The puncture operation of the intramedullary cavity infusion is as follows
Jan 04, 2022
(1) Positioning: Straighten the lower limbs, and the puncture point is located on the flat tibia with the lower edge of the patella about 3 cm (2 finger width) and the medial edge of about 2 cm (1 finger width), as shown in Figure 2.
(2) Disinfection: Wear sterile gloves, center on the puncture point, with a diameter of 15 cm, disinfect the skin 2-3 times from the inside to the outside, and cover with a drape.
(3) Puncture: The left thumb and index finger fix the puncture site, and the right hand holds a traditional bone marrow puncture needle or professional medullary cavity infusion equipment. The puncture needle is inserted perpendicular to the bone surface to reach the bone marrow cavity, and the puncture needle is fixed in the bone.
(4) Withdrawal: remove the core of the puncture needle and withdraw the external syringe to the bone marrow to confirm the correct position.
(5) Fixation: Fix the puncture needle with the skin to prevent loosening or shifting.
(6) Flushing the tube (anaesthesia if necessary): Flush the bone marrow cavity infusion catheter with 5-10ml of normal saline for smooth infusion. For patients who are conscious and painful, give lidocaine anesthesia if necessary. Inject 40mg of 2% lidocaine through the intramedullary pathway for more than 2 minutes, then flush the medullary cavity infusion catheter with 5-10ml of normal saline, and then inject 20mg of 2% lidocaine for more than 1 minute. Lidocaine is repeatedly administered at any time during the infusion period. If lidocaine is given through the intramedullary pathway, the systemic pain control can be considered. Lidocaine allergy is contraindicated.
(7) Infusion: Connect the infusion tube for infusion.
(8) Pull out: It is recommended that the indwelling time in the intramedullary cavity does not exceed 24 hours. In special circumstances, the longest indwelling time does not exceed 96 hours. Remove the bone marrow puncture needle, cover and press the puncture point with a sterile dressing, and fix it with tape.
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