医疗器械标准是医疗器械研制、生产、经营、使用以及监督管理所共同遵循的技术规范,是医疗器械监管和产业发展的重要技术支撑。医用医用无菌塑柄手术刀药监局高度重视医疗器械标准工作,按照“四个严”的要求,结合医疗器械产业发展和监管工作实际,不断完善医疗器械标准管理制度体系、持续开展医疗器械标准制修订工作,我国医疗器械标准体系不断完善,医疗器械标准对监管和产业发展的技术支撑能力持续提升。一、加强医疗器械标准制度建设。医用无菌塑柄手术刀厂家为(wei)贯彻落(luo)实国(guo)务院深化(hua)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)化(hua)改革重大(da)决策(ce)部署,依据(ju)《中华人民共和国(guo)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)化(hua)法(fa)》,立足(zu)我(wo)国(guo)医疗(liao)器(qi)械(xie)(xie)产业(ye)发(fa)展(zhan)和监管(guan)(guan)(guan)(guan)工作(zuo)(zuo)实际,2017年4月,原(yuan)食品(pin)药品(pin)监管(guan)(guan)(guan)(guan)总局修(xiu)(xiu)订印发(fa)《医疗(liao)器(qi)械(xie)(xie)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)管(guan)(guan)(guan)(guan)理(li)办(ban)法(fa)》,该办(ban)法(fa)的(de)出台对指(zhi)导我(wo)国(guo)医疗(liao)器(qi)械(xie)(xie)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)管(guan)(guan)(guan)(guan)理(li)、规范标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)制(zhi)(zhi)修(xiu)(xiu)订、促(cu)进(jin)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)实施、提升医疗(liao)器(qi)械(xie)(xie)质量等(deng)起到了积极(ji)作(zuo)(zuo)用。为(wei)贯彻落(luo)实《医疗(liao)器(qi)械(xie)(xie)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)管(guan)(guan)(guan)(guan)理(li)办(ban)法(fa)》,原(yuan)食品(pin)药品(pin)监管(guan)(guan)(guan)(guan)总局先(xian)后印发(fa)《医疗(liao)器(qi)械(xie)(xie)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)制(zhi)(zhi)修(xiu)(xiu)订工作(zuo)(zuo)管(guan)(guan)(guan)(guan)理(li)规范》和《医疗(liao)器(qi)械(xie)(xie)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)报批发(fa)布工作(zuo)(zuo)细则》等(deng)文件,进(jin)一步规范了医疗(liao)器(qi)械(xie)(xie)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)工作(zuo)(zuo)程序,强化(hua)了标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)精细化(hua)过程管(guan)(guan)(guan)(guan)理(li),为(wei)提升医疗(liao)器(qi)械(xie)(xie)标(biao)(biao)(biao)(biao)准(zhun)(zhun)(zhun)(zhun)质量奠定了坚实的(de)制(zhi)(zhi)度(du)基础。
插管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)时的(de)护(hu)理(li)⑴清(qing)醒患(huan)(huan)(huan)者(zhe)(zhe):操(cao)(cao)纵(zong)中应(ying)鼓励其增强决心(xin)信念(nian),调动自我(wo)控制(zhi)能力,从(cong)而按捺不良情(qing)绪,配合(he)插管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)。插管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)时如碰到(dao)阻力,切勿强行置(zhi)(zhi)(zhi)(zhi)入(ru),应(ying)查(cha)明发生原因,如管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)腔(qiang)内(nei)有堵塞,可(ke)向胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)内(nei)注入(ru)空气,若泛(fan)起(qi)呃逆(ni),说明管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)腔(qiang)启(qi)齿部(bu)(bu)位在食管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)内(nei),可(ke)将胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)向下试插。⑵意识障碍(ai)(ai)患(huan)(huan)(huan)者(zhe)(zhe):可(ke)采用诱导吞咽法插胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan):患(huan)(huan)(huan)者(zhe)(zhe)取平卧(wo)或头(tou)高位,操(cao)(cao)纵(zong)者(zhe)(zhe)两人分站两侧,左侧操(cao)(cao)纵(zong)者(zhe)(zhe)按传统方法将胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)轻插至(zhi)14~16cm休止(zhi),待患(huan)(huan)(huan)者(zhe)(zhe)不适症状(zhuang)消失后(hou),左侧操(cao)(cao)纵(zong)者(zhe)(zhe)用木帛签蘸水(shui)(shui),轻擦患(huan)(huan)(huan)者(zhe)(zhe)唇部(bu)(bu)及(ji)舌面,见(jian)患(huan)(huan)(huan)者(zhe)(zhe)泛(fan)起(qi)吞咽动作(zuo),右侧操(cao)(cao)纵(zong)者(zhe)(zhe)即将胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)向前推进(jin)送入(ru)食道(dao)再插至(zhi)胃(wei)(wei)(wei)部(bu)(bu)。插管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)后(hou)护(hu)理(li)(1)胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)留(liu)置(zhi)(zhi)(zhi)(zhi)时间:长期(qi)鼻(bi)(bi)饲(si)患(huan)(huan)(huan)者(zhe)(zhe)7天更换1次(ci)(ci)胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan),一次(ci)(ci)性(xing)使用灌肠包,改(gai)插另一侧鼻(bi)(bi)孔,以预防鼻(bi)(bi)咽黏膜(mo)---性(xing)损伤;若为硅胶胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)则每月更换1次(ci)(ci)。(2)保持(chi)胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)通(tong)畅(chang):逐日用20ml生理(li)盐水(shui)(shui)冲刷2次(ci)(ci),防止(zhi)胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)因堵塞或胃(wei)(wei)(wei)液黏稠而引流不畅(chang)。(3)口(kou)腔(qiang)护(hu)理(li):住院(yuan)患(huan)(huan)(huan)者(zhe)(zhe)在留(liu)置(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)期(qi)间机(ji)体(ti)抵挡(dang)力降低(di),导致口(kou)腔(qiang)的(de)自洁(jie)作(zuo)用减弱。因此,留(liu)置(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)期(qi)间,对意识障碍(ai)(ai)患(huan)(huan)(huan)者(zhe)(zhe)进(jin)行口(kou)腔(qiang)护(hu)理(li),对清(qing)醒患(huan)(huan)(huan)者(zhe)(zhe)嘱定时刷牙(ya)。(4)心(xin)理(li)护(hu)理(li):清(qing)醒患(huan)(huan)(huan)者(zhe)(zhe)留(liu)置(zhi)(zhi)(zhi)(zhi)胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)时护(hu)士应(ying)多与其沟通(tong),加强胃(wei)(wei)(wei)管(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)(guan)护(hu)理(li)知识的(de)宣教(jiao),定时匡助患(huan)(huan)(huan)者(zhe)(zhe)翻身,推拿背部(bu)(bu)、肩(jian)颈部(bu)(bu),以减轻因头(tou)颈部(bu)(bu)制(zhi)动及(ji)被动---带来的(de)不适。
一(yi)(yi)次(ci)性(xing)使用(yong)导(dao)尿(niao)包是(shi)(shi)(shi)临床护(hu)理(li)、抢救和(he)治(zhi)疗(liao)中(zhong)必须使用(yong)的(de)(de)(de)(de)医疗(liao)器(qi)(qi)械。它主(zhu)要(yao)由以下几(ji)(ji)个部(bu)分组成:导(dao)尿(niao)管(guan)、橡胶外壳手(shou)套(tao)、洞巾、敷料镊、包布(bu)(bu)、引流(liu)袋、大(da)托盘(pan)、腰(yao)盘(pan)、脱脂纱布(bu)(bu)方(fang)、吊带绳、别针、试(shi)管(guan)、碘伏(fu)棉球、滑润纱布(bu)(bu)方(fang)、塑料夹、注射器(qi)(qi)等主(zhu)要(yao)部(bu)件。不是(shi)(shi)(shi)所有的(de)(de)(de)(de)一(yi)(yi)次(ci)性(xing)使用(yong)导(dao)尿(niao)包都是(shi)(shi)(shi)一(yi)(yi)模(mo)一(yi)(yi)样(yang)的(de)(de)(de)(de),也会出现(xian)个别的(de)(de)(de)(de)部(bu)件的(de)(de)(de)(de)不同(tong),大(da)同(tong)小异。那一(yi)(yi)次(ci)性(xing)使用(yong)导(dao)尿(niao)包的(de)(de)(de)(de)主(zhu)要(yao)原(yuan)理(li)是(shi)(shi)(shi)什么呢?它有怎(zen)样(yang)的(de)(de)(de)(de)制(zhi)作标准呢?一(yi)(yi)次(ci)性(xing)使用(yong)导(dao)尿(niao)包的(de)(de)(de)(de)所有的(de)(de)(de)(de)部(bu)件不是(shi)(shi)(shi)随意的(de)(de)(de)(de),而是(shi)(shi)(shi)按照一(yi)(yi)定合理(li)的(de)(de)(de)(de)顺序包装(zhuang)(zhuang)在一(yi)(yi)起,不是(shi)(shi)(shi)大(da)家想象(xiang)的(de)(de)(de)(de)一(yi)(yi)大(da)堆的(de)(de)(de)(de)部(bu)件随意放到一(yi)(yi)个袋子中(zhong),而是(shi)(shi)(shi)已经组合好了。并且所有的(de)(de)(de)(de)部(bu)件包装(zhuang)(zhuang)都是(shi)(shi)(shi)无菌的(de)(de)(de)(de)。这样(yang)的(de)(de)(de)(de)处理(li)就大(da)大(da)降(jiang)低了在使用(yong)过程中(zhong)出现(xian)的(de)(de)(de)(de)交(jiao)叉感染(ran)的(de)(de)(de)(de)几(ji)(ji)率(lv),也降(jiang)低了医护(hu)人员的(de)(de)(de)(de)工(gong)作负担,提(ti)升了工(gong)作效率(lv),从而提(ti)升了手(shou)术的(de)(de)(de)(de)安全(quan)性(xing)和(he)可靠性(xing),从源头杜(du)绝了疾病的(de)(de)(de)(de)传染(ran)和(he)一(yi)(yi)些常见的(de)(de)(de)(de)感染(ran)
据(ju)悉,70%世界医(yi)(yi)疗(liao)器(qi)械oem产(chan)品(pin)是(shi)中国(guo)(guo)(guo)企(qi)业制造的(de)(de)(de)(de)(de),但未必是(shi)中国(guo)(guo)(guo)企(qi)业的(de)(de)(de)(de)(de)牌(pai)子(zi),可(ke)能是(shi)通过(guo)OEM方(fang)式进(jin)入的(de)(de)(de)(de)(de)(OEM指的(de)(de)(de)(de)(de)是(shi)定牌(pai)或者贴牌(pai)生(sheng)(sheng)(sheng)产(chan))。”据(ju)了解,我(wo)(wo)国(guo)(guo)(guo)高端医(yi)(yi)疗(liao)器(qi)械主要靠(kao)进(jin)口(kou),检验(yan)设备出(chu)口(kou)占(zhan)(zhan)85%,心电(dian)图出(chu)口(kou)占(zhan)(zhan)90%,中高端监护占(zhan)(zhan)到(dao)80%,高档生(sheng)(sheng)(sheng)理记录占(zhan)(zhan)到(dao)90%。 “一(yi)(yi)(yi)带(dai)一(yi)(yi)(yi)路(lu)”有(you)助于产(chan)生(sheng)(sheng)(sheng)中国(guo)(guo)(guo)品(pin)牌(pai)。 “我(wo)(wo)国(guo)(guo)(guo)产(chan)品(pin)的(de)(de)(de)(de)(de)特点(dian)是(shi)知识(shi)产(chan)权少,自(zi)有(you)品(pin)牌(pai)少。”蔡天智表示。提倡的(de)(de)(de)(de)(de)“一(yi)(yi)(yi)带(dai)一(yi)(yi)(yi)路(lu)”战略,为(wei)中国(guo)(guo)(guo)发展(zhan)自(zi)主品(pin)牌(pai)的(de)(de)(de)(de)(de)医(yi)(yi)疗(liao)器(qi)械提供了环(huan)境和(he)条件。“一(yi)(yi)(yi)带(dai)一(yi)(yi)(yi)路(lu)”覆盖了44亿人口(kou),这(zhei)些和(he)地区(qu)的(de)(de)(de)(de)(de)国(guo)(guo)(guo)民(min)生(sheng)(sheng)(sheng)产(chan)总值为(wei)21万(wan)亿美元(yuan)。我(wo)(wo)国(guo)(guo)(guo)出(chu)口(kou)到(dao)亚(ya)洲的(de)(de)(de)(de)(de)医(yi)(yi)疗(liao)器(qi)械占(zhan)(zhan)整(zheng)个出(chu)口(kou)市场的(de)(de)(de)(de)(de)33.12%,而(er)我(wo)(wo)国(guo)(guo)(guo)需要从中亚(ya)进(jin)口(kou)大量(liang)的(de)(de)(de)(de)(de)医(yi)(yi)疗(liao)器(qi)械原料,与(yu)其这(zhei)样,不如把高分(fen)子(zi)类产(chan)品(pin)直(zhi)接输入到(dao)中亚(ya),在(zai)那里进(jin)行组(zu)装,在(zai)当(dang)地进(jin)行销售。
导尿(niao)(niao)(niao)(niao)设备在(zai)医(yi)疗(liao)当中也(ye)(ye)(ye)是(shi)(shi)经(jing)常使(shi)用(yong)(yong)(yong)(yong)的(de)(de)(de)(de)(de)一种(zhong)产(chan)(chan)(chan)品(pin)(pin)(pin),在(zai)泌尿(niao)(niao)(niao)(niao)肛肠等医(yi)疗(liao)科室经(jing)常用(yong)(yong)(yong)(yong)到导尿(niao)(niao)(niao)(niao)设备一般(ban)都(dou)是(shi)(shi)一次(ci)性使(shi)用(yong)(yong)(yong)(yong)的(de)(de)(de)(de)(de)。下面(mian)介绍的(de)(de)(de)(de)(de)这(zhei)(zhei)种(zhong)-次(ci)性的(de)(de)(de)(de)(de)无(wu)莹(ying)导尿(niao)(niao)(niao)(niao)产(chan)(chan)(chan)品(pin)(pin)(pin)就(jiu)是(shi)(shi)同类(lei)产(chan)(chan)(chan)品(pin)(pin)(pin)中性能(neng)(neng)(neng)非(fei)(fei)常优越的(de)(de)(de)(de)(de)一种(zhong)。产(chan)(chan)(chan)品(pin)(pin)(pin)的(de)(de)(de)(de)(de)用(yong)(yong)(yong)(yong)途和性能(neng)(neng)(neng),这(zhei)(zhei)种(zhong)-次(ci)性的(de)(de)(de)(de)(de)无(wu)菌导尿(niao)(niao)(niao)(niao)包主要是(shi)(shi)给临床(chuang)上(shang)(shang)的(de)(de)(de)(de)(de)患者导尿(niao)(niao)(niao)(niao)之用(yong)(yong)(yong)(yong),这(zhei)(zhei)种(zhong)产(chan)(chan)(chan)品(pin)(pin)(pin)是(shi)(shi)经(jing)过(guo)了(le)环(huan)氧乙(yi)烷灭(mie)莹(ying),非(fei)(fei)常的(de)(de)(de)(de)(de)卫生(sheng)和安全,使(shi)用(yong)(yong)(yong)(yong)起(qi)来也(ye)(ye)(ye)非(fei)(fei)常方便。该产(chan)(chan)(chan)品(pin)(pin)(pin)是(shi)(shi)由(you)洞(dong)巾,布和一次(ci)性使(shi)用(yong)(yong)(yong)(yong)的(de)(de)(de)(de)(de)导尿(niao)(niao)(niao)(niao)管(guan)、橡(xiang)胶医(yi)用(yong)(yong)(yong)(yong)手套(tao)、海绵刷、纱布块、石蜡棉球(qiu)物(wu)品(pin)(pin)(pin)盒和一次(ci)性的(de)(de)(de)(de)(de)引流袋等几部分组成。这(zhei)(zhei)种(zhong)- -次(ci)性产(chan)(chan)(chan)品(pin)(pin)(pin)使(shi)用(yong)(yong)(yong)(yong)起(qi)来也(ye)(ye)(ye)非(fei)(fei)常方便。这(zhei)(zhei)种(zhong)产(chan)(chan)(chan)品(pin)(pin)(pin)使(shi)用(yong)(yong)(yong)(yong)起(qi)来也(ye)(ye)(ye)比较(jiao)简单(dan),首(shou)先,在(zai)使(shi)用(yong)(yong)(yong)(yong)前要检查单(dan)包装(zhuang)是(shi)(shi)不是(shi)(shi)没有损(sun)(sun)坏,灭(mie)菌的(de)(de)(de)(de)(de)有效(xiao)(xiao)期(qi)(qi)(qi)是(shi)(shi)不是(shi)(shi)正(zheng)常;其(qi)次(ci),在(zai)使(shi)用(yong)(yong)(yong)(yong)的(de)(de)(de)(de)(de)时候(hou),先打开(kai)包装(zhuang),在(zai)将包布打开(kai),再(zai)戴上(shang)(shang)手套(tao),然后;按照常规的(de)(de)(de)(de)(de)方法(fa)来使(shi)用(yong)(yong)(yong)(yong)导尿(niao)(niao)(niao)(niao)包里的(de)(de)(de)(de)(de)组件;其(qi)三,-般(ban)的(de)(de)(de)(de)(de)产(chan)(chan)(chan)品(pin)(pin)(pin)的(de)(de)(de)(de)(de)有效(xiao)(xiao)期(qi)(qi)(qi)是(shi)(shi)两年 ,如果产(chan)(chan)(chan)品(pin)(pin)(pin)已经(jing)过(guo)了(le)有效(xiao)(xiao)期(qi)(qi)(qi),绝对不能(neng)(neng)(neng)使(shi)用(yong)(yong)(yong)(yong);四,如果包装(zhuang)破损(sun)(sun)了(le)也(ye)(ye)(ye)不能(neng)(neng)(neng)使(shi)用(yong)(yong)(yong)(yong);五,这(zhei)(zhei)是(shi)(shi)-次(ci)性的(de)(de)(de)(de)(de)使(shi)用(yong)(yong)(yong)(yong)产(chan)(chan)(chan)品(pin)(pin)(pin),禁止重(zhong)复使(shi)用(yong)(yong)(yong)(yong),在(zai)使(shi)用(yong)(yong)(yong)(yong)完后要销毁,生(sheng)产(chan)(chan)(chan)日期(qi)(qi)(qi)般(ban)在(zai)包装(zhuang)封口处。
一次性使(shi)(shi)(shi)用(yong)(yong)吸(xi)痰(tan)管(guan)(guan)(guan)(guan)操作(zuo)方法(1)检(jian)查吸(xi)引(yin)器各(ge)部(bu)连接是否(fou)完善,有无漏气。接通电源(yuan),打(da)开(kai)开(kai)关,检(jian)查吸(xi)引(yin)器性能,调(diao)节负(fu)压。一般成人吸(xi)痰(tan)负(fu)压约40-50 kPa,小儿吸(xi)痰(tan)约13-30kPa,将(jiang)一次性使(shi)(shi)(shi)用(yong)(yong)吸(xi)痰(tan)管(guan)(guan)(guan)(guan)置(zhi)于(yu)水中,试(shi)验(yan)吸(xi)引(yin)力,并冲(chong)洗皮管(guan)(guan)(guan)(guan)。(2)将(jiang)病人头部(bu)转向护士(shi),铺治(zhi)疗巾于(yu)颌下。(3)插(cha)入一次性使(shi)(shi)(shi)用(yong)(yong)吸(xi)痰(tan)管(guan)(guan)(guan)(guan),其(qi)顺序(xu)(xu)是由(you)(you)(you)口腔前(qian)庭→颊(jia)部(bu)→咽(yan)部(bu),将(jiang)各(ge)部(bu)吸(xi)尽(jin)。如口腔吸(xi)痰(tan)有困难时,可(ke)由(you)(you)(you)鼻(bi)(bi)腔插(cha)入(颅底骨折患(huan)者禁用(yong)(yong)),其(qi)顺序(xu)(xu)由(you)(you)(you)鼻(bi)(bi)腔前(qian)庭→下鼻(bi)(bi)道→鼻(bi)(bi)后孔→咽(yan)部(bu)→气管(guan)(guan)(guan)(guan)(约20-25cm),将(jiang)分泌物(wu)逐段吸(xi)尽(jin)。若有气管(guan)(guan)(guan)(guan)插(cha)管(guan)(guan)(guan)(guan)或气管(guan)(guan)(guan)(guan)切开(kai)时,可(ke)由(you)(you)(you)插(cha)管(guan)(guan)(guan)(guan)或套管(guan)(guan)(guan)(guan)内插(cha)入,将(jiang)痰(tan)液(ye)吸(xi)出。昏迷病人可(ke)用(yong)(yong)压舌(she)板或开(kai)口器先(xian)将(jiang)口启开(kai),再行(xing)吸(xi)引(yin)。