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  • MON TORI]LOF CALALROMAN E

    Crpitolul ? IERAPII VASCULARE

    7.I M 0 ntN rcN .dete rului veDos p erifcric pcn tru pcrtunic!turi in puncliondq unci lcnc rrirericc, in condlliiJc ascpsie ieuroasr.5j adnrjnislrdcdur or solui i m cdic.men rorse, inlcnitcnl sau conrnr!u. in cnculad. vcnorsi.Accst carcrer ene lisar pc loc in tunctic dc ncvor si^atr in luDctic dc durala rml.rnonrutui.

    - rbldri' .d.ldrulli se faoe nurui la indmrt. mcdicutuijrctdsdrca sa va fi impcradva ti inodiari jnainlca oricrru slspiciuni dc inflamaric soui'ifecic a loorlui punclionar sar in caalunor sdmnc g.n.rde dc intcc!ie suscctrjbiic dodii lcFatc dc nre/enla cdetcruluil

    - c.roterulmpolrc ii mcnlinur (in condirii n.nnaLe, firi conptidalii) maimulr dc 96 dc ore(3 zilc)jdc rcguki, sc s!.lrinbii locrl inscrrlei la .13-72 otoisolutiiLc dc bdzn cclc oii Lrilizalc sunr clorur.1dc $dtu 0.9%, el0cozi 5%. t0%. sotutiihidrocl.crolnicd (soLu!ie',geo:

    ba(d nrdiclnreDrctc t soluliite rdiugarc sc imc$c.i cu solulia de bazi I'rirl'".r.oJr..!!c . '. nFJt iF 1.'e hi.n'n.L'in'DcdicmdrcLc ddrueare in solutic lrcbtric ncm nrre pc o bandi adczivlt llpiri lrcnune, sar ilacon cu,lcnumirc. con.ri, carriraiea prcscrisi:

    ' prcndraRr nnci Dcrtuzii mixlc si mnipulared ei, xbui. efectuoi. in .ondidi de ascpsicdeoarccc soll(iic dc pofuzlo $Dr un ndiu bun pcnlrudcaoLlarur gcmenitorisc.trch'd dc ld dncftcun dcoricetipl

    - siinlol. si ddiladc de sangei- soluliiLc de aniroacizii

    emulsiilc llpidicc:sotuiiilc conccmnle pentru toramcnl dstodric (muitor, osmonrndin)j

    , solutii n.lrre pcDro corcct.rcd &hitibrutui acido-barc (hjcarbond de sodnr 4,3%,ri..t9l". clorura dc polasiu 7,45%)i

    . data expilirii unci solurii rcbuic veriica$ inlotderuno Dcntu a eviia adninisiEnr ri.innuliidcvcnn, indcrvt sal bricrjsislcDul dc p$lizic cu lihru de aeristrc incortonl ir .anctu de piciruri. Ircbuic inchisifai c dc intrddlceE! unor solulii nrediclDrcnloasc in recipicrtut dc rcrtur.. pcnrru aovira hetea lilinlLi .u lichidul dc pcf0zic si a sc pisla lnic!ionatjlara rccnuia:.r,\:l ea

    'i 'lu - oi a n o. - tL ' tr ni',u' .. .oJ. a!. o r. un ,o,., Fnumir picarui/mi.ur:!olu'nul lotaltinpulin minurc x lnumir picaun/minur = vorrnuL brrL al sotuljci (in mt) x piciruriht sau dunl,pcdnzici (jn minure)

    E\anptu de .u/. |arc . n ndntlti .le pi6tu -i ./ pat lLnnull u .1,n:v.hrril !.rat = I liltu s.hrie Glurczn 5%D rut. Pe,ttEiei - 21h 4a1nr1.)N rlantl d( pi( /nin t= t000r1lr2A/ 141)= t3,33((u. t4 pit/unn )

  • covA\nlaAPl}l'\lob9btsll'.201.

    I n dicrtii $ i con rrdindi.rtii

    - hidmtm i ryort clerrolitic:dinrcntalic parcnreali:

    - .po dc ucdicamcnlcltansluzjo.tr riinlo Jldcriv c dc sdngc.

    lndica{ii pentru diagnostir- prclcvin d. stngc, rcpctatc intu'un inteNal de tinp scuni

    adminlsrmrd de subMnrc dc conm$:Accstc indicatii lrcbuic limnare h sricruL necesr' $i r.vture ,ilnic in rirrctic dc n capacicnlului, si in panicular. in iunclic de aptitudi'!c! sa de r Drimi tmt!rrcnnll pc c.lc diseniyi.

    Constraindiotii absoluteNu sc va puncfiona bralnl caE

    pETinti fi$Li anernJ vcnoasii- abLrlio ernBlionilor axilari.

    brlrul este DaDli7Mu hrndi4rjerinn leziuni outdDore !i infec!ii a loourile de puncliomrc.

    se identiri.i Fdcrr!l:se irtbflncazi d.sprc iDport!4a ridurah proccduii .ri cvcnnrdl Jcirrt lsp{rclc lce.rc dc

    - sc {bonlcnzi dcngdr, bbtL ncdonindm nl t'cicnruluiisc insralcri conlonahil:sc dcpilcr,

    ^nain car dcDikrhre imporraDtiise explicd acstorilc cc rrcbuic clnae pcntu prolqarer abod tu vcnos prccutu sisinnlomcl. unor cdmplicr{ii pdl.nrlale.

    - supon pcnh pdliLzic h picio{rolc prtului. dc pRferinlt mobil daci peicntul cstcmlre al pentn protcctia patuhil

    - o pcrehDdcninutld. unici f.losinlJi

    conrprcsc stcrilc/timDoatrc dcvord:- soluliidnriscpliociod{rcs clorhcxidin alcooli., dact pacicnrul eslc aldgic h iod;

    pungicu sdlulii d. pdfuar, indi.d. dcmddici'reLlirr.c xlcprc\-i.cpenradJn! irdt.rnrcru/.

    . tnuadcpcftzxtncnli d dcbinnctn si unr eumrihlhe ciidc l)crluzdi

  • MONITORUL OFICIALAL ROMiNIE

    robincr tifizic pcDttu ncordrftr !inntr.ni al I)crl0zi tr acecasi inic vDnorsi:catoterc / hmntrlc dc dimensiu.i difcritc:plasnd, tdNancnre rdezivc dc rin folic sau plr\i:Dcrnc phtu poziionar.j .\entual alctc pmruo pozllie corrinabili a braFtuinrairtcs lx

    I'regitircn lini{i dc Dertuzio- s. verilicaUcsoriprixhrdiralii

    \c spili miituld si se i'nbnca miiu:i dc utrici tblosinliiscdddpbrzt (ubuhtom pnncipali lo pmgr cu sotutte scitii

    ' :c ddaugi robinctul la ciilc dc pcrtnzaft a $lulirkn. docii sunr Deccsre nrai m0trcdcnvati. .noi pElunginrrul cc vd lj.drprat la calere t/ bfrnLla cndovciorsi:se clrnpcad rubul llcrtuzo{Lltrijscutuple crNcm tiuu.ldtului h runftarei

    - sc doschidc prcsubul /clcma penm a puria lrsambhrt liniei dc pcrtua!:- se clam|]Nz-i dpoi {ubul pincipal xt pc.tirzorutri j sc rcopcri jeri i

    sc ,lor.az, rubulatura pincinrli ri sc schinbi la liecarc 2.j h daclt Dcrttr7i. duea; mai

    se lnbnci ntrusi $crihi- scnaselzdhmtLLl pa.icDrtrlui dcasupD mlrcrialrttridcDbrccrje:

    vcnd de punciion tuand in catcu princiDiuL\chimbrtud ldcunlor dc pun.lninrrc:s! .pli.t grrcul (nu s. menrinc rnaindr de 3 hinurc)si sc dcrrticteaza lar! zona dcsc rit.. mzr \!hoj\i ituhu an$ial Friliric se priDcazi. in caz conlEr sc mat llibcsrc.u nrlnd n.donririnri sd crcrcna o prcsiunc usord rsupm etii Dcnrn a $abiLiz \rn!J. nrtudu.. cotcrurul 1 brinlL! or vnrflt mandnnltui oneniar in sN lt sc tunctjor.az,

    . ll -i.i.L r" oo

    '.1 ctru tr' r T,. \,d! t r inJ,hur:- sc rtunca n..drenul in rcoipicmut lpccjati

    \e admrcaTi anbotrl pdn4rului la broutarse dcs.hidc tubul portirdruluii

    - tunxcazaclrcrctul/branulrcLunpansdtucnroclNivrerit,ituhztndncordu r.mi t.'rJdJdr.dzinurctutd.1i i nr-., , L nc,tr J . ouor .bn c.Lndrdi

    - sc inde_pancru i minusilc. sc spah menilc:\e norca^ F.ccdtrid in Fisa de procsduri (nmo. daii, or. minijrini, tipul *rltrijci,

  • cxtdvazarca $luliei in drE lcrci ti lrtrhcfiorcr du6r.$a azonci:rc.m/.' \L'

    'lu n,,-d.!\F.,..'.',J.o1 i teno,(.- inleclir locaLi dclccrdta pdn scm. i'rfllDarorii lo.ate: eriicm. dumr, citdud locati.

    tu mcticl ic s i lczdra funclici scemento lui rcspecriv:- obslru.br crtcrctului / br$ulci cu chcaguri dc singc h rbscnh jmnerctor shndrrd dc

    cde'nul pulmonar & d prin hiDerhidr arc h cdztrl in.an nu se calcuLe,i corcct trtrmirutdc picfturi pe miDurtiN rc rctrccl,linpul dc pdrtu^re.

    7.2 tlenrj.qe! si ingrijir$ unci linii venorse oxktcntclnsrijirca unci linii lcno$c prcsupunc:

    vcrili.m pcmcahilii4li &leteduii- pcncabiliTareacalctcnluil- schnnbareapaNancmclor si a nxatorclori

    schnnban rfu/offi lor ii a s.hrliiLor pcrloz$ilc

    iixaioarclc sddsi pansrrcnrdlc se sohiDbi arunci cind scudi s scnld5rc{, sruodrricu r$cnra untr1 nou da(ebr:l! picicnrii cu adninisrr.re iftavdoal' coniinui, I)crlu2or te se schinbi la 18 orc jarl..ul de inscrlic . c.lererului tlchuic schnnbar ta fiecarc ?2 orc ti lrcbtric insDedar l.ficcare 4 orc nnn fixatoDllEnsFrcn! sis.nipcmeabil:pcnncabllilater canulci/bratr0lci ln caz de pcdnzic/adminhtmrc i.tmirenra sc ve.ifi.apnn asphrrc inoinld ori.rrci MDini$rai inravenorse

    Penrruvcincucasi pcmelbilizma bftnulei:

    - sfingi serile dc 5 nl c re sterilc:- fiolc cu serliziologic. heparinij

    niru$ dc uni.i rolosinla:Penh schiNbarca pflrsamcmrtui / fixdrontni

    0adrri dl.oolizarc suucu bciadini:- bdnd,j xdelivlcuco xsi

    .ompEsc $crl lo sru fixaior tmn spa rum si se'niperDcabi t.Pcntu schbb.r., $lu!iilo!

    - laconu /puneo cu solutia dc ddhinistrati

    bcnziadczivcphtd noErea cvcnu elo. Drcdicrmc c inrodusc in sotulh porfuzabiti.Pcnltu schinbarea periizonlul

    rrusi dc pcftz.r (erili:

  • MON TORL]L OFCIALALFOMANE

    S. prcg csr Darmrlele Dcccs.r. pc ciflci.nrLdc tuctu respc.rind..gtrlx Jc baza in ce l].jrcncs.N cxmarerillclor{.rie\i.u'iird..clcmudrrcildcrecipidrL.lcdecolcci.re

    { \rr li.a prcsripria medic.lairc id.ndlci lr]cieffuli

    ' ic oplicli plcicntulur. in renlcni a.(sibrti procedura penrn I obrinc col.borrrea srp.ntu!.i din,iu rnxidatcrjsc inbradr, ohli8rhnr.

    'niinusi (cilc ci.d r hcrrui nr zona d. jiscnie I cxr1cf,r,,i

    Pcm.ihiLiTarcxbfundcr serfiziololi.sc d.!cr2li sdringr cu scr tirnJ ogir h birtrulii rcspcd,Dd rchntcr rscDtrci:sc rsp,ri si\c obscFa dacii 1lpi.ur sitrsc in so ingti:

    - dlcii m rparc si.s. i'r si'r:., qticli on grrou de!$Drx locu 0i dc i'scn1c nt [rcrcn,]rltrmp de I nriiur. dwi cJt sc rsp .:i Jin Dou:dfti nici dc dah accxno fr rprc \iDpc in se,in!i. sc5i'nplu dupi .c s. dcs itr!rtuul:

    injluerz.l t

  • MON TORULOF CALAL ROMANIE

    Schi'nbarcr solutlcido po.li zx{

    s. instccrerzi pu4. sau U.conul ctr soluria 'lc FrtirzoL pcnh a iieriUc. cvenrLrtelcmodilican: dccoldirer $lurlei, astrct hr burc, cxpi.ard remrcNlui de vatabititoic.

    fisumrer flacooulul sru purgii:se clampciz, hl pcnu^nrtul pcnrtr d impiddica pahnderer a.n'tui nr siycm lcncu Ldor (in ru ul in c,r pfinrzorul esie adoplai L n.c.n);

    - pc.rtuciorulJe Lucruse pregtrege nxconuls. pmgadcschiDb sc inddpireaza ceacnlsar ddnulnaconuhri t sc dczinttcrcr^ cu DadllcooLiarrse indcpartc.zi n.... tr I vec h i dln $rr ir si sc scoah noc{nrl pffuzorului d ii a. csn:

    - sc inrodtrcs imediat tocarul pcinzonrlui in ll.c.tr0l pcrftrrorului in flrc.nut sau Frgridui iisc suspcrda in nlri\ise dcclanrD$7.i ltrtarl pcrluzdrultri larcnric \i nu dxi$c .( nc 1ub) ,si sc tis, rohlid stcurF ld rirhrl dnifior su l. .lr nh rrescris dc mcdic.

    sc chDrpcaza pcrtu2orulcu crilcra de Dicumlc pcjumaturc plinil( iurc,0..'n ic n.o" ili' nJ..n i.. .!rF,n r.'tr- sc dczinlccren/i dopuL ilacoDului nou sisc lnrddurr rocarutDotrlui rsrfuzo. nr n.!or:- sc cwuerTj rcrul dc p ubuL ncrllzonlli si apoi se inctridc prciubut:- se spala Draini c cu ui.euN dnriscpric:

    s. nnhacii nidtrsi icnlc:rc ptrnu o comp li {cnli deasupm lo.rlui de insenlc . cdclcrului fi j. pr.u/a rL urJ.gd pcrh a DEveDi singeHeals. dcconeure!z.. cn.rcntic!c.hiuLpeduzor lirii sii s.!dcm rrjd.nratj bnnLt3lscindepinc.zicnpxculprotecto.rlfouluipcrlnzorsi{adoprrziLrcd.rcnrtlcnos.se lixcazi c.teterul ;i nib(l pcrlirz.tul$ h bglment .u un fix0lor r.inspdrcnr !isenipcm.i b i L avind griji sa pcmi(ilibcnarc de mifarc padientului ri slt prcvi ie$iEa.areleruLui diD vcM l{ o mis.arc bnr$i:

    - sc indcpi caza pcnizonrl v cchi si sc lruncd ir r..inr.ntu I 'n.lfialc coDranimr.ise supnlcelicszi ntrldcscurgcre,loort pui cr ionat I j compoiranrcniul pa.j.nluhi.

    ?,3 ind$nrtrrer disp0znivului intrrr.nos Derife.ic

    tucvcnnda co'!pLiciliiLor locrlo.

    rcc il' icr lc pcnlr0 .olcdarda dcscln or.

  • - disDouilivele intL.lcnoasc !'nr schi'nbai. nr unniiro.rutc \iruatiila indic.F mcdicrLuicdt inrcnrnclcrapia i rr\emasii

    . rhfthrrer locuLuiDundiclh 72 dc orc DeDbua co.rinur ic.iDtx nnnvcnoasilda.i li tocu puicriodarn rparqeala. cdc'n. durere sau tflituric suhcuhnaa:d&i bdidr rdczirii 4licrrii deasupn loctrtL'i punciici nu .rc(ni suficicfi lres uc:

    . pcnh a prc\ cn i sin:erarca sr h.mrbnru :ntr \c schi'nba [crodfti nn d*pTitiv irrmv.ros in ttrncr]unc lx un rucicrr ii std!cririca piii ciid Du \e e\ecuii cu nr.cs. o rlri runcrie lcmaril

    se prcgiics. toorc trDlcridlclcrsc lcri llcii dui orJ nru I dc lc.nin rre a rcraplci i.v x fonaLo.xr:sc nluliliciprcicD{tr1:

    - s.cxplidiptucedlr:plcicntuhrs1s.rveniTcrzinmicDrlcivasimtiouy iscr/iiicdr

    s. id.hidc rrc{ubuL,..m D.ni'z.n'lui. Jaci telfu/lx csrc in dert0rci. Jr', l

    '. ,. ,ptr i. u... a

    'i\eohr$;1\ t!tror.:zatrrcaloctrluiNnclioialiialesutuuidi,rjur\c as.a7a o onpr.ii n.nli dcxsutQ locuh'i puncrnrnat. .r.tonind o usoari nre\iunc:r. indcrran.id ,rul din !rni sisc coilnrirni loo'l:s. vurilldi drca dlspozirnal din ycf i c*c jnft ri

    ' xr indcpincyi corrpr.s. cind s:ingcrrcx sc oprclc si se a'u.i in rccjp cNt Jc Jqieuri:sc asepriz..z, locuL si se rpLi.i i c.nrprsli rcnti. utitjziid rchrtcr ascprici,i b.ndr de$ irun.i echiPaDrfh'r:sc \.rifi.i diD n.! dupa 15 nrinu{c ocut pnn.hei. rcnrm . tu rsisun cll stn!c.0,ca sase i'xtrui.r{c prci$rul sii evire oricc rcrivilarc Lr nir!tul {gnrertotL,i rtccra!s. n(n cic r errul sa nnunl. rsisrcnk tucdicali Jaca sinlc.rrc. jlaDarc ta l.cnt

    . scinrtuieaza pldcm'tsi c'casci i|g.indc Lidridc d.ci cje tosibit:sc norcrzi |lrtJcedurr dc nrd.piirlirc a Jispozni\rhri inhlcios in t;ira dc pruccdn.t .

    7.r Plrtictprru l, puner.a ii lndcpnrhrc, catelerului vcnos ccntrstlqxpr \cnorsicerral c$c o nn).edfti d. D.to rchnicirare ctrrc ifti j,r dribdijtc nredi.n ni

    '-.J . ,,d. ieip'. 'u'Crrererul rcnos cenrml .$c utr c.1cr( vcnos neLil. corLciomr (L crlciuc potnrcrar sNsilicon..rre sc iorod0cc lansrurrn. tnr o \cni ccnra;i dc.itrb

  • MONITOFUL OFICIALALROMANIE

    - colaps.ifullror Dcriftric (lenele pcritncc {nr cohbarc Dri[ p.]busirea oncutarici4lnrinislrarc. unor c.nlilfui n.i de fluidc ir !rgcrtci

    - hranenl intavenos indcluneai;- nutrilicparcnlcnid cu soLuiipolinumi!c (or. Krbilcn)j

    nroniroiTrrca prusiunii vonoasc ccmhlc.

    d\h mai costisiroarc dccfu lcrapiavcnoasipeifericil- risc cr.sculde complicntli, pnermotoEx, scpsis.limrrca dc rombii- pcrfiJmrea de orgrnc FiMscnr timpul nrorlirili- scidcrca srdului dc mobilizrrc a pac onrulli.

    P.nt0 inscrri. ca brcru lui venos centdl :rc lor prcCiti pc caflciorul dc lucn'. seDarind circuiru] malorialctor sre tc cuixre cu cel atnratcialclor rnrd,r rm'.,nr..

    rrisli chnursicalcicdmrurisLcilo:

    - padlri alcoolizrcj- hsa dtpdflrdrl

    2 caiere! renoasc ccnti.lc dc 14 16c:seri'igi dc ditarir nrnni (eile (1.5. t0 mt)i

    - sohlii salineneriLeinpungi sau lhcor.ci- solLtii inesteTice: Xilini l%l- co'nprcsc dc iilon scrilci

    rli slcrild pchltu strrurijtiarlc.n iciilt:li xdlor tansp, icm si scminencabi ll

    - tiolc.u hellind $i cu soliziologictcnlru vciliodrc, \jspil.rc. daretcDlui:

    - uns ent c! !trlibi.tjciMaicrialele sterilc sc vor.tczr pc un.:nnp rcriL.

    Pcniru nnbpiimra daiererului venos cc.htl- niinNi dc unicd folosintii

    lrus, cu pcnsc ncriLe. bisruriulpaduri rlcddLi4te / comprcsc slc lc:

    - prnsamcni n an$r rcn r. {dczi v iforrticc $qilii. M$.nr cr bcbdini:rccipicnrc acrilc n,edii de culturi ncn1ru insitrraDhrd singctui iccotrar dc pc vartirlcatcrctuluiextr\ drct cdc ic.c\xr

  • MON TORUL OFICJAL AL ROMANIE

    sc x\cr7a f.licrtul pozilictrrni.lcnblrgpcntruap,oduccdtLrhrcryefcL.rcc[:lcsiItr .r, t'.F ho' ,{ is.xrii o rl.7i sub rc!nru r.rxhci I pxci.rrLttrr pcnru a pror.ir .rjcra dc prl:

    - \r irno !. cipulF.irnrunisprc |nicr optrsi inrolcnljci renhn r n,c\.ni.oiiimrar.rrNidc ris.iic I crrcrnLli.u !\mr[Lixlenri piiogcnr nrovcfrh din c]tk rcsntxhisp.nrto x fx Tora mirc!!s bill (o Nnrenra \. cnrn. Fci.{t in rceaji lo/ir.):\r Dagfun. 7.r. d. i'rc..nri.: raderc tr nehie. d.7 rltchc i !/or.h iiihr!. i'rllM r:tr'.tliorlcrcllfhr \i \iptrM Nscx. bhrl. Drnnaitc.

    de idcncni. .u uf .irp j..il decup.r I n ioc. antct incitr.. scol.ri n,odiculLriscrinsn cL \ili'i ric rn r.tNcrrarclr/rn L.crtii:

    \c d.schrdc si se olcli rn.din' tritr nrod {oilc[i. r!.]r.rnr :in riDn .. rnedi.trl nmdrcc cxr.rctul irr vcri. a\nrDh tjcsrr.j. sotorx de FrtnT h.rto rdrpr.rTi ru!r d. prtiLznr ilclmiii rcn'tdc 0c llnnn pcrtu/oo LLri:

    - fcdctrl rixr.r/rxpoi nbotrl t)c'luzofl'tur tr.ar.rrr\i rrbilcsrririnL tt.scurl.rr:Drcd l i\crziipnn{Nria pioar.le uictcnrtur I picL.:s. tu alii si \! Jrri,a.cuzi

    ^nr I

    s! xpli.i rpoi tiutonl rinsprrcfi. s.triiDcncrhiL si cr.rrrr cr rtirx in\enicj rderctr,iui.r\!izitNionn i'nr.n./iri.!ooJnnrbiUijs.rc.!atu..zri jr!ari!rne.al:i:.l:i.r.rnnir Lri ritri ,L L(rL I tuprnal.rnldc soLL,rrcsrtinr) s( \e, iiTnr olrc

    iuprlcsh.ru rrktrului \i I plcientutui.. i:i rbr prn\rnrorut ! d.ruLui tr ri.cn,..Jlt orc. i.r liuronr tr :l /ite Mu o d . J)c\+ri niir drr, Dtr \! trdi sNr \. Druxlrr{c:n.rrnronLs. i.hinba tr Tt or. si$ttrriilc lrcrirzrijrt. dc Lrtrru dLLntri t.24 o,t Lr h/iIrl

    .. . n,"ct. - L r,,,lcJ(on!!r k.r,,rr i

    sc nlmhlici t,rcleri,l:. scoblinc$rsiDrirliir'l lo.Dmirl na.rcnru tri fxnrili.r

    s ficc.,r iic/r prcicDh, ri(..ft.mcd]c pcnh r.\:jLdc 0tr $srull isrorir

    sc Nrr nri7.r7ii ctr dcDri. rrcie[h]t ltnh . {urpi,rdc Dreco.c s.mict..n'bol:c paL.rre. ciiiozi. rNe s.rci. dispfcc [hi.mdi.. sirj!opii.

    - pncuDalora\: r.s nhc rurc.ri.h r. Aimcrtr Dscil.Lor knxcicN.- $rnultmldicu .si{ irrc^,ir). rtrrL.DIn] u/decoDrf irrrii

    ie.1| icii p'o.cdon nrrlennLhi:s. .\clu ii prci.ntul i! d.orh dor{l:

    . s. sprl:i rnili'rilc. sc nnbiLcil nitr si\ \rrnttdr rrsc. pe frii:

  • rc rnrFItiitr/.:. { n cpiiac,zisi \.anNi pan\rm.nLul vrcri. fixxlnul:

    \r indqrir r.r/i rnrn\ie si\c fricLirnryi miiDilc cu un !ctrniscp{ir:5! irbft!a ipol nratrur:s.rLc:!r mNcter/:, /ofr de rnscrfe r.dter.ruh p.n.x r vcdcr drci ntrr s.trtrr.dc inl]rmdir:r rric iirclcdcmhtr. uriliTtndbi{n iulsi. nrDsi n.. r.lsr..dc cd.lcn'rn'dr{ trr{.tu f!r,x:sr rphcli nn.! rnr { b.LrJi'i pr lo l dc inscrri. :c x.olkri cu o connr.$ n.riii s s.'\,i

    ."l '

    r'1t."ri 'it '.'e.5e inspccrc.zi ! dcnrl nrdcpanlr perN x \cllm d.ci c{c nlrtg !i drri prc7irfi

    in cx/tr1 in .re \e {LsDecLe'i r inleclie \e rri! ltrlLLl cdcrrnrrrL c0 o toulrc nc.lii. s.nrodu.. n,

    'c.i0i.Dh,l ncriLctr ,n.diL, d! .uLrtrrd. sc dididcx/r sr \. rinn. h Lrborr(r- \c.turcr tru(c.id.lc lblosilcir,.c Dirncl. d. colddtrc

    l*re o !'b!itun], .dflitui(ri c! scopul dc. r.r.clr tr d.fic r coDgoinrl s.r cijrlxl nr unulsau mii nnrlli corni(ucilir sinlclL'i.Sc hr^riperfLizrrcrde.lcivrr. \ang m Drl)xmrc lri tri'nr d. Lr ! Jonrr. dc i:iisc cFlnrafirurcsEctrrcrt,i',.illilo,voL,Lnhrx.'lr.hci.wrtrrlLL.rionnnatultri\ir ips.ldcbcfcfiotrtr'nt itrhttn tk tlDn ittr. u t".i rrdpii n"rh.i, t h.Lri. lriand J. h rhli ,t1,\ ulnr at it Futtltrhst)1dtjtI tt..j. lrtii\t\nnrhhkn!( Dt&lnthti !! ti" d.n tq4ra.

  • MON TORULOF C AL AL ROMAN E

    lndic.tii ri prec.utii in uiilizarcr produsetor sanguine

    l..r''.o dnr.Ln.u Jr,t(p..jc F,t.. tu!r dctroi,,oo. L.{c.,qr.e. .o, e.

    'i ,.,l ''.1 I'I U , ' ':.rdt.,n!!r! ,, JTi\'tL''!c40urr0500m

    Dr alc rlc prnn i Den rru conn.nenic san g! inc tu caz dc dunralis rmc. hemonli i sau x^rri- r n-ribrh'1.J i..1,"/ -t r,. rL,L, r d, ini, rot.,tphr r,r, i,,hrfl ni'oalr .rlpd.a1- iu, \."...ni\.8!, prr r ai."p.,i \B^

    va priini o, iind nccceri si c.nporibiln.ba dc licrorRh l:/irn r'nr q,.tu: .e" "t ,. ,r'u,1. urt? . ,.,t,Jn.N !r

    ' 'a.d ,

    ,n i.,1. "".or -"0,n ,.r,,v. m., , ro.

    - vcriticrrua,spccruLuipnngiisi coDJinunrl inain!edca fi adNnrij.d:v$ific.rl !alabitlrftii (ccr l5 zitc)

    b) conccntrrt $ilrocir,rlr.oh'i',uro .i'"

    '.. J..:(.cer.,rq,otrsr.4r fJ,,.,n ,.u., rc oul,0.{ r' .nr 204 .J r1l. L. . .u J,.., cc or. ,,,.r.,daloritarca eucocncLor, si o crnriratevanabiti dc rohbocire.

    Dir.de, rnlunc pondiiDrgi.dtc.

    ., ,D hl . . , r' r u 't .,,,pr1 FL oAB- tu-rir' 1or r' L -..,P'- .'. onhgd

    \.nhcrrea rspccr!hi plnglisi a conliNrutui inainre dc a rj adnini\rrarl\erfi .rrer $ !biliradi (.ca il2 zitclc) Con.rntmt trdmbocitar shndardSc oblinc pri. cdncernr.a rnajoliratii tombocn.to,iiDrFo uniratc de sirAc torat inr ur rohrmredus d! pldnu. O uiirrtc odutr cdnrinc 50.60 nn.

    rom blc itopcnic sd vcri.

    .ompdribiliraiea O B si Rh c! pri' rotut cnc jrdi.di d.rid mhil ririlc rcne rrrc dc romboci rcl

    - filrru pcnru nricroagNsrrc:timp dc rdnrinhlr.rc: hdr 20 nin./uniirr.:vcnficrre aspdulli pungji si , coniiNlllri

    . veriucarcd vrlabilirilii (cc.. 5 ?ilc).

  • MONITORUL OFICIAL AL ROMAN E

    Sc obrinc din dinse inreA"l din carc s.n crhsprin ciraferczd c hcnclc

    .danribioticctingrnulociropciii,.tidzll'ic llnt de 5 zilc sau pln la rdhrdr

    - htEr sctsisu lui carc nu risDtrDdc lx hrancdrulsc t)o.h anminiiia d lnitrtc (dc dbidd lio nn),

    - ldnrishr de aniipi.eric intrucir nanstuzia dc cofccnrar tcucocitar dcrcnnini tcbliaeila.ca usoari a ntuonuhri/punsii imi.rc, pcntru onogcnizaft fi pcrrru prclonirca

    e) Plnsnt proNspitn .ongelarisc obiine fie dinlr.o unirarc dc singc lohL.lle prin pLosnutcrcTi. sc.ongeleaza t.o remDeratuli( 25'C) ti iot-un inrcrvrl de rlmr caR Fcnnil nrcnlirsca ddccldri i flcronlor de coaeutor! jnsoLc linctionili. O miratcconiirc 200100 ml.

    rulbu.ir i dc coagr ldru (hcmotil lc) l

    con,patibilnarc o AB !i RLInllru pcntu microag.c8llc:

    ' hn de rdmirrishrc: mdr. 20 mitunilrter- sc utilizcazi inlali{l Jtrp, dczghclare Gc dczgherti inrr-un ncdtu cn rhDenturi

    co.nolnli, ld 37 'C. jn l0 ninuie)lvclilicarc{ aspccnnui pu'gii tia coDFNtului nrairtcdcr fi dhini$'arilcri6cdcr vilabilir,lii (l2luri in car de corscrvrrc td 25 oC).

    (pm{cine phsnaricr) in conccnlDtic dc 5%. 2s%

    - taiarlo hipoprorcnchici cu sau 6$cdme:Drcv cnirca hcn ocoD ce nicli

    - riabilirca lolunuhi cr.utrnr in caz dc tmum{r(mo, rsuri, intcclii sevcrc.Nu c$d neocs.6 nici un feldeconrporibiLilo!c.

    - tusiic hnslirz.l sl.Co. psvizdi cu filrn pdrtu hicrcagrcsaro ricu rub sinDtusru i[

  • MONITOR L OF CIALALROMAN E

    frngi eu r:lac.n ctr s.rf7n,tolrr:ptudusrl sxfgui[: 1ii"!c lora \au dcrif c d. siiL! ct1bcr1r. (t. llfcnLt de hrnsln, i\ugufrc iPls) dn spirrl p. hrz. b.nnhil.$crc:{r \t,or !\p!rJJ cr!u r-!' l rnit ,,t..rqud.l'. ,

    '. Io.. ." .'

    . s. cxpljli pmc.dnn [cicnru]tri !r s..hrjm..'si,nliiDrnrtrl !crr: t .r/ut nriorilo,sc ninr. nrdnl. \irx c al. Fcientu ri:. .,.

    '.t ,,d.' t'r ,!pr, ,,,.ct. !.,.,, I!, , !. : tE\ !tnr.Lt AU '

    r. 'rn,lLl< L,l.'b'ltrJrr! rr'.dtr.,r prlh dc mnn hi ird. crtrbrcxu irrrc {ii,j-!clo llcicnrLh/Drjruirortr ui lsc

    .

    .1. -

    "r " ., to, {.,sc sprti mi itc. scnnbn!iminusin..tc:sc d(c lidr nM dc rr\auz sr se rd4r.azii tr pus.mc r crli.r! 1r.Mnu/o' i| t). un crfii sc xdrpreyi h .tr scr liTLologici d.ri taDdn,onl0 n8r.L Sci tizioogic ir .rl:iLrtr.rnllr rtu gr .u n(lr(l ixfgri[:{ R'{f .ndi rtrnctr,pm!ite iLr drli!:s. urpl. crnr.r dc picun'. t.lLniifure N Sef 11,! tr n n| .! bL roit.tr trDLrga ru sar!!.ft ilcrr(l

    . s. lllniM adlLldc D. ndn rnnsnr..uhi ari ri cujli clrc\i pi.iiror din sorfx didrla tu\a n. ifuinn/r. rre 0n sinstrr n'tl. sr irrch {tc prdtuh]l \c $tri,nbi ptrtrlx.u \.rizn, o!..,,.N,u \in!.r! ,Lrii../i t'por prn rrnrcx r{fh.l. rntrorL r,nsln7on,ltri l1 bnfuLi { cdetq s sr( p' ,J '|l .4

    ".',''''''''',''l''''.t.

    N.!il.: irr r..!crl. { ni.hd. rlbul.dxprai r nmgx.uscr\ sc dc\.hiJc tubrt itlrdH Isr .a.ducrzi r..hi [n]to.Lrcli O.lc.tte. lisitut \ii ruLlti in r.r 20 rnL srrgr dr0r crrc $tu!lcr. ftnruld. \cL rs.rN t3 lo.ls n c jn tr rimD de s;ri,ntrc:

    . ,L't 1 'cJ , p.,i .

    ' .'jL' {'ll'

    'in'n .i!{!h{^.,orr.rmtr!,"".,,t.., ,,r I ..

    ' dxci xprr rucrisd\.r\r r sdnrc tu nconprhbilihrc sc oD,c\r. hansh,,r cu sril!.. scconriN'ripcrnyh ru $ urii stini \is.. Lnlu i,ncdir( n.di!ut:'

    ll,.i '

    . ,."o.,J - .r.,.

    - ntr-rc rdni'nnr!r/a ir nungr cu pr,dtr\ut5.n!uin rncdj.anrcnr s.u rttc \ohrrii DcLhzxbrh:,o,\dufJ{rJ.trLl

    duti rctr rrxn Niacisemrca/iniiinjpxcicnruuion.dajlr,lcnerilarprcteftrlL,i.Juti scinrihnNicnr.i cr.acf.cru r.,)s1iL7ir:

  • MONIORUL OFICIALAL ROMAN E

    - punga sc titun. lr onihled de hnsfuii san8lilc imprcuni ctr o hici clnrirate dc singc(5 6 ml.) ri sc ptsrrcazi a8 orcjsc surnvcsfudTi prcicntul in unniirorolc 24 43 drc poiftansfuzic.

    7-6 t,rotocol de inv$ligrre/ inregistrare a nrci rc.c{ii rcutt trinnnzionrle- se oprcSrc lrddnzia !i sc pasteui aborduL vends cu ser fiziologi. ji rimp cc sc lhcc d

    cvxluare lniridli r toicrlei acure:

    sc mponcoTii inlrli{L Lorlc r!.ctiilc tdnsfuzion o rcsronlrbilului cu hcilovisiLenh \iocnhlLi Jc tdnsluzii dc singc lumizorsc in giirca/i in tuaia dc obsdrvdie ! paclentulu i

    ' iipul reaqici (ftbrili, aldsici, soc)l' i cna hr l intc inccpnto I d. nsfuzici si marirl. rercrici:- ripul si voLLmnl Dn hnsfn/ati- c.dnrile uniccrle psllmns&zre:

    i$cdilr dul,i ip ith rc.clici sc rccoLrc.zi unnftoarclc Drcbe ic singc. se coDrplctcazilormul.nldc ccrercJo rndlia sl sc tinirc prs/cb hmiTorl

    - o probi fir.i anricoigulan| o pbbi pe rniiooagulant(cdra) dc h bratulopus:hcnoculturi daci se luspecrerTi ros sepric:uniraiea psl + tnua dc tansftzicipirna cnisic dc niini Dos rcele - prcbr prcrrnsliziotr.ti I pacienrului lolosni L.dcrcdninarcr gtupei sanguine !l ncomtalibilitdliii

    ' sd conpLctcui un lormnhr dc ml]onirc d ndlilor trnsfuTiomlcidupi inkstie4iilc inithlc sc trinit la prs/crsinrohc dc singc (l+l/cdk) (cdlrxrc ia 12 ore J 2.1 orc dc lx dparitia rcictidi (dd la bdul

    - roaro disiild dd unni (probe r volun)din umtrDrclezl orc.?.7 A utotrlnsfu zia (r. n. fuzir rutobgn)Aurorransftzia cnc relnfuir prcprinlui sdngc dupi cc a tb$coteud ri

    'lhllrsteefcctu.ri lnlnle. in rimpuliitilpi ir crvctrtiitcchtrtrryicate$ulnum'risDr..

    nu rpf r&lii poinnstuzinrlc &iorit! inc.hpxribttitilitor sou grcsclilo {tc nabih r

    Dietlerca dc sin8c cic inl.cuitt imcdlatj- singclc rutotanstuzar .onrinc ur trivcl n nnal dc 2,3 dlportqliccrar cdro djuri It

    orrceuer icsuturilor.

    rccolrarca de sAnse peN! autornnsrL're 5e Fatc ii.c prNpc.dor J cnc iccdmandatiDacientilorcu incflmtii chnurgicrle odopcdicc, nr rimptrl cibm se picrdc mutr sinpci

    . .oc, n:. .in.-! roJ l,.i irf.' ho\i.D.n.:r 'ndir co.,,|rJ c,

  • de mlle ori, in intcpdtiilc .hioreic,te ou piqdoi m.i dc srnsc s fotosclre m apdtconFht in{ruopdatd !i postopeEto! to lubut tre drcn al ptisii, me p;a sangclopaoiotului, Il lmcesesd Si ll anror'ustuzeaz4lcbxicbmiro 20lndnohrio titaradcsansec@eautorrftsfi,rzi;pa.ienlii crc an donat pmDmror .nnge vd fi s,Etuiji si rrnnn! in rcpaus ta p{r tnc, I ()ninulc dwt donc, sd bco c6l bai nulte lichide in orale ihcdilt l]ftrozcp&'m'i' cr rub$tufu'c vd' f Don n izzricr aEnr c.l riDputb4:tuz.cr s dJns eeinhcJlnor$ apra ra.1:iqsvag:te rhirorsy dc. brdMrJic sr hrpovohnie; spdEl