# 一位護理師在兩次給藥之間，使用肝素鎖住的端口沖洗中央靜脈導管。下列哪項程序正確應用了 SASH 程序？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391890&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一位護理師在兩次給藥之間，使用肝素鎖住的端口沖洗中央靜脈導管。下列哪項程序正確應用了 SASH 程序？

## 選項

1. Saline → 給藥 → Saline → Heparin（S-A-S-H），使用10 mL針筒以降低壓力 **✔ 正確答案**
2. 使用1 mL針筒更快推注
3. Heparin → Saline → 藥物 → Saline
4. 只給藥，不沖洗

**正確答案: 1**

## 解析

正確答案 (2)：SASH 程序用於肝素鎖住的中央靜脈導管：生理食鹽水沖洗 → 給藥 → 生理食鹽水沖洗 → 肝素沖洗。使用 10 毫升或更大的注射器可產生較低壓力（較小的注射器可能導致管路破裂）。僅針對瓣膜式或生理食鹽水鎖住的裝置才只需使用生理食鹽水沖洗。脈衝式推注／推-停技術有助於清除殘留藥物。(1) 順序錯誤。(3) 有凝血風險。(4) 小注射器會導致破裂。

## 深入解析

記憶提示 SASH =「Saline、Administer、Saline、Heparin」。使用≥10 mL針筒。有瓣膜裝置（PowerPICC）只需saline。植入式port未使用時也需每月heparin沖洗。

## 臨床情境

情境 居家成人個案有化療用植入式port；使用SASH流程沖洗。

## 重要概念

- **SASH沖洗流程** — Heparin鎖定中心管路沖洗順序：Saline-Administer-Saline-Heparin。
- **脈衝推停沖洗** — 間歇式沖洗技巧，可加強清除殘留藥物。
- **10 mL針筒規則** — 使用較大針筒以限制壓力；較小針筒可能使管路破裂。

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