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電動止血帶的使用方法
1. 根據患者的年齡,體重,手術部位是上肢或下肢選用合適的袖帶(上肢:短、窄;下肢:長、寬)。 1. According to the patient's age, weight, the operative site is the upper extremity or lower limb with the appropriate cuff (upper extremity: short, narrow; Lower limbs: long, wide. 2. 袖帶不能直接接觸皮膚,而應用棉紙覆蓋在皮膚表面,然后綁袖帶。 2. The cuff cannot reach the skin directly, and the application of cotton paper covers the skin surface and then ties the cuff. 3. 選擇縛扎部位上肢應在肱骨上1/3段;下肢在大腿根部(因上肢避開了橈神經,下肢容易直接壓迫股動脈,但也有報道認為對于下肢遠端的手術,止血帶的袖帶越寬,四肢的周徑越小,阻斷血流所需的壓力就越低,使用者就越舒適,因此建議足趾手術時,止血帶最好放置在踝上方) 3. Select the upper extremity of the binding site should be 1/3 of the humerus; Lower limbs in the thigh root (for upper limb to avoid the radial nerve, easy to direct pressure stocks lower limb artery, but there have also been reported for lower limb surgery, on the far side of a tourniquet cuff is wider, limbs weeks size is smaller, blocking blood flow to the required pressure, the lower the user is more comfortable, it is recommended that during the operation of digit tourniquet is best placed above the ankle) 4. 接通氣管,檢查接頭處是否銜接緊密、袖帶內氣囊是否漏氣。 4. Connect the airway to check whether the connection is tightly connected and the air bag inside the cuff is leaking. 5. 設定壓力值:為了避免局部組織損傷及神經干擠壓傷,同時又要達到理想的止血目的,止血帶的設定壓力要根據局部組織薄厚、患者年齡、肢體周徑大小及局部動脈收縮壓而定。上肢為收縮壓的1.5倍,下肢為收縮壓的2倍 5. Set pressure value: in order to avoid local tissue injury and nerve crush injury, at the same time to achieve the ideal hemostatic purpose, tourniquet set pressure according to local tissue thick diameter week, patient age, body size and local artery systolic blood pressure. The upper extremities are 1.5 times the systolic pressure and the lower extremities are 2 times the systolic pressure 6. 設定時間:上肢一般不超過60 min,下肢不超過90 min。若手術時間長,則應讓肢體恢復血流10~15 min,然后再阻斷。 6. Setting time: the upper extremity shall not exceed 60 min, and the lower extremity shall not exceed 90 min. If the operation is long, the limb should be restored for 10 to 15 minutes and then blocked. 7. 加壓:止血帶加壓前,先將肢體抬高3 min左右,加速靜脈血回流,以減少肢體血量。 7. Pressure: before the tourniquet is pressurized, lift the limb up to about 3 minutes, and accelerate the recirculation of the venous blood to reduce the amount of blood. 8. 及時記錄充氣時間,術中注意加強對患者呼吸、循環功能的監測。 8. Record the time of inflation in time, and observe the monitoring of respiratory and circulatory functions in patients. 9. 聽到提示音,做好放氣的準備(傷口須加壓包扎,防止滲血。放氣前,對有潛在性影響血壓的因素,如貧血或失血量過多者,需預防性應用小劑量麻黃素10~15 mg,以預防止血帶休克的發生,同時要適當加快補液速度以補充和維持有效的血容量)。 9. When you hear the prompt, prepare for air release (the wound should be pressed and packed to prevent bleeding. Deflated, with potential factors that influence the blood pressure, such as anemia or blood loss too much, the prophylactic use of small dose of ephedrine to 10 ~ 15 mg, in order to prevent the happening of the tourniquet shock, at the same time to speed up rehydration appropriate to supplement and maintain effective blood volume). 10. 放氣時應適當抬高患肢。 10. Raise your extremities properly when releasing gas.