Basic nursing: prevention and nursing of intravenous infusion reaction

Keywords: nursing care of intravenous infusion reaction

[Abstract]? Purpose? Familiar with the possible adverse reactions during intravenous infusion, and take corresponding treatment measures urgently to prevent complications. Method? Correctly carry out the routine operation of aseptic technology, do a good job of "three checks, seven pairs and one attention", and make more inspections and observations during infusion. And the result? Once transfusion reaction is found, treatment and nursing measures should be taken immediately. The patient recovered quickly and no complications occurred. Conclusion? Most transfusion reactions can be avoided through our careful examination and normal operation. However, some reactions are inevitable, such as the purity of Chinese patent medicine injection and the individual specificity of the body. However, complications can be avoided as long as medical staff carefully observe and patrol at work, find out in time and deal with them in time.

[Keywords]? Infusion reaction; Prevention and control; nurse

? Intravenous infusion is an effective method to treat diseases, and it is the most commonly used treatment means and methods. However, intravenous infusion also has certain medical safety risks and should not be abused. Serious reactions and complications that may occur during infusion should be considered and paid attention to. If it is not found and handled in time, it will lead to adverse consequences. There are many reasons and factors that cause transfusion reaction, such as pyrogen, contaminated or deteriorated liquid or medicine, unclean or deteriorated infusion set, improper liquid selection, improper drug compatibility, too fast and too fast infusion speed, etc. How to carry out effective prevention and care is commonly described as follows.

? 1? Fever reaction

? 1. 1? What are the characteristics of this disease? During infusion, the patient suddenly felt cold and trembled involuntarily, and quickly turned into high fever, severe cyanosis, pale face, accelerated heart rate, accelerated pulse and collapse, and most of them quickly improved after treatment. Fever reaction is one of the most common transfusion reactions. The common causes are pyrogens (common bacteria and poisonous bacteria, etc.). ) or other substances pollute the liquid or infusion supplies, which may also be caused by impure drugs or drug incompatibility.

? 1.2? Prevention and care? In the process of infusion, once the shivering reaction occurs, the infusion should be suspended or completely stopped immediately, and the causes of the reaction should be examined in detail. Keep warm when shivering, and immediately inject phenanthrene (25 ~ 50 mg) or other antiallergic drugs, moxibustion at Baihui point, etc. Acupuncture can be used in patients with collapse, and epinephrine (0.5 ~ 1 mg) can be injected in severe cases. When the fever drops below 38℃ and there is no other discomfort, the observed patient can leave.

? 2? thrombophlebitis

? Due to long-term infusion of hypertonic glucose solution and intravascular drugs, the diseased intima is inflamed and the blood in the venous cavity condenses into thrombus.

? 2. 1? Main symptoms? There are redness, tenderness and heat pain. Locally along the venous path, but generally no systemic symptoms or only discomfort.

? 2.2? Prevention and care? Comfort the patient to eliminate nervousness, change the injection site for the patient, let the affected limb rest and apply local hot compress. In severe cases, 95% alcohol or 50% magnesium sulfate is used for local hot and wet compress.

? 3? acute pulmonary edema

? 3. 1? What are the characteristics of this disease? Too much or too fast infusion, especially when too much sodium-containing liquid is input, is prone to acute pulmonary edema. Patients with primary heart disease, cardiac insufficiency and pulmonary insufficiency should pay special attention to the infusion of elderly and frail children. When the patient suddenly feels dyspnea, shortness of breath, severe cough, irritability and cyanosis, a large amount of pink foam-like liquid can be sprayed from the nose and mouth in severe cases, and dry and wet rales appear in both lungs during auscultation, and the heart sounds are weak.

? 3.2? Prevention and care? If this situation is found, stop infusion immediately, take a sitting position and droop your legs to reduce venous reflux and relieve the burden on your heart, and immediately pressurize oxygen inhalation. Humidify the bottle with 20% ~ 30% alcohol and oxygen. If necessary, intravenous injection of aminophylline and diuretics, diuretic drainage. Intravenous injection of cedilanid 0.4 mg and 50% glucose 40 ml slowly.

? 4? anaphylactic reaction

? 4. 1? Are allergic reactions mainly caused by drugs more common? At present, Qingkailing injection, Shuanghuanglian injection and ofloxacin injection are commonly used in clinic. During about 10 min ~ 1 h of intravenous infusion, the patient developed skin urticaria, itching, chest tightness, fever, cyanosis and other symptoms, so we should pay attention to the occurrence of shock.

? 4.2? Prevention and care? Immediately replace the liquid medicine and infusion tube, that is, maintain the infusion with 5% glucose for emergency medication, and immediately inject perphenazine 25 mg and dexamethasone 5 mg. In severe cases, give oxygen inhalation and intramuscular injection of adrenaline 1 mg, and those with anaphylactic shock will be treated as anti-shock. Observe the general situation of the patient closely and leave the hospital after the symptoms completely disappear.

? 5 air embolism

? 5. 1? What are the characteristics of this disease? Because the air is not exhausted when the infusion tube is infused, the connection of the infusion tube is not tight, the pressurized infusion and continuous infusion are not timely, and the air is not rearranged, so that the air enters the vein and blocks the pulmonary artery orifice with the blood flow from the right atrium to the right ventricle, so that the blood cannot enter the lungs, resulting in severe hypoxia. At this time, the patient feels chest tightness, dyspnea or severe cyanosis, and a loud "bubbling sound" can be heard in the precordial area of auscultation.

? 5.2? Prevention and care? Stop infusion immediately, notify the doctor, actively cooperate with the rescue, comfort the patient and alleviate the fear. Immediately move the patient to the left lying position and the position with head low and feet high to reduce the air entering the lung mouth. And give oxygen, closely observe the general situation of patients, if necessary, symptomatic treatment.

? 6? Clinical investigation of transfusion reaction

? The number of infusion patients, types of clinical infusion reactions and results in Xinzhou Community Health Service Center from 2003 to 2005 were investigated. See table 1. Table 1? Number of clinical transfusion patients and types and results of transfusion reactions from 2003 to 2005 Note: From 2003 to 2005, there were 44 transfusion patients 16880, accounting for 2.6‰.

? The above survey data show that the general infusion reaction has a good prognosis and few complications as long as it is found and handled in time. However, transfusion reaction can also lead to serious consequences. Therefore, we should emphasize the principle of putting prevention first. Nurses should have good professional ethics, carefully check patients' medication, and be meticulous in every aseptic technique operation. In the process of infusion, always check the patient and observe the patient at any time. If there are suspicious reaction symptoms, stop using or replace the liquid immediately, and take necessary corresponding measures in time to ensure the safety of patients.