这个市场的(de)(de)(de)(de)(de)(de)现(xian)状到底(di)怎么样?在国家(jia)医(yi)疗(liao)(liao)改(gai)革诸(zhu)如分(fen)级诊疗(liao)(liao)等大的(de)(de)(de)(de)(de)(de)浪潮(chao)冲(chong)击下(xia),未来(lai)的(de)(de)(de)(de)(de)(de)机会和(he)(he)趋势如何(he)?对于一些(xie)(xie)想(xiang)在这块市场有所行(xing)动的(de)(de)(de)(de)(de)(de)企业(ye)来(lai)说,又(you)如何(he)下(xia)手呢?带着这些(xie)(xie)问题,绿豹(bao)医(yi)疗(liao)(liao)经过与医(yi)械(xie)圈、医(yi)药圈里多(duo)年从事营(ying)(ying)(ying)销工作的(de)(de)(de)(de)(de)(de)同道沟通和(he)(he)交流(liu);同时,也深(shen)入部分(fen)乡(xiang)镇卫(wei)(wei)生院(yuan)及(ji)社区(qu)卫(wei)(wei)生医(yi)疗(liao)(liao)机构,与相关(guan)领导了解(jie)信息;最终(zhong)结合(he)笔者自身营(ying)(ying)(ying)销经验,经过梳理后,希(xi)望抛(pao)砖引玉,为部分(fen)企业(ye)的(de)(de)(de)(de)(de)(de)低值耗材推广提(ti)(ti)供一些(xie)(xie)思路(lu)和(he)(he)借鉴。1、采(cai)购(gou)目前在乡(xiang)镇卫(wei)(wei)生院(yuan)及(ji)社区(qu)医(yi)疗(liao)(liao)机构,大型医(yi)疗(liao)(liao)器械(xie)设(she)备由医(yi)院(yuan)提(ti)(ti)出需(xu)求(如有具体参数也要附(fu)上),卫(wei)(wei)计(ji)委(wei)(wei)负责采(cai)购(gou)并配(pei)发(fa)给卫(wei)(wei)生院(yuan);而小型设(she)备及(ji)一次(ci)性使(shi)用的(de)(de)(de)(de)(de)(de)低值耗材类,具有最终(zhong)端(duan)决策权的(de)(de)(de)(de)(de)(de)就(jiu)基(ji)本上是(shi)院(yuan)长一个人(ren)了,当(dang)然一般由化验室提(ti)(ti)出需(xu)求,供货商多(duo)数是(shi)多(duo)年与该院(yuan)合(he)作器械(xie)经营(ying)(ying)(ying)或(huo)原药品营(ying)(ying)(ying)销关(guan)系转行(xing)从事器械(xie)耗材推广的(de)(de)(de)(de)(de)(de)公司,亦(yi)或(huo)和(he)(he)卫(wei)(wei)计(ji)委(wei)(wei)有一定的(de)(de)(de)(de)(de)(de)业(ye)务关(guan)系。
一次性(xing)使用(yong)(yong)无菌(jun)(jun)阴(yin)(yin)道(dao)扩(kuo)(kuo)张(zhang)器(qi),是(shi)(shi)妇(fu)科医生(sheng)查看你(ni)(ni)的(de)阴(yin)(yin)道(dao),或者是(shi)(shi)子宫时用(yong)(yong)到的(de)一种工具。运(yun)用(yong)(yong)扩(kuo)(kuo)张(zhang)器(qi)是(shi)(shi)为了保(bao)护你(ni)(ni)的(de)子宫不遭到损伤,用(yong)(yong)它来(lai)查看你(ni)(ni)的(de)阴(yin)(yin)道(dao)是(shi)(shi)否有病变,或者是(shi)(shi)查看子宫里边是(shi)(shi)否存在(zai)什么相同的(de)肿瘤。有些阴(yin)(yin)道(dao)手术也(ye)是(shi)(shi)需求(qiu)这个(ge)(ge)扩(kuo)(kuo)张(zhang)器(qi)的(de),在(zai)阴(yin)(yin)道(dao)手术中,一向选用(yong)(yong)妇(fu)科的(de)鸭(ya)嘴(zui)状阴(yin)(yin)道(dao)扩(kuo)(kuo)张(zhang)器(qi),将(jiang)阴(yin)(yin)道(dao)扩(kuo)(kuo)开,但扩(kuo)(kuo)张(zhang)器(qi)外口不能随(sui)意扩(kuo)(kuo)大和缩小,这样(yang)扩(kuo)(kuo)张(zhang)阴(yin)(yin)道(dao),手术起来(lai)会方(fang)便(bian)许多。需求(qiu)留意哪些问题:但需求(qiu)留意的(de)是(shi)(shi),运(yun)用(yong)(yong)阴(yin)(yin)道(dao)扩(kuo)(kuo)张(zhang)器(qi)进行(xing)阴(yin)(yin)道(dao)查看今后,回家有必要运(yun)用(yong)(yong)护理液(ye)清洗阴(yin)(yin)道(dao),防止阴(yin)(yin)道(dao)扩(kuo)(kuo)张(zhang)器(qi)不洁净带(dai)来(lai)一些细菌(jun)(jun),或者是(shi)(shi)不洁物。总之阴(yin)(yin)道(dao)是(shi)(shi)个(ge)(ge)很灵敏,简(jian)单感染的(de)当地,咱们女性(xing)朋友一定要留意卫(wei)生(sheng)。
插(cha)(cha)管(guan)(guan)(guan)(guan)时(shi)的(de)护(hu)理(li)⑴清(qing)(qing)醒(xing)患(huan)(huan)者(zhe):操(cao)纵(zong)(zong)中应(ying)鼓励其增强(qiang)决心(xin)信念,调动自我控(kong)制(zhi)能力,从而按(an)(an)捺不(bu)良情绪(xu),配合插(cha)(cha)管(guan)(guan)(guan)(guan)。插(cha)(cha)管(guan)(guan)(guan)(guan)时(shi)如碰到阻力,切(qie)勿强(qiang)行(xing)置(zhi)入(ru),应(ying)查明(ming)(ming)发生原因,如管(guan)(guan)(guan)(guan)腔(qiang)(qiang)内(nei)有堵(du)塞(sai)(sai),可向(xiang)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)内(nei)注入(ru)空气,若泛(fan)起呃逆,说明(ming)(ming)管(guan)(guan)(guan)(guan)腔(qiang)(qiang)启(qi)齿部(bu)位(wei)在食管(guan)(guan)(guan)(guan)内(nei),可将胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)向(xiang)下(xia)试插(cha)(cha)。⑵意识(shi)障(zhang)碍(ai)患(huan)(huan)者(zhe):可采用(yong)(yong)诱导吞咽(yan)法插(cha)(cha)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan):患(huan)(huan)者(zhe)取(qu)平卧或头高位(wei),操(cao)纵(zong)(zong)者(zhe)两(liang)人分站两(liang)侧(ce),左侧(ce)操(cao)纵(zong)(zong)者(zhe)按(an)(an)传统方法将胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)轻(qing)插(cha)(cha)至14~16cm休止,待(dai)患(huan)(huan)者(zhe)不(bu)适(shi)症状(zhuang)消失(shi)后,左侧(ce)操(cao)纵(zong)(zong)者(zhe)用(yong)(yong)木帛签蘸水,轻(qing)擦患(huan)(huan)者(zhe)唇部(bu)及(ji)(ji)舌面,见患(huan)(huan)者(zhe)泛(fan)起吞咽(yan)动作(zuo),右侧(ce)操(cao)纵(zong)(zong)者(zhe)即(ji)将胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)向(xiang)前推进(jin)送入(ru)食道(dao)再插(cha)(cha)至胃(wei)(wei)(wei)(wei)部(bu)。插(cha)(cha)管(guan)(guan)(guan)(guan)后护(hu)理(li)(1)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)留(liu)(liu)置(zhi)时(shi)间:长期鼻(bi)饲患(huan)(huan)者(zhe)7天更换1次(ci)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan),一(yi)次(ci)性(xing)使用(yong)(yong)灌肠(chang)包(bao),改插(cha)(cha)另一(yi)侧(ce)鼻(bi)孔,以预防鼻(bi)咽(yan)黏膜---性(xing)损伤;若为硅胶胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)则每(mei)月更换1次(ci)。(2)保持(chi)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)通(tong)畅:逐日用(yong)(yong)20ml生理(li)盐(yan)水冲(chong)刷2次(ci),防止胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)因堵(du)塞(sai)(sai)或胃(wei)(wei)(wei)(wei)液黏稠而引(yin)流不(bu)畅。(3)口(kou)腔(qiang)(qiang)护(hu)理(li):住(zhu)院患(huan)(huan)者(zhe)在留(liu)(liu)置(zhi)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)期间机体抵挡力降低(di),导致口(kou)腔(qiang)(qiang)的(de)自洁作(zuo)用(yong)(yong)减弱(ruo)。因此,留(liu)(liu)置(zhi)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)期间,对意识(shi)障(zhang)碍(ai)患(huan)(huan)者(zhe)进(jin)行(xing)口(kou)腔(qiang)(qiang)护(hu)理(li),对清(qing)(qing)醒(xing)患(huan)(huan)者(zhe)嘱定时(shi)刷牙。(4)心(xin)理(li)护(hu)理(li):清(qing)(qing)醒(xing)患(huan)(huan)者(zhe)留(liu)(liu)置(zhi)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)时(shi)护(hu)士(shi)应(ying)多与其沟通(tong),加强(qiang)胃(wei)(wei)(wei)(wei)管(guan)(guan)(guan)(guan)护(hu)理(li)知识(shi)的(de)宣教,定时(shi)匡助患(huan)(huan)者(zhe)翻身,推拿背(bei)部(bu)、肩颈部(bu),以减轻(qing)因头颈部(bu)制(zhi)动及(ji)(ji)被动---带来的(de)不(bu)适(shi)。
一(yi)(yi)次(ci)(ci)性(xing)(xing)吸(xi)(xi)(xi)(xi)痰(tan)包的使(shi)用(yong)(yong)方法一(yi)(yi)次(ci)(ci)性(xing)(xing)使(shi)用(yong)(yong)吸(xi)(xi)(xi)(xi)痰(tan)管(guan)(guan)用(yong)(yong)于(yu)临床患者抽(chou)取气(qi)管(guan)(guan)内(nei)痰(tan)液(ye)或(huo)分(fen)泌液(ye)用(yong)(yong)。一(yi)(yi)次(ci)(ci)性(xing)(xing)使(shi)用(yong)(yong)吸(xi)(xi)(xi)(xi)痰(tan)管(guan)(guan)吸(xi)(xi)(xi)(xi)痰(tan)动作(zuo)要轻、稳。一(yi)(yi)次(ci)(ci)吸(xi)(xi)(xi)(xi)痰(tan)时(shi)间(jian)不应超(chao)(chao)过(guo)15秒,吸(xi)(xi)(xi)(xi)引(yin)(yin)器连(lian)续使(shi)用(yong)(yong)时(shi)间(jian)不超(chao)(chao)过(guo)3分(fen)钟。1检查吸(xi)(xi)(xi)(xi)引(yin)(yin)器各部(bu)连(lian)接是否完(wan)善,有无漏气(qi)。接通(tong)电源,打开开关,检查吸(xi)(xi)(xi)(xi)引(yin)(yin)器性(xing)(xing)能,调(diao)节负(fu)(fu)压(ya)。一(yi)(yi)般成人吸(xi)(xi)(xi)(xi)痰(tan)负(fu)(fu)压(ya)约40-50 kPa,小儿吸(xi)(xi)(xi)(xi)痰(tan)约13-30kPa,将一(yi)(yi)次(ci)(ci)性(xing)(xing)使(shi)用(yong)(yong)吸(xi)(xi)(xi)(xi)痰(tan)管(guan)(guan)置于(yu)水(shui)中,试验(yan)吸(xi)(xi)(xi)(xi)引(yin)(yin)力,并(bing)冲洗(xi)皮(pi)管(guan)(guan)。2将病(bing)人头部(bu)转向护士,铺治疗巾于(yu)颌下(xia)。插入一(yi)(yi)次(ci)(ci)性(xing)(xing)使(shi)用(yong)(yong)吸(xi)(xi)(xi)(xi)痰(tan)管(guan)(guan),其顺序是由(you)口(kou)腔前(qian)庭→颊部(bu)→咽部(bu),将各部(bu)吸(xi)(xi)(xi)(xi)尽(jin)。如(ru)口(kou)腔吸(xi)(xi)(xi)(xi)痰(tan)有困难时(shi),可由(you)鼻(bi)腔插入(颅底骨折(zhe)患者禁用(yong)(yong)),其顺序由(you)鼻(bi)腔前(qian)庭→下(xia)鼻(bi)道→鼻(bi)后(hou)孔(kong)→咽部(bu)→气(qi)管(guan)(guan)(约20-25cm),将分(fen)泌物逐(zhu)段吸(xi)(xi)(xi)(xi)尽(jin)。3气(qi)管(guan)(guan)内(nei)吸(xi)(xi)(xi)(xi)痰(tan),待病(bing)人吸(xi)(xi)(xi)(xi)气(qi)时(shi),快速将导管(guan)(guan)插入,自下(xia)而上(shang)边(bian)退(tui)边(bian)左右(you)旋转导管(guan)(guan),消(xiao)(xiao)除气(qi)道分(fen)泌物,并(bing)注意观(guan)察病(bing)人的呼吸(xi)(xi)(xi)(xi)。在吸(xi)(xi)(xi)(xi)引(yin)(yin)过(guo)程中,如(ru)病(bing)人咳嗽厉害,应稍(shao)等片(pian)刻后(hou)再行吸(xi)(xi)(xi)(xi)出。并(bing)随时(shi)冲洗(xi)吸(xi)(xi)(xi)(xi)引(yin)(yin)管(guan)(guan),以免痰(tan)液(ye)堵塞。4吸(xi)(xi)(xi)(xi)毕,关闭吸(xi)(xi)(xi)(xi)引(yin)(yin)器开关,弃吸(xi)(xi)(xi)(xi)痰(tan)导管(guan)(guan)于(yu)小桶内(nei),吸(xi)(xi)(xi)(xi)引(yin)(yin)胶管(guan)(guan)玻(bo)璃接头插入床栏上(shang)盛有消(xiao)(xiao)毒液(ye)瓶内(nei)备用(yong)(yong),将病(bing)人口(kou)腔周围擦净。观(guan)察吸(xi)(xi)(xi)(xi)出液(ye)的量、颜色及(ji)性(xing)(xing)质,必要时(shi)做(zuo)好记录。
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