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Komplikationen bei Portimplantationen
1.
Komplikationen bei Portimplantationen
2.
Allergie/Unverträglichkeit • Latex • Pflaster •
Kontrastmittel • Medikamente • Nickel
3.
Allergie/Unverträglichkeit vermeiden • Anamnese •
Allergen vermeiden • KM-/Medikamentengabe vermeiden
4.
Dauerhafte Folgen/Nebenverletzungen • Organverletzungen •
Ablösung von sklerotischen Ablagerungen aus einer Schlagader • Hautnekrose • Narben
5.
Dauerhafte Folgen/Nebenverletzungen vermeiden: • Training •
Alternative • Ultraschall
6.
Ultraschall ↓Zeit ↓Erfolglose Punktion ↓Fehlpunktion ↓Blutung ↓Infekt ↓Schmerzen
7.
Stärkere Blutungen • Hämatothorax •
Hämatoperikard • Hämatomediastinum
8.
Gasembolie vermeiden • Anamnese •
Valsalva • Kopftieflage • Entlüften • Katheter nie offen lassen
9.
Herzrhythmusstörungen
10.
Lymphfistel/Chylothorax vermeiden • Rechte
Seite punktieren? • Ultraschall
11.
Nervenverletzung vermeiden • Training •
Ultraschall
12.
Pneumothorax vermeiden • VJI
Punktion • Ultraschall • Training
13.
Thrombose/Embolie vermeiden • Anamnese •
Blutverdünnende Medikamente
14.
Ist der Heparinblock
von Portsystemen sinnvoll?
15.
Dislokation vermeiden • Bewegungseinschränkung •
Katheter länger lassen • Naht • Training
16.
Pinch-off vermeiden • VJI
17.
Katheterdysfunktion vermeiden • Spülung •
Regelrechte Katheterposition • Gerinnunsstörung behandeln? • Thrombolyse (Cath-Flo) • Funktionsprüfung
18.
Funktionsprüfung • Patienten fragen •
Inspektion/Palpation/Ultraschall • Röntgenkontrolle
19.
Spitzenposition
20.
Spitzenposition
21.
Herzperforation?
22.
Katheterfehllage vermeiden • KM-Gabe •
Seitliche Projektion • Dicker Katheter • Scharfes Bild • Führungsdraht bis zur VCI
23.
Membranschädigung vermeiden • Huber-Nadel •
Nadelimmobilisierung
24.
Fehlpunktion vermeiden • Nicht
zu tief implantieren • Richtige Punktionstechnik
25.
Infektion vermeiden • Aseptische
Maßnahmen • Nadelwechsel • Wundpflege • Entfernen unnötige Zugänge • Kein Port bei Kachexie • Katheterpflege • Subclavia • Antibiose
Hinweis der Redaktion
mehr Risiko von Sinusvenenthrombose.
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