Bo m khf C 0 2 va o d p h u c m a c vi nhi6u m u c di ch k h a c nhau: - L a m c a n g b u n g , tao an t o a n khi c h o c cdc trocart.
- Tao phau t r u o n g q u a n sat de d a n g vi ap luc d u o n g c u a khf C 0 2 lam c a c tang ta ch xa nhau.
- G i u p c h o c ac d o n g tac boc ta ch m o de d a n g hon.
- G iu p c h o viec c a m ma u t huan loi n h o ap luc d u o n g tinh t r o ng o b u ng . Buoc nay c an phai thuc hien c h i n h xac thi moi c o the t ra n h d u o c c a c tai bien.
Ki e m tra kim c h o c : da m bao kim t h o n g tot, t ha n g. p h an ruot k im c o dau tron di d o n g de d a ng .
D i e m c h o c kim b o m khi C ( ) 2: t h u d n g tien h a n h c h o c d n g a y m e p d ud i ron c u n g ia noi se c h o c trocart 1 1 va d ua den soi q u a day. D a y la d i e m c h o c p h o bien nhat. Mot so tac gia c o n de nghi d u o c c h o c o' v u n g ha s u d n t r o ng tru dn g hop co seo m d cu d d u d n g t ra n g giua. N g u d i ta da bd k h o n g c h o c d hai ho c h a u hay q u a tui c u n g D o u g la s .
Ky th ua t c h o c kim b o m kh i C ( ) 2: d u n g da o mui n h o n c h o c dut da v un g m e p dudi ron vdi mot do r o ng sao c h o c a n d a o c o the di q u a d u o c . T a y phai c am doc kim sao c h o p h an ruot kim c o the tu do di d o n g d u o c (can luu v d o n g tac nay). Ta y trai d m lay t ha nh b un g trudc d dudi ron (c a c d au n g o n tay de d bd n go ai c o t h a ng to). C u n g mot luc tay trai n a n g t h a nh b u n g len c ao nhat c o the d uo c . tay phai c h o c k im tu tu, h u d n g t he o mo t g o c 90° vdi mat p h a n g da b u n g tuc la h u d n g x u o n g phfa d udi vi luc nay t h a n h b u n g da d uo c n a n g len c a o ( hinh 11 x e m d phu ban). Pha u t huat vi en c o c a m g iac kim c h o c q u a hai b inh dien (hai lan n h a y lo xo), do la b inh d ie n c a n va bi nh dien p h uc ma c. D o n g tac n a n g t ha nh b u n g len c a o k h o n g lam t a c h xa c a c quai ruot khoi dau kim n h u n g c o y n g h l a lam g i a m c a c n g u y c o t h u o n g ton c ac m a c h m a u ldn. Tu y n h ie n d o n g tac n a n g c a o t h a n h b u n g g ay ra hai n h u g c diem: kho n h a n biet d u g c c a m giac k im born C 0 2 di q u a hai binh dien c u a t ha nh b u n g va de bi b o m C 0 2 vao k h o a n g n goa i p h u c m a c . M ot khi kim b o m C 0 2 da n a m t r ong k h o a n g p h u c m a c thi t uyet ddi k h o n g d u g c di c h u y e n kim.
C h u n g toi xin trinh b ay mo t ky t huat c h o c k im b o m C 0 2 do GS. J. L A N S A C (t ha nh pho T o u r s - P h a p ) de xuat. T h a y c h o ban tay trai o m va n a n g t h a n h b u n g len cao. tac gia da d u n g hai k im K o c h e r t h a n g k ep lay c a n t h a n h b u n g d noi m e p dudi ron da d u g c ra ch da va n a n g t h a n h b u n g t ru dc len cao. T r o n g t r u d ng h g p tien h a n h c h o c d m a n g s u d n trai thi k h o n g c a n n a n g c a o t h a nh b u n g va van c a m n h a n d u g c kim di q u a tu n g ldp (c an , p h u c m a c ) vdi hai lan n h a y lo xo.
K i e m tra vi tri k im b o m C ( ) 2: c o rat n h i e u c a c h kie’m tra vi tri c u a k im born C O ; t rudc va sau khi tien h a nh b o m k h i v a o k h o a n g p h u c ma c .
Ky th u a t bom tiem th u y tin h t u trtiot: c an co m o t b o m tiem t h u y tinh. p is ton co k h a n a n g tu tut x u o n g . Budc mo t hut k i e m tra k h o n g rut ra d u g c gi. b ud c hai de pis ton c u a bo'm tiem tu tut. N eu p i s to n tu tut c h u n g to da u
kim da na m t r ong k h o a n g phuc ma c. Ky that nay c o n h u g c die’m la k h o n g phai luc n a o c u n g de d a n g c o d u g c m ot b om tiem t huy tinh m a pis ton co kha n a ng tu tut.
Ky th u a t d u n g h u y e t th a n h : Buoc mot ba o g i d c u n g la m o t b o m t iem hut kieim tra k h o n g rut ra d u g c gi. Sau do de n u o c d d o c k im c h o c , n a n g c a o thanh b u n g len se thay giot n u de tu tut x u o n g . Ket q u a do chufng to da u kim c h oc da n a m d u n g c ho . C h u n g toi t h u d n g ap d u n g ky thuat nay.
Ky th u a t ham h u t: d u n g bo'm tiem hut kiem tra k h o n g hut d u g c gi. Sau do d un g b o m tiem b o m do 20 ml huyet t ha nh h oac k h o n g khf, bo'm de d a n g k h o n g co sue can, n g a y sau do hut luon thi k h o n g hut ra d u g c gi.