TPN, TDM & CDR

Ada sesiapa PPF disini yg boleh berkongsi pengalaman?

TPN DAN CDR perlukan teknik aseptik..kalau TDM run machine aje..tapi kalau dhiya suka buat TPN lagi sebab kurang risiko pada diri sendiri tapi risiko pada orang lain plak kalau teknik aseptik kita tak betul..

Buat TPN kat tempat dhiya tu calculation buat manual or computerised? Brapa bag persediaan adult n paed purata sehari?

saja nak tahu... dah lama tinggal sejak tukar ke klinik kesihatan.

TPN tu dikira secara computerized tapi kita akan double check guna manual..kita kene kira secara manual tu sebab ye la komputer pun kadang2 buat silap jugak. dhiya ni pun dah lama tinggal jugak TPN tu..tapi kalau takat calculation dia tu insyaallah la no sweat..cuma mungkin teknik dah banyak yang berubah dan di tingkatkan..nak buang bubble tu yang paling best sekali..

Yes.. part buang bubble tu mmg best. Lenguh jari dibuatnyer . Sampai x sedar kepala masuk sekali dlm laminar flow hehehe.. aper lagi kalau prepare > 20 bag sehari!

Ada tak latest manual/prosedure ttng GMP buat TPN ni.. kalau ada i nak copy.

topup wrote:Yes.. part buang bubble tu mmg best. Lenguh jari dibuatnyer . Sampai x sedar kepala masuk sekali dlm laminar flow hehehe.. aper lagi kalau prepare > 20 bag sehari!

Ada tak latest manual/prosedure ttng GMP buat TPN ni.. kalau ada i nak copy.

kalau dhiya dulu buang buble tak pakai tangan. dhiya pakai syringe 50ml ketuk2 kat bag..memang tak kan pecah punye. tangan pun tak sakit le...tak de la sampai kepala nak masuk dalam laminar flow.. macam ne la rupe topup nak masuk kepala tu..hehehehe

GMP tu klau kata ade nanti dhiya PM kat pada topup ok..

kalau dhiya dulu buang buble tak pakai tangan. dhiya pakai syringe 50ml ketuk2 kat bag..memang tak kan pecah punye. tangan pun tak sakit le...tak de la sampai kepala nak masuk dalam laminar flow.. macam ne la rupe topup nak masuk kepala tu..hehehehe[/quote]

Bukan kepala topup jerr yg masuk, kepala Pegawai pun masuk sekali pasal nak squeez bubble tu naik atas . Tapi hasilnyerr perfect!! observe dalam Allen Viewer langsung takder bubble hehehe... keluar jerr drp preparation room penat giler..

hehehe...dhiya suka buat large volume topup. tapi biasa pempuan suka buat small volume. small volume leceh la..banyak bebeno bahannya. kalau large volume tu org tak suka sebab volume banyak..

gurl suka wat TPN gak, senang la bbnding CDR yg bagi risiko kt staff..elaun kritikal wt CDR kita xdpt. So lebih baik bg kt pegawai bior diaorg wat CDR nti xberkat elaun yg bratus2 2 sbb wt keja yg x kritikal .

kita pun kan dah jadik penolong pegawai..so, pe lagi? keje menolong je la nih.

cuba anda renungkan...maksud menolong adalah membantu apabila seseorang tidak mampu melakukan sendiri ssuatu pekerjaan, ttpi adakh pegawai xmampu sedangkan mereka mampu utk memperoleh elaun kritikal..

Dengar khabar warga PPF akan ada Pos Basic untuk TPN, TDM dan CDR selama 6 bulan di Kolej Kesihatan Bersekutu Sg Buloh. Harap bukan khabar angin sahaja, bolehlah refresh pengalaman dan dapat sijil pula tu...elaun Pos Basic??

entahla..kalau takat kabar angin ni dah macam2 yang kedengaran.pelaksaan ada atau tidak pun tak tau la..tapi kalau yang junior2 ni jangan harap lah nak dapat pegi dulu yek..akan diberikan kepada senior dulu..pas tu balik2 pun pass over kat orang lain yang buat..tapi tak kisahlah, at least kalau betul ppf ni dah maju setapak lagi ke hadapan.

Just to recap and share what is Total Parenteral Nutration (TPN) and to anyone want to know what is TPN all about (edited from Wikipedia version):

It is a practice of feeding a person intravenousely, bypassing the usual process of eating and digestion. The person receives nutritional formulas containing salts, glucose, amino acidss, lipids and added vitamins.

Also referred to as Parenteral nutrition (PN), is provided when the gastrointestinal tract is nonfunctional because of an interruption in its continuity or because its absorptive capacity is impaired (Kozier et al, 2004). It has been used for comatose (coma/deep sleep) patients, although enteral feeding is usually preferable, and less prone to complications. Short term TPN may be used if a person's digestive system has shut down (for instance by Peritonitis), and they are at a low enough weight to cause concerns about nutrition during an extended hospital stay. Long-term TPN is occasionally used to treat people suffering the extended consequences of an accident or surgery.

The preferred method of delivering TPN is with a medical infusion pump. A sterile bag of nutrient solution, between 500 mL and 4 L is provided. The pump infuses a small amount (0.1 to 10 mL/hr) continuously in order to keep the vein open. Feeding schedules vary, but one common regimen ramps up the nutrition over a few hours, levels off the rate for a few hours, and then ramps it down over a few more hours, in order to simulate a normal set of meal times.

Chronic TPN is performed through a central intravenous catheter, usually in the subclavian or jugular vein. Another common practice is to use a PICC line (peripherally inserted central catheter), which originates in the arm, and extends to one of the central veins, such as the subclavian. In infants, sometimes the umbilical vein is used.

Battery-powered ambulatory infusion pumps can be used with chronic TPN patients. Usually the pump and a small (100 ml) bag of nutrient (to keep the vein open) are carried in a small bag around the waist or on the shoulder. Outpatient TPN practices are still being refined.
Aside from their dependence on a pump, chronic TPN patients live quite normal lives.