Arterial Line Placement, by James A. DiNardo. Hi, my name is Jim DiNardo. I am an associateprofessor of anesthesia at Harvard Medical School and I’m one of the cardiac anesthesiologistsand cardiac ICU attendings here at Children’s Boston. We are going to be talkingabout arterial pressure monitoring today, specifically placement of arterial pressuremonitoring catheters. Indications: The indications for placing an arterial lineinclude patients who require continuous blood pressure monitoring, such as those who: arehemodynamically unstable, require vasoactive

agents or active volume resuscitation, orin whom noninvasive blood pressure monitoring is unreliable or unobtainable. Patients whorequire significant respiratory support and need frequent lab sampling, including regulararterial blood gases. But these indications must be weighed against the potential risks:infection, trauma to the artery, potential thrombosis, hematoma. Contraindications: Some healthcare providers would refrain fromperforming this procedure in patients with: infection at the insertion site, traumaticinjury proximal to the insertion site, inadequate

collateral circulation of the extremity indicatedby a failed Allen’s test. Complications: The complications that you may observe include:infection, trauma to the artery, thrombosis. Equipment: You will need the following equipment to performthe procedure: arm board, tape, chlorhexadine prep solution, arterial catheter, guidewire(we must make sure that the guidewire fits through the catheter), Tconnector, sterileocclusive dressing, sterile gloves, sterile towels, transducer system, saline flush.

Techniques: Basically there are two types of techniquesfor obtaining peripheral arterial access. The first is known as the slideoff, or threadofftechnique, where we place a catheter and needle system in the artery and then we actually,once we obtain access, we slide the catheter off the needle into the artery. The othertechnique is known as the throughandthrough technique where we use a needle and cathetersystem to actually intentionally go through both the anterior and posterior wall of theartery and then we actually remove the needle from the catheter, pull the catheter backto the point where just the catheter is in

the artery and we have obvious arterialblood coming out of the catheter and at that point, we insert a guidewire throughthe catheter, which is then going to come out the end of this catheter and we use thatas a guide to thread the catheter off into the artery If you decide to use this threadoff techniqueor slideoff technique, you are going to approach the artery at a much shallower angle thanyou will if you intentionally do a throughandthrough technique. And obviously the advantage ofapproaching at a shallower angle is it is much more amenable once you get flow to threadingthe catheter off into the artery. Whereas

you can see in this technique, it’s veryunlikely that you are going to get a catheter to thread off a needle at a steep angle likethis. When you decide to go with this technique,it’s important to remember that if you are unsuccessful at threading the catheter off,it’s best to remove the catheter, hold pressure for a little bit and then reattempt again,using that same technique if that’s the technique you are going to use, rather thandoing what people will often times try to do which is to convert this threadoff techniqueto a throughandthrough technique. And the problem with doing that is if you imaginethat I go at this shallow angle and attempt

High Blood Pressure Natural Ayurvedic Home Remedies

L’hypertension artérielle Telle une pompe, notre cÅ“ur assure la circulationsanguine des artères vers nos différents organes. Cette pompe a donc besoin d’une pression assezélevée pour fonctionner correctement. Il arrive parfois que la pression soit tropimportante, ce qui donne lieu à de l’hypertension artérielle. Parmi les symptômes, on peut citer des mauxde tête, des vertiges, une vision floue, des nausées, des vomissements,

des douleurs thoraciqueset l’essoufflement. Mais au fait, quelles sont les causes à l’originede ce problème ? L’obésité, l’excès de sel, la consommationd’alcool et le stress mental ou physique peuvent entraîner des problèmes d’hypertension artérielle. Penchonsnous dès lors sur quelques remèdesnaturels proposés par l’Ayurvéda afin de les traiter. Remède 1 Remède 1 Placez 2 c. à soupe de groseilles écraséessur un tamis

pour en extraire le jus dans un récipient et ajoutezy une c. à café de miel. Mélangezbien. Buvezen chaque matin. Remède 2 Versez 1 c. à café de graines de pastèqueséchées dans un mortier. Ajoutezy une cuillère à café de graines de pavot. Broyez le tout. Prenezen une fois le matinet une fois le soir. Mâchez 23 gousses d’ail tous les jours.

L’ail permet de ralentir le pouls et le rythmecardiaque. Nous vous recommandons de consommer des grainesde lin. L’hypertension artérielle peut entraînerde nombreuses complications comme des crises cardiaques, des problèmes d’insuffisancerénale, des accidents vasculaires cérébraux et d’autresmaladies artérielles. Ne laissez pas votre santé se dégrader. Surveillez votre alimentation et prenez soinde vous. Si vous voulez découvrir d’autres remèdesnaturels issus de l’ayurvéda, consultez dèsmaintenant notre site homeveda

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