插管(guan)(guan)时(shi)的(de)(de)(de)护(hu)(hu)理(li)(li)⑴清醒(xing)(xing)患(huan)(huan)(huan)者(zhe)(zhe)：操纵(zong)(zong)中应(ying)(ying)鼓励其增(zeng)强决(jue)心信念(nian)，调动(dong)自(zi)我控制(zhi)能力，从而按捺不良情绪，配合插管(guan)(guan)。插管(guan)(guan)时(shi)如碰到阻(zu)力，切勿(wu)强行(xing)置(zhi)入，应(ying)(ying)查明发生原(yuan)因，如管(guan)(guan)腔内有堵(du)塞，可向(xiang)胃(wei)(wei)(wei)管(guan)(guan)内注入空(kong)气，若泛(fan)起(qi)呃(e)逆，说(shuo)明管(guan)(guan)腔启齿部(bu)位(wei)在(zai)(zai)食管(guan)(guan)内，可将胃(wei)(wei)(wei)管(guan)(guan)向(xiang)下(xia)试插。⑵意识(shi)障碍(ai)患(huan)(huan)(huan)者(zhe)(zhe)：可采(cai)用(yong)(yong)诱导吞咽法插胃(wei)(wei)(wei)管(guan)(guan)：患(huan)(huan)(huan)者(zhe)(zhe)取平卧(wo)或头高位(wei)，操纵(zong)(zong)者(zhe)(zhe)两人分站两侧(ce)，左侧(ce)操纵(zong)(zong)者(zhe)(zhe)按传(chuan)统方法将胃(wei)(wei)(wei)管(guan)(guan)轻(qing)插至(zhi)14～16cm休止，待患(huan)(huan)(huan)者(zhe)(zhe)不适症状消失后(hou)，左侧(ce)操纵(zong)(zong)者(zhe)(zhe)用(yong)(yong)木帛(bo)签蘸水，轻(qing)擦患(huan)(huan)(huan)者(zhe)(zhe)唇部(bu)及舌面，见患(huan)(huan)(huan)者(zhe)(zhe)泛(fan)起(qi)吞咽动(dong)作(zuo)，右侧(ce)操纵(zong)(zong)者(zhe)(zhe)即将胃(wei)(wei)(wei)管(guan)(guan)向(xiang)前推进送(song)入食道再插至(zhi)胃(wei)(wei)(wei)部(bu)。插管(guan)(guan)后(hou)护(hu)(hu)理(li)(li)（1）胃(wei)(wei)(wei)管(guan)(guan)留置(zhi)时(shi)间(jian)：长期鼻饲患(huan)(huan)(huan)者(zhe)(zhe)7天更换1次(ci)胃(wei)(wei)(wei)管(guan)(guan)，一次(ci)性使用(yong)(yong)灌肠包，改插另一侧(ce)鼻孔，以预(yu)防鼻咽黏膜(mo)---性损(sun)伤；若为(wei)硅胶(jiao)胃(wei)(wei)(wei)管(guan)(guan)则(ze)每月更换1次(ci)。（2）保持胃(wei)(wei)(wei)管(guan)(guan)通畅：逐日用(yong)(yong)20ml生理(li)(li)盐水冲刷2次(ci)，防止胃(wei)(wei)(wei)管(guan)(guan)因堵(du)塞或胃(wei)(wei)(wei)液黏稠(chou)而引流(liu)不畅。（3）口腔护(hu)(hu)理(li)(li)：住(zhu)院患(huan)(huan)(huan)者(zhe)(zhe)在(zai)(zai)留置(zhi)胃(wei)(wei)(wei)管(guan)(guan)期间(jian)机体抵挡力降低(di)，导致口腔的(de)(de)(de)自(zi)洁作(zuo)用(yong)(yong)减(jian)弱。因此，留置(zhi)胃(wei)(wei)(wei)管(guan)(guan)期间(jian)，对意识(shi)障碍(ai)患(huan)(huan)(huan)者(zhe)(zhe)进行(xing)口腔护(hu)(hu)理(li)(li)，对清醒(xing)(xing)患(huan)(huan)(huan)者(zhe)(zhe)嘱定时(shi)刷牙。（4）心理(li)(li)护(hu)(hu)理(li)(li)：清醒(xing)(xing)患(huan)(huan)(huan)者(zhe)(zhe)留置(zhi)胃(wei)(wei)(wei)管(guan)(guan)时(shi)护(hu)(hu)士应(ying)(ying)多与其沟(gou)通，加强胃(wei)(wei)(wei)管(guan)(guan)护(hu)(hu)理(li)(li)知识(shi)的(de)(de)(de)宣(xuan)教，定时(shi)匡助患(huan)(huan)(huan)者(zhe)(zhe)翻身，推拿背部(bu)、肩颈部(bu)，以减(jian)轻(qing)因头颈部(bu)制(zhi)动(dong)及被动(dong)---带来的(de)(de)(de)不适。

一次性使用吸痰管操作方法(1)检查吸引器各部连接是否完善，有无漏气。优质一次性使用医用无菌阴道扩张器接通电源，打开开关，检查吸引器性能，调节负压。一般成人吸痰负压约40-50 kPa，小儿吸痰约13-30kPa，将一次性使用吸痰管置于水中，试验吸引力，并冲洗皮管。(2)将病人头部转向护士，铺治疗巾于颌下。(3)插入一次性使用吸痰管，其顺序是由口腔前庭→颊部→咽部，将各部吸尽。一次性使用医用无菌阴道扩张器厂家如口腔(qiang)吸(xi)(xi)痰有困难(nan)时(shi)，可(ke)由鼻(bi)腔(qiang)插(cha)入(颅(lu)底骨折患者禁(jin)用)，其顺序由鼻(bi)腔(qiang)前庭→下鼻(bi)道→鼻(bi)后孔→咽部→气管(guan)(约(yue)20-25cm)，将分泌物逐段吸(xi)(xi)尽。若有气管(guan)插(cha)管(guan)或气管(guan)切开(kai)时(shi)，可(ke)由插(cha)管(guan)或套管(guan)内插(cha)入，将痰液吸(xi)(xi)出。昏迷病人(ren)可(ke)用压舌板或开(kai)口器先(xian)将口启开(kai)，再行吸(xi)(xi)引。

一(yi)次(ci)性(xing)(xing)吸(xi)(xi)(xi)(xi)痰(tan)(tan)包的使用(yong)方法一(yi)次(ci)性(xing)(xing)使用(yong)吸(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)(guan)(guan)用(yong)于临床患(huan)(huan)者(zhe)抽取气(qi)(qi)管(guan)(guan)(guan)(guan)内痰(tan)(tan)液或分泌(mi)(mi)液用(yong)。一(yi)次(ci)性(xing)(xing)使用(yong)吸(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)(guan)(guan)吸(xi)(xi)(xi)(xi)痰(tan)(tan)动作要(yao)轻、稳。一(yi)次(ci)吸(xi)(xi)(xi)(xi)痰(tan)(tan)时(shi)(shi)间不(bu)应(ying)超过15秒，吸(xi)(xi)(xi)(xi)引器(qi)连(lian)续使用(yong)时(shi)(shi)间不(bu)超过3分钟。1检(jian)查吸(xi)(xi)(xi)(xi)引器(qi)各(ge)部(bu)连(lian)接(jie)(jie)是(shi)否(fou)完善，有(you)无漏气(qi)(qi)。接(jie)(jie)通(tong)电源，打开开关(guan)，检(jian)查吸(xi)(xi)(xi)(xi)引器(qi)性(xing)(xing)能，调节负压。一(yi)般成(cheng)人(ren)(ren)吸(xi)(xi)(xi)(xi)痰(tan)(tan)负压约40-50 kPa，小(xiao)儿吸(xi)(xi)(xi)(xi)痰(tan)(tan)约13-30kPa，将(jiang)(jiang)(jiang)一(yi)次(ci)性(xing)(xing)使用(yong)吸(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)(guan)(guan)置于水中，试(shi)验吸(xi)(xi)(xi)(xi)引力，并(bing)冲洗皮(pi)管(guan)(guan)(guan)(guan)。2将(jiang)(jiang)(jiang)病人(ren)(ren)头部(bu)转向护士，铺治疗巾于颌下(xia)。插入(ru)一(yi)次(ci)性(xing)(xing)使用(yong)吸(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)(guan)(guan)，其顺(shun)序是(shi)由(you)(you)口(kou)腔(qiang)(qiang)前(qian)庭→颊(jia)部(bu)→咽部(bu)，将(jiang)(jiang)(jiang)各(ge)部(bu)吸(xi)(xi)(xi)(xi)尽。如口(kou)腔(qiang)(qiang)吸(xi)(xi)(xi)(xi)痰(tan)(tan)有(you)困难时(shi)(shi)，可由(you)(you)鼻腔(qiang)(qiang)插入(ru)(颅(lu)底骨折患(huan)(huan)者(zhe)禁用(yong))，其顺(shun)序由(you)(you)鼻腔(qiang)(qiang)前(qian)庭→下(xia)鼻道(dao)→鼻后孔(kong)→咽部(bu)→气(qi)(qi)管(guan)(guan)(guan)(guan)(约20-25cm)，将(jiang)(jiang)(jiang)分泌(mi)(mi)物(wu)逐(zhu)段吸(xi)(xi)(xi)(xi)尽。3气(qi)(qi)管(guan)(guan)(guan)(guan)内吸(xi)(xi)(xi)(xi)痰(tan)(tan)，待病人(ren)(ren)吸(xi)(xi)(xi)(xi)气(qi)(qi)时(shi)(shi)，快速将(jiang)(jiang)(jiang)导(dao)管(guan)(guan)(guan)(guan)插入(ru)，自下(xia)而上(shang)边退(tui)边左右旋转导(dao)管(guan)(guan)(guan)(guan)，消除气(qi)(qi)道(dao)分泌(mi)(mi)物(wu)，并(bing)注(zhu)意(yi)观(guan)(guan)察病人(ren)(ren)的呼吸(xi)(xi)(xi)(xi)。在吸(xi)(xi)(xi)(xi)引过程(cheng)中，如病人(ren)(ren)咳嗽(sou)厉(li)害，应(ying)稍等片刻后再行吸(xi)(xi)(xi)(xi)出。并(bing)随时(shi)(shi)冲洗吸(xi)(xi)(xi)(xi)引管(guan)(guan)(guan)(guan)，以免痰(tan)(tan)液堵(du)塞(sai)。4吸(xi)(xi)(xi)(xi)毕，关(guan)闭吸(xi)(xi)(xi)(xi)引器(qi)开关(guan)，弃吸(xi)(xi)(xi)(xi)痰(tan)(tan)导(dao)管(guan)(guan)(guan)(guan)于小(xiao)桶内，吸(xi)(xi)(xi)(xi)引胶管(guan)(guan)(guan)(guan)玻(bo)璃(li)接(jie)(jie)头插入(ru)床栏上(shang)盛有(you)消毒液瓶内备(bei)用(yong)，将(jiang)(jiang)(jiang)病人(ren)(ren)口(kou)腔(qiang)(qiang)周围擦净。观(guan)(guan)察吸(xi)(xi)(xi)(xi)出液的量、颜色(se)及性(xing)(xing)质，必要(yao)时(shi)(shi)做(zuo)好记录。

一(yi)次(ci)(ci)(ci)性(xing)(xing)使用(yong)换(huan)(huan)药(yao)(yao)(yao)包怎(zen)(zen)么(me)换(huan)(huan)药(yao)(yao)(yao)？我们应该怎(zen)(zen)么(me)使用(yong)一(yi)次(ci)(ci)(ci)性(xing)(xing)换(huan)(huan)药(yao)(yao)(yao)包？所谓一(yi)次(ci)(ci)(ci)性(xing)(xing)换(huan)(huan)药(yao)(yao)(yao)包，顾名思义(yi)当(dang)然是作为(wei)一(yi)款一(yi)次(ci)(ci)(ci)性(xing)(xing)换(huan)(huan)药(yao)(yao)(yao)的(de)产(chan)(chan)品，一(yi)般情况下(xia)里(li)面都会(hui)有(you)(you)一(yi)次(ci)(ci)(ci)性(xing)(xing)镊子(zi)、纱布、棉球(qiu)、乳胶手(shou)(shou)(shou)套/PE手(shou)(shou)(shou)套等(deng)等(deng)，放(fang)在(zai)家中，随时随地都可以(yi)使用(yong)，而且就算出(chu)去旅游时，也可以(yi)携带一(yi)次(ci)(ci)(ci)性(xing)(xing)换(huan)(huan)药(yao)(yao)(yao)包，遇到擦伤(shang)或磕碰的(de)时候，就可直接使用(yong)。需(xu)要注意的(de)是，一(yi)次(ci)(ci)(ci)性(xing)(xing)换(huan)(huan)药(yao)(yao)(yao)包内一(yi)般没有(you)(you)消毒酒精(jing)，所以(yi)家里(li)好配(pei)备消毒酒精(jing)。一(yi)次(ci)(ci)(ci)性(xing)(xing)换(huan)(huan)药(yao)(yao)(yao)包使用(yong)方(fang)法(fa)：1取出(chu)一(yi)次(ci)(ci)(ci)性(xing)(xing)换(huan)(huan)药(yao)(yao)(yao)包内的(de)医用(yong)手(shou)(shou)(shou)套，戴(dai)上；2、取出(chu)镊子(zi)、棉球(qiu)，沾(zhan)酒精(jing)，对擦伤(shang)的(de)伤(shang)口(kou)进(jin)行消毒处(chu)理(li)；3、如果伤(shang)口(kou)比较大(da)，就需(xu)要用(yong)纱布进(jin)行包扎。4、使用(yong)后(hou)，销毁换(huan)(huan)药(yao)(yao)(yao)包内的(de)所有(you)(you)物品，内置产(chan)(chan)品皆为(wei)一(yi)次(ci)(ci)(ci)性(xing)(xing)使用(yong)产(chan)(chan)品，不可重复之用(yong)。

疫苗(miao)(miao)(miao)管(guan)(guan)(guan)(guan)(guan)理(li)法草案(an)23日(ri)首次提请十(shi)三届(jie)人大常委会(hui)第(di)七次会(hui)议审议。草案(an)就疫苗(miao)(miao)(miao)管(guan)(guan)(guan)(guan)(guan)理(li)单独立(li)法，突出疫苗(miao)(miao)(miao)管(guan)(guan)(guan)(guan)(guan)理(li)特点，强化疫苗(miao)(miao)(miao)的(de)(de)风(feng)险管(guan)(guan)(guan)(guan)(guan)理(li)、全(quan)程(cheng)控(kong)制(zhi)、严格监管(guan)(guan)(guan)(guan)(guan)和社会(hui)共治，切(qie)实疫苗(miao)(miao)(miao)安全(quan)、有效(xiao)和规范接(jie)种(zhong)。党中央(yang)、国(guo)务院高度重(zhong)视疫苗(miao)(miao)(miao)监管(guan)(guan)(guan)(guan)(guan)工作，要求加快(kuai)完善疫苗(miao)(miao)(miao)药(yao)品监管(guan)(guan)(guan)(guan)(guan)长效(xiao)机制(zhi)。疫苗(miao)(miao)(miao)管(guan)(guan)(guan)(guan)(guan)理(li)单独立(li)法，有利于进(jin)一步提高疫苗(miao)(miao)(miao)管(guan)(guan)(guan)(guan)(guan)理(li)措(cuo)施(shi)的(de)(de)稳(wen)定性。药(yao)监局(ju)政策法规司有关负责人介绍，2005年(nian)国(guo)务院出台了《疫苗(miao)(miao)(miao)流(liu)通和预防(fang)接(jie)种(zhong)管(guan)(guan)(guan)(guan)(guan)理(li)条(tiao)(tiao)例》，并(bing)于2016年(nian)进(jin)行了修(xiu)订。此次提交审议的(de)(de)疫苗(miao)(miao)(miao)管(guan)(guan)(guan)(guan)(guan)理(li)法草案(an)，对疫苗(miao)(miao)(miao)研(yan)制(zhi)、生(sheng)产(chan)、流(liu)通、预防(fang)接(jie)种(zhong)、补偿、赔偿等(deng)以法律(lv)形式进(jin)行明确规定，有利于建立(li)系统的(de)(de)、全(quan)链条(tiao)(tiao)的(de)(de)疫苗(miao)(miao)(miao)管(guan)(guan)(guan)(guan)(guan)理(li)制(zhi)度。