指导要点(dian)1.告知(zhi)(zhi)(zhi)患(huan)者胸(xiong)(xiong)(xiong)(xiong)腔引(yin)(yin)流(liu)的(de)目的(de)及(ji)(ji)配(pei)合方法(fa)。2.鼓励(li)患(huan)者咳(ke)嗽(sou)，深(shen)呼(hu)吸及(ji)(ji)变换体位，并(bing)告知(zhi)(zhi)(zhi)正确咳(ke)嗽(sou)、深(shen)呼(hu)吸、变换体位的(de)方法(fa)。（四）注(zhu)意事项。1.出(chu)血量多于100ml／h，呈(cheng)鲜红(hong)色(se)，有血凝块，同时伴有脉搏增快，提示(shi)有活(huo)动性(xing)出(chu)血的(de)可(ke)能，及(ji)(ji)时通知(zhi)(zhi)(zhi)医(yi)生。2.水封瓶打(da)破或(huo)接(jie)头滑脱时，要立(li)即夹(jia)闭(bi)或(huo)反折(zhe)近胸(xiong)(xiong)(xiong)(xiong)端胸(xiong)(xiong)(xiong)(xiong)引(yin)(yin)管(guan)(guan)(guan)(guan)。3.引(yin)(yin)流(liu)管(guan)(guan)(guan)(guan)自胸(xiong)(xiong)(xiong)(xiong)壁伤(shang)口(kou)脱出(chu)，立(li)即用手顺皮(pi)(pi)(pi)肤纹理方向捏紧引(yin)(yin)流(liu)口(kou)周围(wei)皮(pi)(pi)(pi)肤（注(zhu)意不要直接(jie)接(jie)触伤(shang)口(kou)），并(bing)立(li)即通知(zhi)(zhi)(zhi)医(yi)生处理。4.患(huan)者下床活(huo)动时，引(yin)(yin)流(liu)瓶的(de)位置(zhi)应低于膝盖且(qie)保持(chi)平稳，保障长管(guan)(guan)(guan)(guan)没入液(ye)面下；外出(chu)检(jian)查前须将引(yin)(yin)流(liu)管(guan)(guan)(guan)(guan)夹(jia)闭(bi)，漏气明显的(de)患(huan)者不可(ke)夹(jia)闭(bi)胸(xiong)(xiong)(xiong)(xiong)引(yin)(yin)管(guan)(guan)(guan)(guan)。5.拔管(guan)(guan)(guan)(guan)后注(zhu)意观察患(huan)者有无胸(xiong)(xiong)(xiong)(xiong)闷、憋气，皮(pi)(pi)(pi)下气肿，伤(shang)口(kou)渗液(ye)及(ji)(ji)出(chu)血等症状，有异常及(ji)(ji)时通知(zhi)(zhi)(zhi)医(yi)生。一次性(xing)使用导尿包(bao)（三(san)）指导要点(dian)。1.告知(zhi)(zhi)(zhi)患(huan)者心(xin)包(bao)、纵(zong)膈引(yin)(yin)流(liu)的(de)目的(de)、配(pei)合方法(fa)。2.告知(zhi)(zhi)(zhi)患(huan)者更换体位时防止引(yin)(yin)流(liu)管(guan)(guan)(guan)(guan)意外脱出(chu)或(huo)打(da)折(zhe)、受压等措施。

2月13日(ri)，联合整(zheng)治“保(bao)健(jian)”市(shi)场(chang)乱象(xiang)百(bai)(bai)日(ri)行(xing)(xing)(xing)动(dong)联合工(gong)(gong)作(zuo)组在市(shi)场(chang)监(jian)(jian)管(guan)(guan)总(zong)(zong)局(ju)(ju)召(zhao)开(kai)工(gong)(gong)作(zuo)组会(hui)议(yi)。市(shi)场(chang)监(jian)(jian)管(guan)(guan)总(zong)(zong)局(ju)(ju)副局(ju)(ju)长甘霖同志(zhi)出席会(hui)议(yi)并讲话，市(shi)场(chang)监(jian)(jian)管(guan)(guan)总(zong)(zong)局(ju)(ju)、工(gong)(gong)业(ye)和(he)信息化部、公安部、民政(zheng)部、住房和(he)城(cheng)乡建设部、农业(ye)农村(cun)部、商(shang)务(wu)部、文化和(he)旅游部、卫生健(jian)康委员(yuan)会(hui)、广播(bo)电视总(zong)(zong)局(ju)(ju)、中医药管(guan)(guan)理局(ju)(ju)、药品监(jian)(jian)督管(guan)(guan)理局(ju)(ju)、网信办等13部门成(cheng)员(yuan)单位负责同志(zhi)及联络(luo)员(yuan)和(he)市(shi)场(chang)监(jian)(jian)管(guan)(guan)总(zong)(zong)局(ju)(ju)“百(bai)(bai)日(ri)行(xing)(xing)(xing)动(dong)”工(gong)(gong)作(zuo)组成(cheng)员(yuan)单位负责同志(zhi)及联络(luo)员(yuan)参加会(hui)议(yi)。“百(bai)(bai)日(ri)行(xing)(xing)(xing)动(dong)”开(kai)展以来，各部门积(ji)极落实《关于开(kai)展联合整(zheng)治“保(bao)健(jian)”市(shi)场(chang)乱象(xiang)百(bai)(bai)日(ri)行(xing)(xing)(xing)动(dong)的通知(zhi)》要求(qiu)，立足(zu)自身职能，迅(xun)速(su)部署落实，在相(xiang)关领域和(he)行(xing)(xing)(xing)业(ye)内(nei)开(kai)展行(xing)(xing)(xing)动(dong)。市(shi)场(chang)监(jian)(jian)管(guan)(guan)总(zong)(zong)局(ju)(ju)切实履行(xing)(xing)(xing)监(jian)(jian)管(guan)(guan)执法、联络(luo)调度(du)、汇集信息、服务(wu)保(bao)障等职责，通过建立工(gong)(gong)作(zuo)协调机(ji)制、建立工(gong)(gong)作(zuo)台(tai)账(zhang)、召(zhao)开(kai)调度(du)会(hui)议(yi)、加强新闻宣(xuan)传(chuan)等方式，组织各部门、市(shi)场(chang)监(jian)(jian)管(guan)(guan)系统(tong)迅(xun)速(su)深入开(kai)展“百(bai)(bai)日(ri)行(xing)(xing)(xing)动(dong)”。

一(yi)次(ci)性(xing)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)包的(de)使(shi)(shi)用(yong)(yong)(yong)方法一(yi)次(ci)性(xing)使(shi)(shi)用(yong)(yong)(yong)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)用(yong)(yong)(yong)于(yu)临床患者抽取气(qi)管(guan)(guan)内痰(tan)(tan)液或(huo)分(fen)泌液用(yong)(yong)(yong)。一(yi)次(ci)性(xing)使(shi)(shi)用(yong)(yong)(yong)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)动(dong)作要(yao)轻、稳。一(yi)次(ci)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)时间不应超(chao)(chao)过15秒，吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)器(qi)连续使(shi)(shi)用(yong)(yong)(yong)时间不超(chao)(chao)过3分(fen)钟。1检(jian)查(cha)吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)器(qi)各部连接(jie)是(shi)否完善，有(you)无漏(lou)气(qi)。接(jie)通电(dian)源，打开(kai)开(kai)关(guan)，检(jian)查(cha)吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)器(qi)性(xing)能(neng)，调节负(fu)压。一(yi)般成人(ren)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)负(fu)压约(yue)(yue)40-50 kPa，小(xiao)儿吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)约(yue)(yue)13-30kPa，将一(yi)次(ci)性(xing)使(shi)(shi)用(yong)(yong)(yong)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)置于(yu)水中，试(shi)验吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)力(li)，并冲(chong)(chong)洗皮(pi)管(guan)(guan)。2将病人(ren)头(tou)部转(zhuan)(zhuan)向护(hu)士，铺治疗巾于(yu)颌下。插入(ru)一(yi)次(ci)性(xing)使(shi)(shi)用(yong)(yong)(yong)吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)管(guan)(guan)，其(qi)(qi)顺序是(shi)由口腔前(qian)庭(ting)→颊部→咽(yan)部，将各部吸(xi)(xi)(xi)(xi)(xi)尽。如口腔吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)有(you)困难时，可(ke)由鼻腔插入(ru)(颅底骨折患者禁用(yong)(yong)(yong))，其(qi)(qi)顺序由鼻腔前(qian)庭(ting)→下鼻道(dao)→鼻后孔(kong)→咽(yan)部→气(qi)管(guan)(guan)(约(yue)(yue)20-25cm)，将分(fen)泌物逐段吸(xi)(xi)(xi)(xi)(xi)尽。3气(qi)管(guan)(guan)内吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)，待(dai)病人(ren)吸(xi)(xi)(xi)(xi)(xi)气(qi)时，快速将导管(guan)(guan)插入(ru)，自(zi)下而上边(bian)退边(bian)左右旋转(zhuan)(zhuan)导管(guan)(guan)，消除(chu)气(qi)道(dao)分(fen)泌物，并注意观察(cha)病人(ren)的(de)呼吸(xi)(xi)(xi)(xi)(xi)。在(zai)吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)过程(cheng)中，如病人(ren)咳嗽厉害(hai)，应稍等(deng)片刻后再(zai)行(xing)吸(xi)(xi)(xi)(xi)(xi)出。并随时冲(chong)(chong)洗吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)管(guan)(guan)，以免痰(tan)(tan)液堵塞(sai)。4吸(xi)(xi)(xi)(xi)(xi)毕，关(guan)闭吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)器(qi)开(kai)关(guan)，弃吸(xi)(xi)(xi)(xi)(xi)痰(tan)(tan)导管(guan)(guan)于(yu)小(xiao)桶内，吸(xi)(xi)(xi)(xi)(xi)引(yin)(yin)(yin)(yin)胶管(guan)(guan)玻璃接(jie)头(tou)插入(ru)床栏上盛有(you)消毒液瓶(ping)内备(bei)用(yong)(yong)(yong)，将病人(ren)口腔周围擦(ca)净。观察(cha)吸(xi)(xi)(xi)(xi)(xi)出液的(de)量、颜色及性(xing)质，必要(yao)时做好记录(lu)。

对业内企业来说，焦点核心的还有：几十种医疗器械的管理类别降了，有从三类降为二类的，也有从二类降为一类的。推荐一次性使用医用换药包也有部分产品是升类了的。一次性使用医用换药包厂家还(hai)有(you)的(de)产(chan)(chan)品(pin)(pin)将不(bu)再作(zuo)为(wei)医疗(liao)器械(xie)管(guan)理。产(chan)(chan)品(pin)(pin)类(lei)(lei)别上的(de)变(bian)化是要直接(jie)影(ying)响医疗(liao)器械(xie)生产(chan)(chan)经营企业(ye)(ye)的(de)，比如生产(chan)(chan)企业(ye)(ye)，原(yuan)本(ben)自(zi)家(jia)产(chan)(chan)品(pin)(pin)是三(san)类(lei)(lei)，降(jiang)为(wei)二类(lei)(lei)管(guan)理之后，企业(ye)(ye)将无需(xu)再跑到(dao)北京、到(dao)药监(jian)(jian)总局来进(jin)行产(chan)(chan)品(pin)(pin)注(zhu)(zhu)册，只需(xu)在本(ben)省(sheng)药监(jian)(jian)局注(zhu)(zhu)册即可(ke)。从二类(lei)(lei)降(jiang)为(wei)一(yi)(yi)类(lei)(lei)管(guan)理的(de)，生产(chan)(chan)企业(ye)(ye)则(ze)更(geng)(geng)省(sheng)事(shi)，产(chan)(chan)品(pin)(pin)无需(xu)注(zhu)(zhu)册，只需(xu)备案即可(ke)。降(jiang)类(lei)(lei)之后，在注(zhu)(zhu)册更(geng)(geng)省(sheng)事(shi)之外，节省(sheng)的(de)还(hai)有(you)注(zhu)(zhu)册费(fei)用(yong)。以三(san)类(lei)(lei)降(jiang)为(wei)二类(lei)(lei)为(wei)例，原(yuan)有(you)境内三(san)类(lei)(lei)产(chan)(chan)品(pin)(pin)首次(ci)注(zhu)(zhu)册要收费(fei)15.36万(wan)元，而转(zhuan)到(dao)地方注(zhu)(zhu)册后，目前收费(fei)最便宜的(de)宁夏仅有(you)3.13万(wan)元，还(hai)有(you)十多个(ge)省(sheng)份则(ze)还(hai)没开始收费(fei)呢。当然，反(fan)过来，对升类(lei)(lei)产(chan)(chan)品(pin)(pin)而言，注(zhu)(zhu)册要比现在麻(ma)烦一(yi)(yi)些了，由二类(lei)(lei)升为(wei)三(san)类(lei)(lei)的(de)，风险(xian)级别大增，也(ye)将面(mian)临(lin)药监(jian)(jian)更(geng)(geng)为(wei)严(yan)格和密集(ji)的(de)监(jian)(jian)管(guan)举措。