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1、Saving Lives,PerSys Medical Group,大规模意外事故,Intraosseous 骨髓腔通道 IO,Because every second counts 挽救生命，争分夺秒,AHA Common specific guidelines: After a failure in two I.V attempts. 2次IV失败 If it takes more than 90 seconds to find I.V access. 90秒内无法建立静脉通路,What (is I.O)?,通过穿过骨皮质层进入骨髓腔从而联通血管系统。 当静脉穿刺输液失败时，骨髓腔穿刺输液
2、应该应用于成人和儿童。,Where?,Where?,Positioning of the patient,Position the patients hand on top of the Umbilicus this is called Adduction.掌心置于肚脐部，手臂内收尽量贴近身体。 Try to keep patient laying straight on his back with arm close as possible to body- this is called a Supine position 患者上半身直立。,Shoulder Anatomy,肱骨大结节,肩峰
3、,喙突,In the middle of that line draw another line down, toward the Elbow. 喙突与肩峰连线中点向肱骨头连线即可发现大结节。 This is the Proximal Humerus,Acromion Coracoid approach (3):,Why do we rotate the arm ?,To protect nerves, tendons and blood vessels.避免伤及神经，筋膜和深部血管。 To maximum expose the GT. 尽可能暴露肱骨大结节,How?,How?,How?,How?,When Not?,Twice in the same limb 同一部位不能做两次 Bone disease 穿刺部附件有骨疾病 Failure to locate anatomical landmark 畸形 Trauma to the bone 穿刺部位骨折,Osteomyelitis 骨髓炎 Compartment syndrome骨筋膜综合症,Contraindications 禁忌症,Risks 风险,Avoid this,Think BIG!,
