介绍一种消除液体中橡皮屑的简易方法

液体中的橡皮屑一般多由注射针头在刺入瓶塞时带入瓶中,它是引起输液反应的原因之一。为了减少液体中的橡皮屑及针头堵塞,我在10年的工作中摸索出一种简便有效的消除方法,现介绍如下:①加药前选择锋利、无钩、无锈、无损伤针头;②当针头斜面的1/3刺入橡皮塞时向斜面的后方轻轻用力,使斜面与橡皮塞之间有一缝隙,这样针头进入时不易     

病房暖瓶塞污染情况的调查研究

病房暖瓶塞污染情况的调查研究武警总医院护理部吴威，梁慧，张利岩，王丽君，李晶晶（北京１０００３９）关键词暖瓶塞，医院感染医院是病原微生物较集中和体质衰弱、抵抗力较差的人群集聚的地方，由于病人大量应用抗生素，引起耐药菌株增多，菌群失调，加之各种医疗仪器...     

介绍一种消毒包内小液体瓶塞固定法

我院治疗包中放置的液体石腊、1:1000新洁尔灭等液体过去都用10ml/小玻璃瓶盛装、上盖以软木塞或橡胶塞后消毒使用.由于高压灭菌时瓶内液体沸腾冲开瓶塞,或由于小瓶在包内放置时倾倒,致使瓶塞脱落,液体溢出污染包布,并浪费药液.为了解决这一问题,我们将废乳胶手套剪成直径4cm的圆     

防止输液反应的体会

<正> 为了尽快解除患者的痛苦,在用药方面常常采用输液方式给药。用药不慎有时产生热原反应,给患者带来不应有的痛苦,重者甚至造成死亡。产生输液反应是多方面的,为了防止或减少输液反应的发生,从实践中我们认为必须把好三关。 一、把好药品质量关 对自制各种大输液,在制作上一定严格无菌操作,批批做全项检查,尤其是热原检查。对产生热原可疑时一定要复测。对外购大输液及各种小针剂,一定要坚持购买质量信得过的药品,发药前仔细检查。对某些药品在质量上产生疑问时,要坚持热原及其它方面药检检查。过     

冬季更要防止室内空气污染

<正>进入冬季后,气温逐渐降低,人们往往都喜欢把家里的门窗关得严严实实的,生怕冷风钻进来。这样冷风和寒气是被挡在了室外了,屋子里也暖和了,但是同时也产生了另外一个问题,那就是室内空气的流通性随之变差了,室内空气污染加重了。此外,由于天气寒冷,人们待在室内的时间大幅度增多,户外活动的时间大为减少,致使室内污染物给人体造成的伤害更多更大,尤其是室内空气污染物会抑制人的免疫力,刺激呼吸道黏膜,使呼吸系统疾病的发生率大幅度增高。那么,在冬天我们该如何防止室内空气污染呢?     

青、链霉素稀释液防止污染的改进

凡需肌肉注射青、链霉素均要先进行稀释,然而,每一个患者注射前都要穿刺稀释液皮塞一次。设想每天要有十个或更多的患者注射青,链霉素,那么就稀释液防止污染而言,要确保它的无菌性及不被污染,这是一个重要的环节。     

静脉采血防止溶血的体会

静脉采血是临床上常用的一项技术操作,正确、及时地采血送检,常可给诊断治疗提供有利的参考。临床采血中绝大多数情况均能采取比较满意的标本,但仍常有溶血的发生,既增加了病人的痛苦,又延误了诊断时机。如低钾时发生溶血,可因钾进入血清中造成“高钾”而误诊或影响治疗。再如黄疸患者测黄疸指数或胆红质定量时,也可因溶血造成鉴别诊断的困难。本文结合本人临床工作经验并复习有关文献,体会如下: 一、采血时患者前臂不宜过度紧缩,止血带绑扎不宜过久。以免造成软组织损伤,前臂组织淤血,缺氧发生局部酸中毒致使钾由细胞内转移至血浆中。 二、采血用的针头、射注器及试管必须干燥,否则将因低渗水份进入红细胞内引起细胞溶     

铅橡皮手套的改制

钡餐透视检查时习惯用右手去按压患部,所以一副铅手套通常右手容易坏,而左手仍完好无损。现介绍一种将左手铅橡皮手套改为右手的简便方法: 山东产的铅橡皮手套,内、外有布套,中间是铅橡皮,内层布套是活动的,把外布套从袖口拆去缝合线,取掉外套。将铅橡皮翻过来,翻橡皮手套可用一支带橡皮头的铅笔,压手套五指尖部开始向     

防止烧伤病房血压袖带污染方法探析

烧伤患者由于机体失去天然的皮肤保护屏障,致使抵抗力降低,特别是全身大面积烧伤患者,极易发生创面甚至全身性感染.在对烧伤患者的护理工作中,为处于休克期和感染期烧伤患者测量血压是再频繁不过的操作,且极其重要.烧伤早期,体表渗出液较多,血压袖带最容易被污染,而仅仅采用临床常规的紫外线或熏蒸消毒远远达不到彻底消毒的效果.如何避免血压袖带的交叉污染,成了临床护理工作急需解决的难题.2011年12月～2012年12月,我科收治16例大面积烧伤患者,采用了防止血压袖带污染新方法,效果明显,现介绍如下.     

The extrathoracic airway in acromegaly

Pulmonary function tests and a radiological assessment of the larynx and cervical trachea were performed in 26 patients with acromegaly. Pulmonary function tests demonstrated six out of 26 patients to have upper-airways obstruction, while laryngeal tomography demonstrated 14 cases with marked narrowing of the true and false cords. The tracheal dimensions were normal. The thickness of both the true and the false cords showed a statistically significant increase, using the Mann-Whitney U-test, in both male and female patients compared with controls. The transverse tracheal diameter was significantly decreased in male but not female patients. These findings suggest that pulmonary function tests and radiological assessment are of value in indicating those patients with acromegaly who may be at increased risk when undergoing general anaesthesia.     

Dynamic cardiac scintigraphy with a multi-imaging device

Cardiac kinetics can be visualized in two ways after i.v. injection of radiopharmaceutics for labeling either the myocardium or the cardiac chambers. The simpler way is the acquisition of the data in analog mode, using a multiimaging device. Thanks to a short time constant for the image advance, the cardiac cycle is divided into 16 frames, the first being triggered by the R wave of the ECG. The data of a large number of synchronized cycles are integrated on a film. This permits an almost continuous way to follow the kinetics of the studied comtinuous way to follow the kinetics of the studied compartments along the cycle. Several views can be registered successively. This procedure yields separately immediate information on the morphology and dynamics of the myocardium, and chambers. To evaluate quantitatively various parameters of left ventricular function a data processor is connected to the gamma camera. Examples of the two types of data are shown and demonstrate that both are useful for appreciating the value of kinetics thought they are not yet accurate enough to replace in every case contrast radiologic techniques. Nevertheless, the indications for these procedures are continuously growing, due to technical progresses and the noninvasive nature of the investigation.     

Dynamic cardiac scintigraphy with a multi-imaging device.

Cardiac kinetics can be visualized in two ways after i.v. injection of radiopharmaceutics for labeling either the myocardium or the cardiac chambers. The simpler way is the acquisition of the data in analog mode, using a multiimaging device. Thanks to a short time constant for the image advance, the cardiac cycle is divided into 16 frames, the first being triggered by the R wave of the ECG. The data of a large number of synchronized cycles are integrated on a film. This permits an almost continuous way to follow the kinetics of the studied compartments along the cycle. Several views can be registered successively. This procedure yields separately immediate information on the morphology and dynamics of the myocardium, and chambers. To evaluate quantitatively various parameters of left ventricular function a data processor is connected to the gamma camera. Examples of the two types of data are shown and demonstrate that both are useful for appreciating the value of kinetics though they are not yet accurate enough to replace in every case contrast radiologic techniques. Nevertheless, the indications for these procedures are continuously growing, due to technical progresses and the noninvasive nature of the investigation.     

Mammographic and CT detection of extrathoracic lung herniation

Herniation of lung through the chest wall is uncommon and previously reported cases have been found either clinically or by chest radiography. We recently discovered a case of herniated lung on screening xeromammography. These findings were correlated with thoracic CT.     

A novel alignment device for cone beam computed tomography: principle and application

Objectives

The aim of this investigation was to optimize the positioning and size of the scanned field of view (FOV) in cone beam CT (CBCT) scanners using a practical external alignment device fitted in the patient''s mouth in order to train radiographers and reduce radiation dose to the patient. This is particularly challenging when using small FOVs to cover small volumes of interest.

Methods

Test objects were positioned and scanned using the aligner to show that the design and geometry were correct and help the radiographer to superimpose the scanner and the volume of interest axis of rotation. An in vivo study was then undertaken comparing the accuracy of patient positioning when using the aligner, instead of scouts, to position the patient for small FOV (cylinders of 4–8 cm height and 4–8 cm diameter) dental scans. The scanners used were the Accuitomo F170 CBCT scanner (Morita, Kyoto, Japan) and the iCAT Next Gen CBCT scanner (Imaging Sciences, Hatfield, PA).

Results

There was no significant difference in positioning the patient when using the aligner compared with the scout images.

Conclusions

It is possible to rely on the aligner for patient positioning for a small volume scan and therefore spare the radiation dose associated with scout imaging.     

Intrathoracic lymph node metastases from extrathoracic neoplasms.

The clinical records of 1,071 cases of extrathoracic malignant neoplasms seen over a 2 year period sere reviewed: 163 had abnormal chest films, and 25 of these showed evidence of mediastinal and/or hilar lymph node metastases. The primary malignancies which metastasized to intrathoracic lymph nodes included eight tumors of the head and neck, 12 genitourinary malignancies, three carcinomas of the breast, and two malignant melanomas. The chest films were analyzed to determine the distribution of lymph node groups involved. Unilateral lymph node enlargement occurred in eight. The most frequently detected lymph node group was the right paratracheal chain (60%), while the subcarinal and posterior mediastinal groups were rarely affected. Of the 25 cases, 10 had radiographic evidence of hematogenous or lymphangitic metastases in addition in the lungs. Metastatic disease from extrathoracic neoplasms should always be considered in the differential diagnosis of hilar and mediastinal adenopathy.     

A novel vacuum device for extremity immobilisation during digital angiography: preliminary clinical experiences

Our objective was to develop and evaluate a non-invasive device for rigid immobilisation during extremity angiography. The patented BodyFix immobilisation device (Medical Intelligence, Schwabmünchen, Germany) consists of a vacuum pump connected to special cushions and a plastic foil that covers the body part to be immobilised. First, the patient's extremity is covered by a thin plastic bag and then wrapped in one of the cushions, placed on the top of the therapy couch, and covered with the plastic foil. The air is evacuated from the cushion under the covering foil by the vacuum pump, resulting a hardening of the cushion and thus immobilisation of the patient's extremity. The rigid immobilisation resulted in a complete absence of motion artefacts in the majority of patients. No pixeling of the images was required in any of the 100 patients vs 32% in the control group. Repetition of series could be avoided in all cases and a substantial increase in the quality of the images was obtained. Setup of the device takes an additional 1–2 min. Vacuum immobilisation allows for comfortable, effective immobilisation during digital subtraction angiography, eliminating motion artefacts. This device has become an indispensable tool in daily clinical routine at our department. Electronic Publication     

Thermoplastic wrapped lead sheet to reduce cardiac device cumulative dose

The objective of this project is to evaluate the percentage dose reduction in cardiac implantable electronic devices (CIEDs) using a thermoplastic wrapped lead sheet. The dose to CIED is evaluated in various situations with and without a lead shield. The efficiency of this type of shielding is supported by measurements made with a commercial plastic scintillation detector (PSD). Percentage depth dose (PDD) curve and lateral dose measurements (LDMs) were made with and without shielding for photon and electron beams. Photon LDMs were made at a depth of 0.5 cm. PSD measurements were compared with dose calculation from the treatment planning system (TPS). The benefit of shielding is greater at 23 MV than at 6 MV, with an average reduction of 71% and 59% of dose, respectively, for out-of-field distance range between 3 and 15 cm. Measurement of posterior beams shows there is no significant increase in skin dose due to backscatter from the lead sheet even when the field intercepts it. Large deviations between TPS calculation and measurements have been observed. The use of lead shielding with an anterior field is advised and provides an easy way to decrease the cumulative dose to CIEDs. Interception of shielding by an electron beam would increase significantly the cumulative dose to CIED for high energies or decrease the quality of the treatment. For a posterior out-of-field, shielding does not have a significant impact on CIED dose.