i hc Thng Long Khoa iu Dng

Hong Th Thu

i hc Thng Long Khoa iu Dng

Ngi thc hin: Hong Th Thu Ging vin hng dn:

Hong Th Thu

Ni dung:
1.Mc tiu bi hc 2.K thut vn chuyn bnh phm 3.Cch bn giao bnh phm v kt qu

4.Nhng tai bin khi ly mu v cch x l

5. Mt s ch 6.Mt s tnh hung v cch x l
Hong Th Thu 3

1.Mc tiu bi hc
-Ly chnh xc ng cho tng loi ch nh XN. -Bn giao v nhn chnh xc bnh phm & kt qu XN. -Vn chuyn bnh phm an ton. -Nm c nhng tai bin c th xy ra khi ly mu. -X tr ng v ,kp thi khi xy ra tai bin
Hong Th Thu 4

1.Mc tiu bi hc

-Nm 1s tnh hung xy ra khi lm vic ti phng ly bnh phm. -Cch x tr tham kho.

Hong Th Thu

2. K thut vn chuyn bnh phm

- Chuyn bnh phm v cc labo ngay sau khi ly trong thi gian khng qu 30pht vi xn ha sinh, 60 pht vi VS v HH.
Khi vn chuyn bnh phm phi xp ng v phiu ch nh theo th t , xp ng vo xp vn chuyn trnh nghing , v hng cu.
Hong Th Thu 6

3.Cch bn giao bnh phm v kt qu

-Bn giao s lng v cht lng bnh phm, c lng mu, c b ng khng.(k nhn vo s) -Khi thiu bnh phm cn bo ngay ln phng khm gi bnh nhn ly mu kim tra li.
Hong Th Thu 7

3.Cch bn giao bnh phm v kt qu

-Khi nhn kt qu t cc labo ,iu dng phn loi kt qu theo cc phng khm, vo s v chuyn bn giao cho cc iu dng n tip(c mu s bn giao).

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4.Nhng tai bin khi ly mu v cch x l

a.Phng ni ly mu l do thnh mch yu d v hoc do k thut ly cha tt hoc do bnh nhn khng gi cht bng ti im rt kim.
Rn luyn tay ngh tt. Khi rt kim ra dn bnh nhn n gi cht bng,khng day n Khi ht chy mu mi b bng i.
Hong Th Thu 9

4.Nhng tai bin khi ly mu v cch x l

b.Chong ngt do bnh nhn qu lo s c th dn n phn ng ngng tim t ngt.

X tr: ng vin gii thch bnh nhn yn tm trnh h qu s. Nu khi xy ra ngng tim => x tr cp cu ngng tim.

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10

4.Nhng tai bin khi ly mu v cch x l

c.Nhim khun: Do k thut ly mu cha m bo nguyn tc v khun c th gy nhim trng ti ch hoc nghim trng hn c th gy nhim khun huyt, ly cho virus vim gan B,C hoc HIV.
Hong Th Thu 11

4.Nhng tai bin khi ly mu v cch x l

Chng nhim khun : -Trc ht phi nm c k thut ra tay thng quy (c quy trnh ca khoa chng nhim khun).

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12

4.Nhng tai bin khi ly mu v cch x l

Chng nhim khun: -Cch s dng gng tay: l tng nht l mi NB thay 1 i gng nhng iu kin hot ng ca khoa cha thc hin c do vy nn khong 3-5 bnh nhn thay gng hoc thay ngay khi gng c dnh mu.
Hong Th Thu 13

4.Nhng tai bin khi ly mu v cch x l

Chng nhim khun: - Khi thay gng nguyn tc l phi ra tay trc khi i khc hoc dng nc st trng nhanh.

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5. Mt s ch
Huyt hc: + XN t bo mu ngoi vi ly ng c cht chng ng EDTA, 2ml. + XN nhm mu : ly 2 ng , 1 c cht chng ng EDTA.K3 v 1 khng c cht chng ng, mi ng 2ml. +XN ng mu ly u tin v ly ng 2ml vo ng c cht chng ng Citrate, khng c tha cng khng c thiu.
Hong Th Thu 15

5. Mt s ch
Sinh ha +XN TRAb,Folate,Vit B12 ca sinh ha ly vo ng khng cht chng ng + XN HbA1c,ACTH,PTH,BNP,Anti- TG,Vit D ca sinh ha ly vo ng chng ng EDTA +XN D-Dimer ca sinh ha ly vo ng chng ng Citrate. +Cc XN khc ly vo ng chng ng Lithium Heparin.
Hong Th Thu 16

5. Mt s ch

Vi sinh Tt c XN mu ca vi sinh u ly vo ng khng c cht chng ng, ring XN: + HBV- DNA ly vo 2 ng c cht chng ng EDTA, mi ng 2ml. + m s lng virus HIV ly vo 2 ng c cht chng ng EDTA, mi ng 2ml + T bo CD4,CD8 ly ng EDTA- 2ml(khng nhn bnh phm sau 15h hng ngy)
Hong Th Thu 17

6.Mt s tnh hung

1.Trong khi ly mu xt nghim cho BN, BN s qu ngt su bn x tr nh th no? a BN nm ln ging,ni thong mt,n huyt nhn trung,o huyt p. Nu BN lnh th c th p chn m cho BN hoc cho BN ung nc nng hoc sa nng, mi BS khm hoc a vo cp cu nu c biu hin tt huyt p.
Hong Th Thu 18

6.Mt s tnh hung

2. Nhiu BN khi ly mu XN xong b chy nhiu mu, trnh iu bn lm g? Sau khi ly mu xong dng bng kh v trng n vo ch va rt kim,dn BN gi cht bng khng day khong 5-7 pht khi thy ht mu chy mi b bng i.

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6.Mt s tnh hung

3. phng trnh ly cho t BN ny sang BN khc trong khi ly mu XN cho ngi bnh bn cn ch im g? -Cc thao tc cn tuyt i v khun. -Nu gng tay hoc gi k tay b dnh mu phi thay gng hoc gi k tay khc. -Nu gng khng dnh mu th sau khong 3-5 BN th thay gng 1ln, trc khi i gng mi st trng tay nhanh bng dung dch st khun nhanh. -Sau khi ly mu cho nhng BN c chn on HIV hoc VG B bn nn thay gng .
Hong Th Thu 20

6.Mt s tnh hung

4.Khi ly mu gp BN kh ly bn phi ly ln 2,3 BN hoc ngi nh ca h phn ng khng cho ly s ly nhiu ln mt nhiu mu bn x tr nh th no? -Trc ht khi gp trng hp kh bn khng nn ly n ln th 3,bn c th i tay nh ng nghip khc ly h.

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6.Mt s tnh hung

4 (tip) -Cn khi gp s phn ng ca BN bn cn nh nhng gii thch v ven(tnh mch) ca bc(anh,ch) kh ly bc chu kh au mt cht chng ti cng rt khng mun nh vy bc chu kh ti ly lng mu cn thit lm XN tm ra bnh cho bc.

Hong Th Thu

22

6.Mt s tnh hung

4 (tip) -Nh nhng ni cho h hiu rng ly s lng mu nh th s khng nh hng n sc khe ngc li n cn kch thch ty xng sn sinh mu tt hn v d khng ly mu nhng theo quy lut t nhin hng cu cng t cht i thay t bo hng cu khc(hay ni cho BN d hiu l c th con ngi t i mu.
Hong Th Thu 23

6.Mt s tnh hung

5. i vi BN kch thch, tr em vng vy cn x tr nh th no? Cn ng nghip gip ,hng dn ngi nh kp gi ngi bnh tht chc ng thi ng vin an i nh nhng, khch l ngi bnh hp tc theo cch ph hp vi tng i tng ngi bnh

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Xin cm n!
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