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Samenvatting Technische zorgverstrekkingen TMB
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Samenvatting powerpoint technische zorgverstrekkingen TMB
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Technische zorgverstrekkingen1. Veneus bloed: samenstelling........................................................................................................... 3
1.1 Leucocyten/witte bloedcellen ................................................................................................. 4
1.1.1 B-lymfocyten ................................................................................................................... 4
1.1.2 T-lymfocyten .................................................................................................................... 4
1.1.3 Macrofagen ..................................................................................................................... 4
1.2 Trombocyten/bloedplaatjes .................................................................................................... 4
1.3 Samenstelling bloed ................................................................................................................ 5
2. Veneuze bloedafname..................................................................................................................... 5
2.1 Open- en gesloten bloedafnamesysteem ............................................................................... 5
2.2 Materiaal ................................................................................................................................. 6
2.2.1 Knelband/Garrot/Tournicquet/Stuwband ...................................................................... 6
2.2.1.1 Aanleggen knelband .................................................................................................... 6
2.3 Vacuüm bloedafnamesysteem (Gesloten systeem) ................................................................ 7
2.3.1 Naaldhouder .................................................................................................................... 8
2.3.2 Naalden ........................................................................................................................... 8
2.3.3 Vacuümtuben .................................................................................................................. 9
2.3.3.1 Soorten ...................................................................................................................... 10
2.3.3.2 Aandachtspunten vacuümtuben: .............................................................................. 11
2.4 Aandachtspunten gesloten afnamesysteem: ........................................................................ 11
2.5 Spuit & (vleugel) naald (Open systeem) ................................................................................ 11
2.6 Druppelmethode: .................................................................................................................. 12
2.7 Aandachtspunten bij gebruik open systeem bloedafname .................................................. 12
2.8 Hemoculturen/haemoculturen ............................................................................................. 12
2.9 Punctieplaatsen ..................................................................................................................... 13
2.10 Perifere bloedafname............................................................................................................ 14
2.11 Identificatie Tubes ................................................................................................................. 14
2.12 Procedure: bloedafname met het vacutainer systeem ......................................................... 14
2.12.1 Opmerkingen ................................................................................................................. 14
2.12.2 Mogelijke complicaties .................................................................................................. 14
3. Infusie ............................................................................................................................................ 15
3.1 Aanwijzingen = indicaties plaatsen intraveneus infuus......................................................... 15
3.2 Indeling van de infusieoplossingen ....................................................................................... 16
3.2.1 Indeling volgens osmotische druk ................................................................................. 17
3.3 Infusiemateriaal..................................................................................................................... 17
3.3.1 Infusievloeistoffen ......................................................................................................... 18
3.3.1.1 Bewaring .................................................................................................................... 19
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, 3.3.2 Infusieleidingen ............................................................................................................. 19
3.3.2.1 Verlengleiding ............................................................................................................ 19
3.3.3 Inbrengmateriaal ........................................................................................................... 19
3.3.3.1 Katheters ................................................................................................................... 20
3.3.3.1.1 Perifeer veneuze katheters ................................................................................. 20
3.3.3.1.2 Centraal veneuze katheters ................................................................................ 21
3.3.3.1.3 Midline................................................................................................................. 21
3.3.3.1.4 PICC = Periferallaly inserted central catheter ..................................................... 22
3.3.3.1.5 Verschil Midline en PICC...................................................................................... 22
3.3.4 Afsluitmogelijkheden..................................................................................................... 22
3.3.4.1 Microclave ................................................................................................................. 22
3.3.5 Schakelkranen ............................................................................................................... 23
3.3.5.1 Kranenblokken........................................................................................................... 23
3.3.6 Infuusstandaard............................................................................................................. 24
3.3.7 Infuusregelaars .............................................................................................................. 24
3.3.7.1 Soorten infuussystemen ............................................................................................ 24
3.3.7.2 Eenvoudige regelaars: standaard infusieleiding........................................................ 25
3.3.7.3 Eenvoudige regelaars: debietregelaar voor eenmalig gebruik ................................. 25
3.4 Het intraveneus infuus .......................................................................................................... 26
3.4.1 Algemene aandachtspunten bij infusietherapie ........................................................... 26
3.4.2 Keuze prikplaats ............................................................................................................ 27
3.4.3 Voorbereiden punctieplaats .......................................................................................... 27
3.4.4 Punctieplaatsen bepalen ............................................................................................... 27
3.4.5 Punctieplaats ontsmetten ............................................................................................. 28
3.4.6 Keuze katheter............................................................................................................... 28
3.4.7 Plaatsen perifeer veneus infuus .................................................................................... 28
3.4.8 Verband ......................................................................................................................... 29
3.4.9 Fixatie van ketheter en leiding ...................................................................................... 29
3.4.10 IV-Leidingen ................................................................................................................... 29
3.4.11 Plaatsing perifeer infuus................................................................................................ 30
3.4.12 Mogelijke complicaties .................................................................................................. 30
3.4.13 10 gouden regels bij intraveneuze therapie.................................................................. 30
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, 1. Veneus bloed: samenstelling
Voor sommige onderzoeken heeft men vol bloed nodig. Voor ander is enkel plasma, serum of
bloedcellen nodig.
Bloed bestaat uit 2 grote componenten:
− Bloedplasma
− Cellulaire component bestaande uit verschillende celsoorten
Plasma zonder fibrinogeen (alleen na bloedstolling) noemt men bloedserum
Vol bloed = bloedcellen en bloedplasma
Plasma = serum en fibrinogeen
Serum = plasma – fibrinogeen
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