Human Anatomy Model - Complications of Puncture

Human Anatomy Model - Complications of Puncture

(1) Complications: 1. The puncture needle punctures the atrium, ventricular wall or larger coronary artery, resulting in hemopericardium, and in severe cases, cardiac tamponade. 2. Stab the myocardium to produce myocardial damage (ST segment elevation) graphics, resulting in severe arrhythmia, such as ventricular premature, ventricular tachycardia, cardiac arrest or ventricular fibrillation. 3. Shock caused by pain stimulation or nerve reflex. 4. After a large amount of pericardial effusion is suctioned, a large amount of blood may return to the heart and cause acute pulmonary edema. 5. Purulent pericarditis can cause pleural infection or peritoneal infection during puncture. 6. During the puncture process, the patient may feel discomfort, rapid heartbeat, cold sweat, dizziness, shortness of breath and other symptoms. 7. The aseptic operation is not strict, resulting in infection in the pericardial cavity.

(2) Precautions 1. Pericardial puncture has certain risks, so the indications for puncture must be clear, and an experienced doctor must operate or guide it. 2. It is not suitable to puncture a small amount of effusion. If necessary, echocardiography can be used to explore the size of the flat segment of the fluid, and the location and depth of the puncture can be determined. 3. The patient should be explained to the patient before the operation to relieve their concerns, and the patient should not cough or take a deep breath during the puncture. Sedatives or pain relievers can be given half an hour before the operation. 4. During the operation, attention should be paid to occluding the rubber tube in time to prevent air from entering. 5. Slowly insert the needle during puncture. If you feel the heart beat, withdraw the needle immediately to avoid puncturing the coronary artery, atrium or ventricular wall and causing hemopericardium. 6. When pumping fluid, it should be done gently and slowly, not forcefully. See above for the amount of pericardial fluid extracted. 7. In purulent pericarditis, the needle can be inserted under the xiphoid process to prevent pleural or peritoneal infection. 8. The puncture process is best carried out under ECG monitoring. 9. If the extracted fluid is thick blood, the needle should be pulled out immediately, and the signs of pericardial tamponade should be closely observed. 10. When anesthesia is not good, shock may be caused by pain stimulation or nerve reflex. If shock occurs suddenly, vagal cardiac arrest or ventricular fibrillation, immediate rescue should be given. 11. During and after operation, it is necessary to closely observe breathing, blood pressure, pulse and complexion for timely rescue. 12. For patients with a large amount of pericardial effusion or other reasons that require multiple pericardiocentesis, a plastic cannula can be inserted into the pericardial cavity through the puncture needle, and then withdrawn from the puncture needle for continuous drainage. In addition, if the patient has recurrent or persistent pericardial effusion with severe clinical manifestations and the etiology is unknown, a diagnostic pericardial biopsy should be performed, and the specimen should be subjected to histological examination, acid-fast bacilli staining, and bacterial and tuberculosis cultures. At the same time, the pericardial effusion was counted, cytologically examined, stained and cultured to find Mycobacterium tuberculosis, virus cultured, cytopathologically examined and searched for tumor cells, and the activity of protein, glucose, LDH and adenosine deaminase was determined.