关键词: 烧伤, 经外周静脉穿刺置入中心静脉导管, 护理实践, 感染

Abstract: The nursing experience of PICC catheterization in 18 patients with massive burns was summarized. Aiming at the problems of no normal skin tissue,difficulty in fixation,easy contamination of puncture points,and susceptibility to catheter-related infections at the puncture sites in this group of patients,a nursing practice plan was constructed. The catheter indwelling site was located away from the infected wound,and the upper extremity vein was preferred,and with the axillary vein as the secondary choice,small pieces of isolated skin should not be selected. Iodine disinfectant was used to replace alcohol disinfectant for reducing wound irritation. ECG localization technology was applied to monitor the tip position of the peripheral central venous catheter in real time during intubation. Stitching in combination with sterile gauze dressing was used to cross-fix catheters. We established targeted maintenance measures and focused on the risk of infection of PICC caused by wound dressing replacement and VSD drainage to prevent catheter related infection. We identified care problems timely through intravenous access checklists. 18 patients were successfully indwelled with PICC,of which 4 were shock patients,and the maximum indwelling time was 32 days. One case was confirmed as a catheter-associated hematogenous infection. PICC can meet the infusion needs of patients with massive burns and has a low infection rate.

Key words: Burn, PICC, Nursing Practice, Infection