Travmada Damar Yolları
Özet
Travma durumunda mümkün olan en kısa sürede vasküler sisteme erişim olanağı sağlanmalıdır. Tercih edilecek yöntemler hastanın klinik durumuna göre değişebilir. Son kılavuzlarda bu işlemin iki büyük çaplı (bir yetişkinde en az 18-gauge) periferik intravenöz kateter yerleştirilerek gerçekleştirilmesi önerilir. Periferik damar yoluna erişim sağlanamadığında geçici olarak intraosseöz bir iğne yerleştirme düşünülmelidir. Koşullar periferik venlerin kullanımını engelliyorsa, klinisyenlerin büyük çaplı, santral venöz (örn. femoral, juguler veya subklavyen ven) yol açması öneriler arasında yer almaktadır. İntravenöz damar yolu açılırken, kan grubu ve crossmatch, uygun laboratuvar analizleri, kan gazı analizi, toksikoloji çalışmaları ve doğurganlık çağındaki tüm kadınlar için gebelik testi için kan örnekleri alınması gerekir. Acil durumlarda, santral venöz kateter girişimi hastanın durumu göz önünde bulundurularak daha kontrollü bir ortamda değiştirilmelidir.
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