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D Nguyn Th Kim Lin 1

TIM AN TOND Nguyn Th Kim Lin- PD

Thng 9- 2013

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NH NGHA TIM

K thut a: Thuc, Dch Cht dinh dng Cht khcqua da vo c th chn on hociu tr

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NH NGHA TIM AN TON

Khng gy nguy hi cho ngi nhnmi tim

Khng gy phi nhim cho ngi thchin mi tim.

Khng to cht thi nguy hi cho ngikhc v cng ng.

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NH NGHA TIM AN TON

An ton cho:

Ngi bnh

Cng ng

Nhn vin y t

SIGN: Safe Injection Global Network -1999

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TNH HNH

c khong 16 t mitim/ nm

95% iu tr 3% tim chng 1% k hoch ha gia nh1% truyn mu

& sn phm ca mu.

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TNH HNH 70% mi tim khng cn

thit

B bt nhng mi tim

khng cn thit l cch tt

nht phng nga nhng

nhim trng lin quan n

mi tim.6

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TC HI TIM KHNG AN TON Shock phn v Gy h hi thn kinh v nhng m khc

=> abces, bi lit, thng tch Ly truyn:VirusVi khunNmK sinh trng

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i tng b tai nn vt sc nhn

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NGUYN NHN: CHA TUN THNG QUY TRNH- K THUT TIM

Dng chung bm, kim tim cho thuc khc nhau, ngi bnh khc nhau.

Dng mt kim ly thuc pha thuc & rt thuc nhiu ln,

Lu kim trn l. Cha thng xuyn ra tay trc khi:Chun b thucTrc khi timKhi tim t Bn ny Bn khc.

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NGUYN NHN: CHUA TUN THNG QUY TRNH- K THUT TIM

Ct gim cc quy trnh tim . i tim khng mang phng tin. Dng li kim tim tim cho ngi

bnh sau mi tim u khng thnh cng.

Thao tc cha tt: chm tay vo nhng vng v khun .

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TIM KHNG AN TON

Trc tip: dngc ly nhim

Gin tip: qua lthuc b lynhim

ngly:

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Thm ch 1 mi tim khng an ton l qu nhiu!

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NGUY C KHI TIM- LY MU i vi BN: Mi tim khng cn thit S dng li dng c tim Kim & bm tim khng v khun Khng ra tay Ly nhim cho qua:V sinh tay kmng thuc b nhimK thut tim hoc v tr tim b nhim

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NGUY C KHI TIM- LY MU i vi

nhn vin y t:

Mi timkhng cnthit

2 tay ynp kim

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NGUY C KHI TIM- LY MU i vi nhn vin y t: Thiu hp ng vt sc nhn trong tm

tay. V tr ca Bn khng thun tin K thut ly mu km Vn chuyn mu khng an ton V sinh tay km

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NGUY C KHI TIM- LY MU i vi cngng:

Gia tng rcthi t nhngmi tim khngcn thit

Hp ng vtsc nhn khngan ton

bn ngoihp

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NGUY C KHI TIM- LY MU i vi cng ng:

Ln ln vi rc khc.

Khng c ni an ton

Thiu phng tin bo h cho ngi thu

gom

S dng li bm tim v kim

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y nhng hp li khi y v trong

nhng khu vc c bo v

Nim phong hp nga ai

ly kim s dng li . i

khi cn thit phi kha ca

nu ngi ta bn ng tim

s dng li.

Tai nn vt sc nhn c th

xy ra nu hp y qu.

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THC HNH TIM AN TON TT

Ra tay: Mang gant

Dng c bo h dng mt ln

Chun b da & st khun da

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THC HNH TIM AN TON TT

Ch :

Bo m tay kh trc khi bt u bt k th

thut no.

Mang gant ( tay phi kh)

Khng dng dd ra tay nhanh khi thy

tay bn.

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THC HNH TIM AN TON TT

Ch : Khng dng dd ra tay nhanh sau khi da

khng nguyn vn tip

xc vi mu/ dch c

th Ra tay vi x

phng di vi nc

ang chy, lau kh vi

khn tay dng 1 ln.

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S DNG GANT- CHNH

Mang gant sch, va vn, dng mt ln:

Khi c kh nng tip xc vi mu ca

Bn, nhng cht c kh nng ly

nhim: dch tit c th

Khi tin hnh chm cu/ tim tnh

mch/ tip xc vi mu bi v kh

nng nhim mu ni v tr tim.

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S DNG GANT- CHNH

Mang gant sch, va vn, dng mt

ln:

Khi da ca nhn vin y t khng

nguyn vn: chm, nt, da kh.

Khi da Bn khng nguyn vn: chm,

phng, nhim trng da.

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S DUNG GANT- LU

Gant khng bo v

phng kim m hoc

nhng vt thng

khc do vt sc nhn

kim , dao m v

nhng dng c sc

nhn khc cn c

x l cn thn.25

S DUNG GANT- LU Khng dng gant khi :

Tim di da, trong da,

tim bp.

Da ca nhn vin y t

nguyn vn.

Da ca Bn nguyn vn.

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THC HNH TIM AN TON TT-DNG PHNG TIN PHNG H C NHN

khu trang

knh mt

nhng vt dng phng h khc

khng ch nh cho tim ngoi tr

d kin c tip xc vi mu.

khi dng phng tin phng h

c nhn, b ngay sau khi s

dng. 27

CHUN B DA- ST KHUN DA

Dng alcohol swab 60-70O( isopropyl alcohol / ethanol) / gn c cn dng mt ln ( khng dng methanol/ methyl alcohol )

St khun vng tim t trung tm ra ngoi v tr tim , tr / thay gn sau 1 vng.

St khun 30s kh hon ton.

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CHUN B DA- ST KHUN DA khng ngm/ lm t bng gn

trc - n s ly nhim cao do vi khun ni tay v t mi trng.

khng dng cht st khun da bng ru trong tim chng.

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Che ph vng da trc khi tim l khng cn thit

Ra da da vi nc sch v lm kh vi bng/ vi sch

Nu da c bao li, dng mt

gi isopropyl alcohol hoc l

ethanol

NGUY HIM:

Hu ht nhng cht lm sch &

cht alcohol khc ( methy-

alcohol / methanol) khng an

ton s dng cho ngi

-

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DNG C TIM & THUC- DNG C TIM

Nn chc rng c sndng c dng 1

ln , c th s dng mt b dng c

mi cho mi Bn.

S dng mt b dng c dng 1 ln

cho mi quy trnh (thuc / vaccine).

Kim tra bao b.

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THC HNH KIM SOT NHIM KHUN

Khi thc hin thuc: Khng dng ng tim

cha thuc thc

hin thuc cho nhiu bn

- bo m 1 ng tim-1

kim- 1 bn.

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THC HNH KIM SOT NHIM KHUN

Khi thc hin thuc: Khng thay kim s dng li bm tim.

Khng dng cng 1 ng tim pha

nhiu loi thuc.

khng trn thuc s dng cn s

dng cho ln sau.

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THUC N LIU S dng

thuc n

liu cho mi

bn khi c th

trnh ly

nhim cho

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THUC A LIU : CH DNG KHI KHNG THTHAY I C.

Ch m mt l thuc ring l cng vo 1 thi im cho mi khu vc chm sc bn.

Gi mt ng a liu cho mi bn & ct givi tn bn trn ng thuc phng iu tr /t phng thuc.

Khng gi l thuc a liu trong mt phng khng c ngi gim st, n c th v tnh b nhim bn vi bi nc hoc l vng vi.

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THUC A LIU- QUNG B

Nu tnh v khun / thuc trong b xm phm.

Nu ht hn s dng/ hnbo qun ht ( mcd c cht bo qun).

Nu n khng c lugi thch hp sau khi s

dng.

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THUC A LIU- QUNG B 24h sau khi m l. Sau khi ht thi

hn khuyn co ca nh sn xut, nu l thuc khng c cha cht bo qun khng khun.

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THUC A LIU- QUNG B Khng c hn s

dng.

Khng c lu gi

thch hp.

V tnh b nhim hoc

xem nh l b

nhim bt k ngy

ht hn. 38

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S DNG THUC NP BT

S dng thuc np bt hn l l thuc cn phi dng vt bng kim loi khui n

Nu phi s dng l thuc cn dng vt dng bng kim loi khui n, hy bo v tay ca bn vi 1 chn sch nh mt ming gc nh khi m lthuc.

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CHUN B THUC

Chun b thuc & tim trong khu vc

sch dnh cho tim thuc ni m

khng c kh nng b nhim mu

hoc l dch tit.

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CHUN B THUC

Ngn np tt c bmt c th lau chi ddng,

Khng mu/ dng c vy bn.

Lau bng cn 70O

( isopropyl alcohol / ethanol) cho kh trc khi chun bthuc & khi b bn.

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CHUN B THUC

Dng c cn thit cho vic pha thuc: kim - ng tim dng 1 ln. Dung dch pha thuc nh nc ct/

dung mi c bit. Alcohol swab hoc l bng gn. hp ng vt sc nhn.

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RT THUC

St khun nt cao su vi alcohol swab

/gn c cn trc khi m kim qua l

thuc.

Dng kim- ng tim v khun cho mi

ln m kim vo trong l a liu.

Khng bao gi lu kim trn l a liu.

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B kim ng vo tay hoc l nhng b mt

hoc l nhng vt dng khng c v trng.

Nhng b mt & tay cha vi khun

Dng c v

khun tr

nn ht v

khun nu b

chm vo n.

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Che u ca ng thuc hoc l l thuc bng cht khng khun l khng cn thit Khng bao gi dng

ming bng t y cho

vic kh khun.

Tt c cht kh khun c

th tr nn nhim v ly

lan bnh tt

Nu l thuc c y,

dng ng gi ring \

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GHI TRN L THUC SAU KHI RT

Ngy thng pha thuc.

Loi & lng dch pha.

m c.

Hn dng sau khi s dng li.

Tn v ch k ca ngi s dng

thuc.

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TIM THUC

Thc hin 5 ng.

Ra tay

St khun np l thuc.

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Dng cy kim v khun & ng tim v khun cho mi ln tim

M bm tim trc

mt bn bo m

rng ng tim v kim

cha c s dng

trc .

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THUC RT XONG Mt khi ng tim v kim rt thuc ra

t l a liu thc hin thuc cng

sm cng tt.

Nu cha c thc hin ngay lp tc

y np kim dng k thut xc 1 tay.

Lu gi trong bn ht u kh hoc

l vt tng t.51

NHNG IM QUAN TRNG

Khng kim ng vo bt k mt

phng b nhim no.

Khng s dng li bm tim, thm ch

thay kim.

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NHNG IM QUAN TRNG

Khng ng vo np l/ nt cao su sau khi st khun.

Khng m vo l a liu vi cng mt cy kim & 1 ng tim.

Khng bm li thuc qua 1 cy kim / bm tim s dng cho 1 bn nu n c s dng rt thuc li mt ln na ( cho d cho cng 1 bn / bn khc)

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NHNG IM QUAN TRNG

Khng dng

ti dch/ chai

dch truyn

nh l ngun

dng cho

nhiu bn.

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Mng sng ca a b & nim tin ca b m t trong tay bn

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THAM KHO Injection safety- WHO http://www.who.int/injection_safety/about/resources/BackInfoUnsaf

e/en/ Glove use information leaflet- WHO WHO best practices for injections and related procedures toolkit -

SIGN Unsafe injection practices: outbreak, Incidents, and Root Causes-

David Pegues- MD- Prof. Of Clinical Medicine-Los Angeles California-Medscape Education

Giving safe Injections-World Health Organization-International Council of NursesEEmail: sign@who.int

www.injectionsafety.orgmail: sign@who.int

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THAM KHO Health and Safety (Sharp Instruments in Healthcare) Regulations 2013-

Guidance for employer and employees. : www.hse.gov.uk/healthservices/index.htm. Published by the Health and Safety Executive

2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings-http://www.cdc.gov/ncidod/dhqp/pdf/isolation2007.pdf

MMWR- Center for Disease Control and Prevention Weekly./ Vol. 62/ No.21

Preventing Needlestick Injuries among Healthcare Workers: A WHOICN Collaboration SUSAN Q. WILBURN, BSN, MPH, GERRY EIJKEMANS, MD-Preventing Needlestick Injuries

WHO guidelines on drawing blood best practices in phlebotomy ISBN 978 92 4 159922 1 World Health Organization 2010

Guiding principles to ensure injection device security- WHO Hng dn Tim an ton- B y t Hng dn phng nga chun-Phm c McG PR]]\\]]] 58

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