2. Understand the operation of the endoscope and use the correct functioning technique.
3.Good use of the correct light source, cutting source, biopsy pliers and stained catheter.
1.House
In the 1960s, a flexible endoscope was opened which opened a new era for endoscopic surgery and marked an important step in the diagnosis and treatment of gastrointestinal disease. Soft has developed very fast, the first is the fiber endoscope, in 1990, the video endoscope software has created a great development in the quality of the image of the endoscope. With the advent of video endoscopy, other endoscopic techniques have also emerged, such as selective endoscopic imaging (NBI), endoscopic imaging, endoscopic ultrasonography, endoscopic intervention ... has a completely different appearance compared to when new colonoscopy was born.
The endoscope is a high-tech, complicated, expensive device that requires a strict process of use and storage. The endoscopist must understand the machine's structure, know how to use the machine and equipment attached with a proficient machine, otherwise it will damage the machine, causing calamities for patients and the machine itself . Use, the endoscope properly will improve the life of the machine and reduce the cost of machine repair.
2.Introduction of internal machine
The soft light is based on the principle of optical fiber bundles, having a diameter of 2 - 3mm, consisting of 20,000 to 40,000 tiny glass fibers of 10mm in diameter, which are very light transmissive with very low attenuation. little over long distances. Light is focused on each fiber and is transmitted by internal refraction. The transmission of the image depends on the direction of the fiber optic cable and the two ends of the glass fiber bundle. The outer edge of the fiber optic cable is covered by a glass layer to prevent light from being transmitted out, so that the sheath is not transmitting light.
The CCD is equipped with a CCD (Charge Coupling Device) chip, which has 33,000-400,000 CCDs that receive images from the gastrointestinal tract, enhancing clarity. belong to image. The images are transmitted to the CCD of the image processing unit and transmitted to the screen.
All white, black, green, and red of the gastrointestinal mucosa are noted and passed on to the screen in a clear and detailed manner thanks to a filter mounted on a light source called a color filter.
3. COMPONENT CONSTRUCTION
3.1.Soft sofas
- Scanner straight: The machine's view is located on the top of the machine. Many scanners in this group include: gastroscoscope, colonoscope, intestinal endoscope, cryoscope ...
- Side view: The machine's view is located on the side of the scanner. Endoscopic devices for upstream cryptography and interventional endoscopic trinuclear trisomy are constructed in this form.
Small scanners usually have an outside diameter of 0.9 cm - 1.1 cm and a diameter of the procedure channel is 0.28 cm for diagnostic endoscopy.
The large diameter scanner l, 2cm - 1.35 cm, has a biopsy channel diameter of 0.32 - 0.40 cm, used for endoscopic intervention.
3.2. Build outside the machine
3.2.1. Machine settings
Up-down and lock-to-fix buttons.
Left and right controls and keys are fixed.
3.2.3. Body (Machine to patient)
Includes 3 parts:
- Software (Flexible Portion).
- Bending Section.
- Locomotive (Distal End).
3.2.4. General conductor
Fiber optical fiber cable.
Gas and water pumps.
Suction line
Conductors for the automatic contact system used in the procedure.
3.2.5. Connector to light source
Direct connection to the light source.
Air conduit.
Electrical contacts.
The external structure of the scanner:
Connector with suction.
Connector for power supply.
Connector with water jug.
4. PREPARE AND CHECK THE MACHINE BEFORE SOI
The preparation and examination of the machine before the endoscopy is very important and necessary. Good preparation makes the scan convenient and avoid complications as well as damage the endoscope.
4.1. Tools needed for screening
Scanners and accessories.
Light source.
Vaccum.
Power source and accessories.
Camera and film.
Screen (if screen is scanned).
Image Transmitter (when it comes to display).
Water bottle.
Kim biopsy.
Valve biopsy.
Analgesia.
Canun dessert.
Fruit tray.
Silicone oil (applied to metal parts in valves).
Lubricating oil (applied to the machine head and cannon).
White Alcohol 900.
Gloves.
Clean gauze.
4.2. Prepare and check the light source
Connect the light source to the power source.
Adjust the light at a level that can clearly see the mucosal image.
Keep the light source in a safe place, away from combustible gases
- Do not put heavy objects on the light source.
- Do not allow water to enter the light source
4.3. Prepare and inspect the suction machine
Plug in the power supply
Install a suction nozzle, one on the scanner, turn on the suction and suck.
4.4. Prepare and inspect the electricity source
Use a suitable combustion source for the scanner.
If the broken tool has to be replaced.
Tools must be clean, sterile.
Test burns before use on patients
4.5. Prepare the water tank
Fill two-thirds of the water tank with clear water and cover the water tank with the water in place.
Every day to clean and change the water,
Use distilled water if it can not cause infection.
Check the scanner
Always check the machine before any malfunction can damage the patient and make the machine worse.
Checking machine includes:
Check the rubber cover of the machine.
Check the mechanical parts of the machine.
Check the machine's optical components.
Check the pump and water system.
Inspect suction system.
Check the general conductor.
Check out the photography system.
Check the biopsy valve.
4.6.1. Check the rubber cover of the machine
Machine
Use a finger strokes lightly along the body to detect abnormalities, check the surface of the machine to detect the indentation, swelling, unevenness on the body. If you are abnormal not using the machine, send to correct.
Machine curve
Use the test equipment, try to follow the rules if the barrel or abnormal to send immediately.
4.6.2. Check the mechanical parts of the machine
Turn the control knob up - down, left - right to see if the machine is adjustable well, achieve maximum curvature.
Locks to a fixed position and observes whether the curve of the machine is fixed.
Leave the key in the "F" position and watch for the controls to freeze.
4.6.3. Check the optical system of the machine
4.6.3.1. Eye and eyewitness eyesight
If you use 90 ° alcohol, wipe it clean, or use 90 ° alcohol and 7/3 ether to wipe. Caution: Never use abrasives to clean the lens and lens.
4.6.3.2. Turn on the light source and adjust the brightness: adjust the color balance (some types).
Note: a standard object for the objective of 15mm if the optical system is clearly visible
good machine.
4.6.4. Check the pump and water system
Check the inflatable
Turn on the pump at maximum level, immersing the machine soaked deep into the cup of clean water for about 10 seconds, to finger on the valve air pump will bubbles the water cup. If slightly out or no steam out is the inflatable and clogged water.
4.6.4.2.Fighting water pumping
Remove the machine from the water, press the button on the pump and water, the water will shoot straight into the head, if the weak water is blocking the pump water.
Note: pump water to wash the glass object when dirty, if the gastric esophagus should use a syringe to wash the biopsy.
4.6.5. Inspect suction system
Dip the tip of the lamp in the glass of clean water and press it into the water suction valve.
4.6.6. Check the general conductor
No tearing, twisting, twisting, direct connection to light source is not distorted for good electrical contact.
4.6.7. Check the biopsy valve
If the valve is torn or damaged, the suction pressure will decrease and the valve replaced to ensure suction pressure.
5. HOW TO USE SOI MACHINES
5.1. Hold phone
The patient's position must be vertical to form a straight line from the mouth to the stomach
patient.
Left hand holding machine, index finger control valve inflatable, water, suction valve, thumb control up and down.
The right hand controls the left hand as well as the machine in and out.
Attention:
Do not bend the connection between hardware and software on the body.
Do not bend or bend the wire, as it can damage the electrical conductor, the inflatable path, the water, the light conductor, the photo wire inside the conductor.
The thumb up - down and can move to the left, index finger and inflatable - water while the middle finger patch ring finger can help up - down and right - left (right - left).
.5.2.Should be brought to the patient
Lubricate into the curve of the machine and into the cannon, not to the head.
In order to lock the controls at the "F" position, the curves of the machine are moved freely up - down, left - right when turning the control knob.
5.3. Put the machine into observation
Just put the machine into the observation, need to pump enough to observe, if you do not observe the line, but just push the scanner will cause mucosal damage and machine failure.
Only to lock in a fixed position when looking closely at the injury, then back to the "F" position, otherwise, when the machine will cause disaster for patients.
5.4. Adjust the light
Adjust the light at the adjusting unit at the light source, usually allowing the light to be at least sufficient for observation.
Wash the dirt
Press the suction button to drain the fluid, observe the injury.
When needed, use a syringe to pump water through the biopsy to wash.
5.6 Clean the glass
Press the water pump button to clean the glass, then pump the air to dry the object.
5. Adjust the stomach slightly
Do not pump too much gas into the stomach because the patient is uncomfortable. As needed, absorb less gas in the stomach
5.8. Biopsy
Before biopsy, carefully check needle biopsy to see if the platelets are tucked open.
5.8.1 Biopsy pliers
Always stay in front of the monkey for examination as well as before withdrawing the biopsy from the scanner. Pull the biopsy through the instrument, the plunger through the pores of the valve, pushed slowly, gently each short paragraph. If accelerated, strong tissue biopsy and needle biopsy, holding biopsy biopsy near the hole.
If the biopsy forceps through the curved part of the scanner difficult, reduce the curvature of the machine until the biopsy is passed.
When biopsy biopsy is required, biopsy needle biopsy is checked. If biopsy is not observed, the biopsy specimen will not damage the mucous membrane (tear, puncture, etc.).
5.8.2. Conduct biopsy
Cut mucosa, gently pull up to take the biopsy out.
The needle biopsy must always be closed to:
- No biopsy.
- Does not hurt the patient.
Do not biopsy biopsy.
Note: When closing and opening the biopsy pliers, to manipulate lightly, definitively.
If biopsy is not possible:
Push the needle biopsy into the mucosa several times, then pull out when the pliers are closed.
If the needle biopsy has not closed, the need to withdraw the biopsy as close to the machine as possible, then pull both the biopsy and the machine out at the same time, pulling and watching.
5.9. Take out the scanner
Before removing the scanner from the patient, remove the device to the same machine as hemostatic needles, biopsy pliers ...
Suction in the stomach before withdrawing.
In order to lock the controller in the "F" position and adjust the position of the machine in the straight position, the driver withdraws, withdrawing and watching.
Caution: If the curved head is left unattended, it will hurt
The mucus and tissue can not be removed if the device is folded in the esophagus or rolled in the colon.
Wash - disinfect - disinfect and dry the machine after the complete examination according to the instructions.
6. DISCHARGE:
6.1. Technical problems
Table 1. Stroke and complications
|
Technical issues
|
Symptoms
|
|
Use a defibrillator or broken tool.
|
Mucosal injury, perforation, tearing, burns, electric shock.
|
|
Give the scanner or accessory without observing.
|
Injury or rupture of mucosa.
|
|
When suction to the mucus close to the mucosa and suck long.
|
Bleeding, fake lesions.
|
|
Fold the machine in the esophagus or roll the machine in the colon does not pull the machine.
|
Pain, tear, puncture.
|
|
Pull the tool out or not observe.
|
Mucosal injury, perforation, tear, or failure of the scanner and tools.
|
|
Do not observe the location of electricity.
|
Mucosal puncture, perforation.
|
|
Pull the scanner out to lock the adjustment in position "F".
|
Injury, perforation, tear.
|
|
When the scanner is unseen, the scanner is not straight.
|
Injury, perforation, tear.
|
|
Use the solution is not sterilized and well preserved.
|
Cross infection.
|
6.2 Computer problems occur during scanning and remediation
There are many small problems of the machine occur during the scan, can be overcome, no need to send repairs. But if the machine is torn or the machine does not work, it must be repaired, should not repair itself because it can cause further damage.