CN115200937B - Neurosurgery patient vomitus detects sample cleaning device - Google Patents
Neurosurgery patient vomitus detects sample cleaning device Download PDFInfo
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- CN115200937B CN115200937B CN202211118466.2A CN202211118466A CN115200937B CN 115200937 B CN115200937 B CN 115200937B CN 202211118466 A CN202211118466 A CN 202211118466A CN 115200937 B CN115200937 B CN 115200937B
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- G—PHYSICS
- G01—MEASURING; TESTING
- G01N—INVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
- G01N1/00—Sampling; Preparing specimens for investigation
- G01N1/02—Devices for withdrawing samples
- G01N1/10—Devices for withdrawing samples in the liquid or fluent state
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y02—TECHNOLOGIES OR APPLICATIONS FOR MITIGATION OR ADAPTATION AGAINST CLIMATE CHANGE
- Y02A—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE
- Y02A50/00—TECHNOLOGIES FOR ADAPTATION TO CLIMATE CHANGE in human health protection, e.g. against extreme weather
- Y02A50/30—Against vector-borne diseases, e.g. mosquito-borne, fly-borne, tick-borne or waterborne diseases whose impact is exacerbated by climate change
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Abstract
The invention discloses a neurosurgical patient vomit detection, sampling and cleaning device, which comprises a pressurizing part and a sampling part, wherein the pressurizing part is used for pressurizing a patient; the pressurizing part is used for extruding the containing bag filled with vomit so that the vomit enters the sampling part; the pressure price part comprises a supporting bag and a squeezing bag; the support bag is cylindrical after being inflated; the extrusion bag is positioned in the supporting bag, and the bearing bag is extruded after the extrusion bag is expanded; the sampling part comprises a detection bag and a communicating pipe; the detection bag is communicated with the communicating pipe, the communicating pipe is used for inserting the containing bag, and when the containing bag is extruded by the extrusion bag, vomitus is guided to enter the detection bag. The device is convenient for detection sampling operation.
Description
Technical Field
The invention relates to a sampling and cleaning device which is used in a neurology department and is convenient for observing the vomiting process and the vomit characters of a patient.
Background
For neurological diseases, patients often have vomit symptoms, and the detection of vomit and the observation of the vomit reflecting process can assist in diagnosing the etiology of the patients.
The prior vomit sampling device, such as Chinese patent (CN 112629942A), is not suitable for observing and sampling in departments. Which itself does not have an opening suitable for the patient to vomit directly. Moreover, the vomiting process cannot be observed, such as the vomiting of the patient is jet or fluid. Furthermore, the problem of cross-contamination of the storage tank itself, with cleaning and placement, is obvious and difficult to use in a department.
Again, as in prior art CN114778209B, the movement of the piston in the suction cylinder is accomplished by means of a magnet. If a suction cylinder is used, manual operation is sufficient, and the result is too complex. The cleaning of the pumping system itself is also a consideration, and the device structure actually adds unnecessary trouble to medical care.
How to make things convenient for disease vomiting, make things convenient for simultaneously doctor to observe and take a sample, be the required sample cleaning device of department of neurology.
Disclosure of Invention
The embodiment of this application has solved the problem that is not convenient for draw the sample during vomitus detects among the prior art through providing a neurosurgery patient's vomitus detects sample cleaning device, has realized convenient operation, the effect of the clean sanitary vomitus that draws.
The embodiment of the application provides a neurosurgical patient vomitus detecting, sampling and cleaning device, which comprises a pressurizing part and a sampling part;
the pressurizing part is used for extruding the containing bag filled with vomit so that the vomit enters the sampling part;
the pressure price part comprises a supporting bag and a squeezing bag;
the support bag is cylindrical after being inflated;
the extrusion bag is positioned in the support bag, and the bearing bag is extruded after the extrusion bag is expanded;
the sampling part comprises a detection bag and a communicating pipe;
the detection bag is communicated with the communicating pipe, the communicating pipe is used for inserting the containing bag, and when the containing bag is extruded by the extrusion bag, vomitus is guided to enter the detection bag.
Further, the pressurizing part and the sampling part are made of plastic.
Furthermore, the supporting bag and the squeezing bag are respectively provided with an inflation inlet;
furthermore, the openings at the upper end and the lower end of the supporting bag are provided with the binding belts, and the binding belts can bind and close the openings of the supporting bag.
Furthermore, the supporting bag is composed of a plurality of unit bags with the length directions parallel to the axis after inflation, and the unit bags are communicated with each other.
Furthermore, the pressurizing part also comprises a sealing bag which is fixedly connected with the communicating pipe in a sealing way, and the diameter of the inflated sealing bag is 1/6-1/4 of the diameter of the inflated supporting bag.
Furthermore, the communicating pipe can be fixed inside the sealed capsule or on the outer wall of the sealed capsule.
Furthermore, the sealing bag, the squeezing bag and the supporting bag are inflated through a ventilation bag, the ventilation bag is also made of plastic and is provided with an air inlet head which is communicated with an air source, and a cavity in the ventilation bag is communicated with the sealing bag, the squeezing bag and the supporting bag.
Furthermore, the sampling part also comprises a cement bag, and the cement bag comprises a sealing bag, cement and an isolation pipe;
the daub bag is internally packaged with daub, and the communicating pipe passes through the daub bag;
the part of the communicating pipe, which is positioned in the daub bag, is provided with a glue outlet, the isolating pipe is sleeved outside the communicating pipe and isolates the glue outlet from the daub, and the isolating pipe is in sliding sealing fit with the communicating pipe;
one end of the daub bag is fixedly connected with the wall of the communicating pipe in a sealing way, and the other end of the daub bag is fixedly connected with the isolating pipe in a sealing way; the isolating pipe moves to open the glue outlet;
the communicating pipe is divided into two parts, the connecting head connected through threads is connected into a pipeline communicated with the crown, and the connecting head is positioned on one side of the cement bag, which is far away from the detection bag.
Furthermore, the detection bag, the diaphragm, the conical head, the interlayer and the sealing column are arranged;
the diaphragm is close to the communicating pipe in the detection bag and is positioned on the inner wall of the detection bag in a sealing and fixed connection way;
the conical head is a conical tube, and the outer wall of the conical head is fixedly connected with the diaphragm in a sealing manner; the conical head and the communicating pipe extend into the pipe orifice of the detection bag to be in buckle connection, and the conical head can be separated from the communicating pipe under the drawing action of external force;
the interlayer is positioned at one end of the detection bag close to the communicating pipe, the interlayer is made of plastic sheets, the top edge of the interlayer is fixedly connected with the bottom edge of the diaphragm in a sealing way, and the remaining three edges of the interlayer are fixedly connected with the inner wall of the detection bag in a sealing way; the interlayer is provided with two nicks parallel to the length direction of the detection bag;
the upper side of the interlayer is fixed with a sealing column, the lower aperture end is inserted on the sealing column after the conical head is detached, and the sealing column can seal the conical head.
One or more technical solutions provided in the embodiments of the present application have at least the following technical effects or advantages: compared with complex mechanical equipment in the prior art, the device is more convenient for medical personnel and patients to use. In the whole sampling process, patients and medical staff do not have the risk of directly basic vomit, and the sampling device is clean and sanitary.
Drawings
FIG. 1 is a side view of the pressurizing and sampling portions when not in use;
FIG. 2 is a front view of the pressurizing and sampling portions when not in use;
FIG. 3 is a schematic view of the internal structure of the pressurizing part and the sampling part in use;
FIG. 4 is a schematic view of the support bladder, the squeeze bladder and the support bag;
FIG. 5 is a schematic view of a ventilation balloon;
FIG. 6 is a schematic view of the matching structure of the daub bag and the communicating tube;
FIG. 7 is a schematic view of the extruded daub bags in cooperation with the communicating tube;
FIG. 8 is a schematic view of a detection bag configuration;
FIG. 9 is a schematic view of a cone inserted into a sealing post with cement applied to the sealing post and into the barrier;
FIG. 10 is an enlarged view of a portion of FIG. 9;
FIG. 11 is a schematic view of a construction in which the barrier is folded under pressure;
FIG. 12 is a schematic view of the structure in which all the components are housed within the support cell.
In the figure, the position of the upper end of the main shaft, a pressurizing part 100, a supporting bag 110, a squeezing bag 120, a sealing bag 130, a ventilating bag 140, an air inlet head 141,
A sampling part 200, a detection bag 210, a septum 211, a conical head 212, a partition 213, a sealing column 214, an opening 215, a plaster bag 220, a sealing bag 221, a bag mouth 222, plaster 223, an isolation tube 224,
A communicating pipe 230, a glue outlet 231 and a connector 232;
carrying the bag 300.
Detailed Description
To facilitate an understanding of the invention, the invention will now be described more fully hereinafter with reference to the accompanying drawings. Preferred embodiments of the present invention are shown in the drawings. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein. Rather, these embodiments are provided so that this disclosure will be thorough and complete.
It will be understood that when an element is referred to as being "secured to" another element, it can be directly on the other element or intervening elements may also be present. When an element is referred to as being "connected" to another element, it can be directly connected to the other element or intervening elements may also be present. The terms "vertical," "horizontal," "left," "right," and the like as used herein are for illustrative purposes only and do not represent the only embodiments.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. The terminology used herein in the description of the invention is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the term "and/or" includes any and all combinations of one or more of the associated listed items.
Example one
As shown in fig. 1-12, a sampling and cleaning device for detecting vomit of neurosurgical patients comprises a pressurizing part 100 and a sampling part 200;
the pressurizing part 100 is used for extruding the containing bag 300 filled with vomitus to ensure that the vomitus enters the sampling part 200;
the pressure price part 100 includes a support bladder 110 and a pressing bladder 120;
the support bag 110 is cylindrical after being inflated;
the extrusion bag 120 is positioned in the support bag 110, and the extrusion bag 120 extrudes the containing bag 300 after being expanded;
the sampling unit 200 includes a detection bag 210 and a communication pipe 230;
the sensing bag 210 is communicated with a communicating tube 230, and the communicating tube 230 is used for inserting the containing bag 300 and guiding vomitus into the sensing bag when the containing bag 300 is squeezed by the squeeze bag 120.
The pressurizing part 100 and the sampling part 200 are made of plastic.
The supporting bag 110 and the squeezing bag 120 are respectively provided with an inflation port;
the openings at the upper end and the lower end of the supporting bag 110 are provided with the straps, and the straps can tie up and close the openings of the supporting bag 110.
The support cell 110 is composed of a plurality of unit cells whose length directions are parallel to the axis of the inflated cell, and the unit cells are communicated with each other.
As shown in fig. 1-4, the device as a whole can be a disposable product and can be made of common plastics. Compared with complex mechanical equipment in the prior art, the medical staff and patients can use the equipment more conveniently.
After the patient vomits in the garbage can, the garbage bag, namely the holding bag 300, is directly placed into the supporting bag 110. At this time, the communicating tube 230 is inserted into the pouch 300. The support cells 110 and the compression cells 120 are then inflated, either separately or together. The bag 120 presses the bag 300, and the opening of the bag 300 may be within the pressing range of the bag 120, so that the bag 120 presses the opening of the bag 300 to reduce or prevent the vomitus from overflowing, and the vomitus is pressed into the detection bag 210.
Example two
After the bearing bag is pressed, vomitus is easy to overflow from the bag mouth. To improve sealing, a sealing bladder 130 is added, as shown in FIGS. 1-5.
The sealing bag 130 is fixedly connected with the communicating pipe 230 in a sealing way, and the diameter of the sealing bag 130 after being inflated is 1/6-1/4 of the diameter of the supporting bag 110 after being inflated.
In actual use, the mouth of the containing bag 300 is sleeved on the middle part of the sealing bag 130 and fixed by a bandage, and at this time, the orifice of the communicating pipe 230 is positioned in the containing bag 300. Bladder 130 is then inflated, which expands to seal the mouth of pouch 300. The inflation can be operated by a rubber ball, so that the manual control is convenient. Air cylinders or air pumps can also be used.
The sealing bag 130, the squeezing bag 120 and the supporting bag 110 are inflated through an inflating bag 140, the inflating bag 140 is also made of plastic and is provided with an inflating head 141 which is communicated with an air source, and a cavity in the inflating bag 140 is communicated with the sealing bag 130, the squeezing bag 120 and the supporting bag 110.
The sealing bladder 130, the pressing bladder 120 and the support bladder 110 are communicated with the ventilation bladder 140 through a tube made of a plastic film, and are easily closed by hand or by pinching with a clip.
EXAMPLE III
After the vomitus enters the detection bag 210, the detection bag 210 is separated from the pressurizing unit. However, the communicating tube 230 still has a lot of vomitus adhered thereon, which is not convenient for the detection of the inspector and is likely to cause cross infection, so that the sampling part 200 is further improved as shown in fig. 1 to 8.
The sampling part 200 further comprises a cement bag 220, wherein the cement bag 220 comprises a sealing bag 221, cement 223 and an isolation tube 224;
the daub bag 221 is internally sealed with daub 223, and the communicating pipe 230 passes through the daub bag 221;
the part of the communicating pipe 230 located in the cement bag 221 is provided with a cement outlet 231, the isolating pipe 224 is sleeved outside the communicating pipe 230 to isolate the cement outlet 231 from the cement, and the isolating pipe 224 is in sliding sealing fit with the communicating pipe 230;
one end of the cement bag 230 is fixedly connected with the pipe wall of the communicating pipe 230 in a sealing way, and the other end of the cement bag is fixedly connected with the isolating pipe 224 in a sealing way; the isolating pipe 224 moves to open the glue outlet 231;
the communicating pipe 230 is divided into two parts, and is connected to a coronary pipe through a connector 232 connected by screw threads, and the connector 232 is located on one side of the cement bag 220 far away from the detection bag 210.
In use, after the vomitus is completely introduced into the detection bag 210, the isolation tube 224 is pulled to one side so that the mastic 223 can be introduced into the communicating tube 230. At this time, the sealing bag 221 is pressurized so that the mastic 223 can enter the tubes on both sides of the mastic outlet 231. After the daub enters the connector 232, the two sections of the communicating pipes 230 at the connector 232 are disassembled, and the section adhered with the vomitus is plugged into the containing bag 300. And the other section is sent to the laboratory along with the test pouch 210. Because the viscosity of the daub is very big and is not easy to dissolve, the pipeline can be plugged, vomitus is prevented from flowing out of the pipeline, and meanwhile, the detection is not influenced.
Example four
Since the detection bag 210 is a soft bag, it is inconvenient to extract vomit. If the detection bag is cut open, the remaining vomit is easy to flow out, the smell is bad, and the risk of cross infection is also existed. Thus, a further modification of the detection bag 210 is provided, as shown in FIGS. 1-12.
The detection bag 210, the diaphragm 211, the conical head 212, the interlayer 213 and the sealing column 214;
the diaphragm 211 is positioned on the inner wall of the detection bag 210 close to the communicating pipe 230 in the detection bag 210 and is fixedly connected in a sealing way;
the conical head 212 is a conical tube, and the outer wall of the conical head is fixedly connected with the diaphragm 211 in a sealing manner; the conical head 212 and the communicating pipe 230 extend into the pipe orifice of the detection bag 210 to be connected in a buckling mode, and the conical head 212 can be separated from the communicating pipe 230 under the drawing action of external force;
the partition 213 is located at one end of the detection bag 210 close to the communicating tube 230, the partition 213 is made of plastic sheet, the top edge is fixedly connected with the bottom edge of the diaphragm 211 in a sealing manner, and the remaining three edges of the partition 213 are fixedly connected with the inner wall of the detection bag 210 in a sealing manner; the interlayer 213 is provided with two nicks parallel to the length direction of the detection bag 210;
a sealing column 214 is fixed on the upper side of the interlayer 213, the conical head 212 is detached, and the lower aperture end is inserted on the sealing column 214, and the sealing column 214 can seal the conical head 212.
In use, after vomit enters the detection bag 210, the conical head 212 is pulled out and inserted on the sealing column 214. The daub is squeezed to enter the communicating pipe 230, the daub 223 enters the interlayer 213 at the moment, the detection bag 210 is flexible, the interlayer 213 is provided with nicks, and under the squeezing action of the daub, the interlayer 213 is bent and shaped, so that the cross section of one end of the detection bag 210 is basically in a trapezoid shape. This facilitates opening 215 in the upper surface of the detection bag 210 to facilitate the extraction of vomit.
After use, the detecting bag can be opened on the squeezing bag 120 and thrown into the squeezing bag 120, and then the upper and lower openings of the supporting bag 110 are fastened by a binding belt and thrown into a garbage can together, as shown in fig. 12.
The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made to the present invention by those skilled in the art. Any modification, equivalent replacement, or improvement made without departing from the spirit and principle of the present invention shall fall within the protection scope of the present invention.
Claims (7)
1. A device for detecting, sampling and cleaning vomit of a neurosurgical patient, which is characterized by comprising a pressurizing part (100) and a sampling part (200);
the pressurizing part (100) is used for extruding the containing bag (300) filled with vomitus to ensure that the vomitus enters the sampling part (200);
the pressurization part (100) comprises a supporting bag (110) and a squeezing bag (120);
the supporting bag (110) is cylindrical after being inflated;
the extrusion bag (120) is positioned in the support bag (110), and the bearing bag (300) is extruded after the extrusion bag (120) is expanded;
the sampling unit (200) comprises a detection bag (210) and a communication pipe (230);
the detection bag (210) is communicated with the communicating pipe (230), the communicating pipe (230) is used for inserting the containing bag (300), and when the containing bag (300) is extruded by the extrusion bag (120), vomitus is guided to enter the detection bag;
the supporting bag (110) consists of a plurality of unit bags with the length directions parallel to the axis after inflation, and the unit bags are communicated with each other;
the pressurizing part also comprises a sealing bag (130) which is fixedly connected with the communicating pipe (230) in a sealing way, and the diameter of the inflated sealing bag (130) is 1/6-1/4 of the diameter of the inflated supporting bag (110);
the sampling part (200) further comprises a cement bag (220), and the cement bag (220) comprises a sealing bag (221), cement (223) and an isolation pipe (224);
the daub bag (221) is internally packaged with daub (223), and the communicating pipe (230) penetrates through the daub bag (221);
the part of the communicating pipe (230) positioned in the daub bag (221) is provided with a daub outlet (231), the isolating pipe (224) is sleeved outside the communicating pipe (230) to isolate the daub outlet (231) from the daub, and the isolating pipe (224) is in sliding sealing fit with the communicating pipe (230);
one end of the cement bag (230) is fixedly connected with the pipe wall of the communicating pipe (230) in a sealing way, and the other end of the cement bag is fixedly connected with the isolating pipe (224) in a sealing way; the isolating pipe (224) moves to open the glue outlet (231);
the communicating pipe (230) is divided into two parts, a connecting head (232) connected through threads is connected into a coronary pipeline, and the connecting head (232) is positioned on one side of the cement bag (220) far away from the detection bag (210).
2. The neurosurgical patient vomit detection, sampling and cleaning device according to claim 1, wherein the pressurizing part (100) and the sampling part (200) are made of plastic.
3. The neurosurgical patient vomit detection, sampling and cleaning device of claim 1, wherein the supporting bag (110) and the squeezing bag (120) are provided with respective inflation ports.
4. The neurosurgical patient vomitus detection, sampling and cleaning device as claimed in claim 1, wherein the openings at the upper and lower ends of the supporting bag (110) are provided with a binding belt, and the binding belt can bind and close the opening of the supporting bag (110).
5. The neurosurgical patient vomit detection, sampling and cleaning device as claimed in claim 1, wherein the communicating tube (230) is fixed inside the sealed capsule (130) or fixed on the outer wall of the sealed capsule (130).
6. The neurosurgical patient vomit detection, sampling and cleaning device according to claim 5, wherein the sealing bag (130), the squeezing bag (120) and the supporting bag (110) are inflated by an air inflation bag (140), the air inflation bag (140) is also made of plastic and is provided with an air inflation head (141) which is communicated with an air source, and a cavity in the air inflation bag (140) is communicated with the sealing bag (130), the squeezing bag (120) and the supporting bag (110).
7. The neurosurgical patient vomit detection, sampling and cleaning device according to claim 1, wherein, the detection bag (210), the diaphragm (211), the conical head (212), the isolation layer (213) and the sealing column (214);
the diaphragm (211) is positioned on the inner wall of the detection bag (210) close to the communicating pipe (230) in the detection bag (210) and is fixedly connected in a sealing way;
the conical head (212) is a conical tube, and the outer wall of the conical head is fixedly connected with the diaphragm (211) in a sealing way; the conical head (212) is in snap-fit connection with a pipe orifice of the communicating pipe (230) extending into the detection bag (210), and the conical head (212) can be separated from the communicating pipe (230) under the drawing action of external force;
the interlayer (213) is positioned at one end of the detection bag (210) close to the communicating pipe (230), the interlayer (213) is made of plastic sheets, the top edge of the interlayer is fixedly connected with the bottom edge of the diaphragm (211) in a sealing way, and the remaining three edges of the interlayer (213) are fixedly connected with the inner wall of the detection bag (210) in a sealing way; the interlayer (213) is provided with two nicks parallel to the length direction of the detection bag (210);
a sealing column (214) is fixed on the upper side of the interlayer (213), the conical head (212) is detached, the lower aperture end is inserted on the sealing column (214), and the sealing column (214) can seal the conical head (212).
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202211118466.2A CN115200937B (en) | 2022-09-15 | 2022-09-15 | Neurosurgery patient vomitus detects sample cleaning device |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202211118466.2A CN115200937B (en) | 2022-09-15 | 2022-09-15 | Neurosurgery patient vomitus detects sample cleaning device |
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| CN115200937A CN115200937A (en) | 2022-10-18 |
| CN115200937B true CN115200937B (en) | 2023-04-14 |
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| CN202211118466.2A Active CN115200937B (en) | 2022-09-15 | 2022-09-15 | Neurosurgery patient vomitus detects sample cleaning device |
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Family Cites Families (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CA2391641A1 (en) * | 2002-06-28 | 2003-12-28 | Robert Longin | Robotic platform of cellular cultures in miniaturized reactor batteries, equipped with a system for real-time measurement of cell turbidity and all other optical properties |
| DK177496B1 (en) * | 2012-10-03 | 2013-07-22 | Goloo Aps | Urine bag for collecting body fluids |
| CN112567222A (en) * | 2018-06-09 | 2021-03-26 | 托德·科尔曼 | Apparatus and method for gas sampling container |
| CN210612544U (en) * | 2019-05-31 | 2020-05-26 | 田甜 | Vomitus collector |
| WO2021098875A1 (en) * | 2019-11-23 | 2021-05-27 | 江苏恒爱医疗器械有限公司 | Isopressure support assembly, isopressure mattress and isopressure bed |
| CN213407024U (en) * | 2020-07-15 | 2021-06-11 | 中国人民解放军陆军军医大学第一附属医院 | Vomiting device for gastroenterology |
| CN214804892U (en) * | 2021-02-25 | 2021-11-23 | 皖南医学院第一附属医院（皖南医学院弋矶山医院） | Vomitus sampling device is used in gastroenterology nursing |
| CN215458229U (en) * | 2021-04-14 | 2022-01-11 | 中国人民解放军总医院第二医学中心 | Sampler is used in gastroenterology nursing |
| CN114948746A (en) * | 2022-04-29 | 2022-08-30 | 河南大学淮河医院 | Vomitus sampling device is used in gastroenterology nursing |
| CN114733838B (en) * | 2022-06-13 | 2022-09-02 | 山东第一医科大学第一附属医院(山东省千佛山医院) | High-efficient cleaning device is used in internal medicine nursing |
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