Your Tunneled Catheter Chinese 病患教育 4-Southeast 移植手術 / 腎臟科 您的透析 導管 關於血液透析和血漿置換導管 本宣傳資料介紹了用於血液透析或血漿置換的透析導管之相關資訊 其中包括基礎護理指導說明, 需留意的感染症狀, 以及何時通知醫生等 透析導管協助您進行血液透析或血漿置換 當疤痕組織形成時, 此導管固定在疤痕處 使用壽命可為幾個星期或幾個月 導管被置入患者頸部大靜脈中, 血液由此回流至心臟 然後沿著您的胸壁下行, 在距離進入您的靜脈處大約 6 英寸的地方, 向外穿透您的皮膚 依照此材料中的護理指示進行操作, 防止形成血塊並避免感染 透析導管 心臟 透析導管的置放
2 頁 4-Southeast 移植手術 / 腎臟科您的透析導管 當您更換敷料時, 請查看導管 部位是否出現任何感染現象, 或導管是否受損 如果在早期 發現這些問題, 它們有可能得 到解決 查找是否有任何發紅 腫脹 析液或潮濕現象 輕輕地去感覺是否有腫脹感或柔軟感 導管應完好無損, 封蓋位於適當位置, 兩個埠 夾緊 導管基礎護理 盡可能地保證導管放置部位的清潔, 防止感染 保持導管的兩個埠一直處於夾緊狀態 請勿拉伸導管 請勿洗浴 在熱水中泡浴 或游泳 如果淋浴, 用一塊塑膠布覆蓋住整個導管及敷料部位, 用膠帶貼住邊緣 ( 參見下圖 ) 淋浴後立即除去塑膠布 如敷料被淋濕, 應立即予以更換 如導管部位出血或導管脫落, 應按壓導管部位, 然後到急診室進行治療 使用塑膠包裹導管 導管敷料更換 q 我需要每 3 天 或敷料變濕 或脫落時, 更換敷料 q 我僅需要在敷料變濕或脫落時, 更換敷料 其他情況下, 華盛頓大學醫療中心的工作人員或透析中心將更換我的敷料
3 頁 4-Southeast 移植手術 / 腎臟科您的透析導管 您有問題嗎? 您的問題對我們很重要 如有疑問或顧慮, 請聯絡 您的醫生或醫療服務人 員 華盛頓大學醫療中心 (UWMC) 4-Southeast 的護 士同樣可以提供幫助 q 腎臟科護士 206-598-2844 q 神經科護士 206-598-7688 q 移植科護士 206-598-4773 q 4-Southeast 移植手術 / 腎臟科 : 依照下列步驟更換敷料 : 1. 準備以下物品 : ChloraPrep 2 x 2 規格紗布 透明敷料 2. 戴上面罩 3. 用肥皂和水洗手 4. 除去舊敷料 5. 用 ChloraPrep 清洗導管部位, 晾乾 30 秒鐘 6. 使用 2 x 2 規格紗布及透明敷料 何時通知您的醫生 感染是使用透析導管的最常見併發症 來自手部, 口部及周圍環境的細菌能夠進入導管中 這會引起嚴重疾病, 同時導致導管喪失功能 如您認為出現了以下任何一種感染現象, 應立即通知您的醫生 發燒或打寒顫 導管部位出現發紅 溫熱 析液或腫脹 新的疼痛發作 4-Southeast Transplant Surgery/Renal Medicine Box 356086 1959 N.E. Pacific St. Seattle, WA 98195 University of Washington Medical Center Your Tunneled Catheter Chinese 12/2006 Rev. 08/2010 Reprints on Health Online: http://healthonline.washington.edu
Patient Education 4-Southeast Transplant Surgery/Renal Medicine Your Tunneled Catheter About hemodialysis and plasma exchange catheters This handout gives information about tunneled catheters, which are used for hemodialysis or plasma exchange. Included are basic care instructions, signs of infection to watch for, and when to call the doctor. You have a tunneled catheter for hemodialysis or plasma exchange. The tunneled catheter is a catheter that is fixed in place when scar tissue forms. It can be used for weeks or months. The catheter is placed into a large vein in your neck that returns blood to your heart. It is then tunneled down your chest wall, going out through your skin about 6 inches from where it entered your vein. Follow the care instructions in this handout to keep the catheter from clotting and to prevent infection. Tunneled Catheter Heart Placement of a tunneled catheter
Page 2 4-Southeast Transplant Surgery/Renal Medicine Your Tunneled Catheter When you change your dressing, check your site for any sign of infection or catheter damage. If these problems are found early, they can likely be resolved. Look for any redness, swelling, drainage, or moisture. Gently feel for any swelling or tenderness. The catheter should be intact, caps in place, and both ports clamped. Basic Catheter Care Keep the catheter site as clean as possible to prevent infection. Keep both ports of the catheter clamped at all times. Do NOT pull on the catheter. Do not take a bath, soak in a hot tub, or go swimming. When you take a shower, cover the entire catheter and dressing site with a plastic sheet and tape the edges (see the picture below). Remove the plastic cover right after your shower. Change the dressing right away if it gets wet. If you are bleeding from the catheter site or if the catheter falls out, apply pressure at the site and go to an emergency room. Covering the catheter with plastic Catheter Dressing Change I need to change my dressing every 3 days or when it is wet or loose. I need to change my dressing only if it becomes wet or loose. Otherwise, the staff at University of Washington Medical Center or my dialysis center will change my dressing.
Page 3 4-Southeast Transplant Surgery/Renal Medicine Your Tunneled Catheter Questions? Your questions are important. Call your doctor or health care provider if you have questions or concerns. UWMC 4-Southeast Nurses are also available to help. Renal Nurse: 206-598-2844 Neurology Nurse: 206-598-7688 Transplant Nurse: 206-598-4773 4-Southeast Transplant Surgery/Renal Medicine: Follow these steps to change your dressing: 1. Prepare these supplies: 2. ChloraPrep 2 x 2 gauze Transparent dressing Put on a mask. 3. Wash your hands with soap and water. 4. Remove the old dressing. 5. Clean the catheter site with ChloraPrep and let it dry for 30 seconds. 6. Apply 2 x 2 gauze and then the transparent dressing. When to Call Your Doctor Infection is the most common complication of tunneled catheters. Germs from your hands, mouth, and surroundings can get into your catheter. This can cause you to become very ill and your catheter to fail. Call your doctor right away if you think you might have any signs of infection: Fever or chills. Redness, warmth, drainage, or swelling at the catheter site. New onset of pain. of these 4-Southeast Transplant Surgery/Renal Medicine Box 356086 1959 N.E. Pacific St. Seattle, WA 98195 University of Washington Medical Center 12/2006 Rev. 08/2010 Reprints on Health Online: http://healthonline.washington.edu