicators (including coagulation factors). Therefore, it is recommended that when blood starts to flow into the blood collection tube after acupuncture, it should be untied immediately.tourniquetSo as not to cause blood stasis, blood vessel hemolysis or changes in some components of the blood.
After dialysis, the puncture needle is completely pulled out immediately after pressing, so as not to cut the blood vessel wall. The pressure should be appropriate to avoid bleeding and to feel vascular tremors. The tourniquet is made of elastic bands with good elasticity, 3cm wide and 20-25cm long. Velcro sewn at both ends. Roll a cylindrical gauze with a diameter of 1.8cm and a length of 30 cm into a double-sided adhesive tape and stick it in the middle of the elastic belt, or directly apply a cotton ball. After blood purification, pull out the puncture needle and press the puncture point for 15-30 minutes, subject to no bleeding in the needle eye. In particular, the patient should not be careless on the way home until he reaches a safe place.tourniquet. For patients with poor coagulation mechanism, the time can be extended appropriately.
Adequate exposure of blood vessels can improve the success rate of a puncture. Studies of venous filling have focused ontourniquetand topical aspects. The above-mentioned two tourniquet binding method, I .e. binding two tourniquet at the upper and lower joints of the puncture point or about 15cm away from the puncture point, can replace the patient's fist, and at the same time, the local blood vessel filling is satisfactory, especially suitable for children, patients with unfixed blood vessels, unfilled blood vessels and unable to make fist.
In addition, the correct usetourniquetIs an effective way to ensure vascular filling. The study found that the patient's arm drooped when the tourniquet was used. The position of the tourniquet is 10~15cm away from the puncture point, and the tightness is appropriate. The time of tying the tourniquet is within 40~120 s. When the pressure of the tourniquet is 10.7~16.0 kPa, the filling of the distal vein can reach a good state. With the development of intravenous infusion tools and the change of the concept of intravenous infusion, it is necessary to choose the appropriate infusion route, such as CVC, PICC, infusion port, etc., according to the patient's condition, treatment plan and vascular condition.
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