Академический Документы
Профессиональный Документы
Культура Документы
IV CANNULATION
IV THERAPY, VENIPUNCTURE Tunica Intima
the inner layer of the vessel
Basic Intravenous Therapy One layer of endothelial
90-95% of patients in the hospital receive some type of No nerve endings
intravenous therapy. Surface for platelet aggregation w/trauma and recognition
This presentation will enhance your knowledge of how to of foreign object at this level
care for them PHLEBITIS begins here
Page 1 of 6 by jam
Supplies (cont’d)
o Infusion Sets
10 or 15 gtt/cc (large/macro drip)
60 gtt/cc
(small/micro drip)
“Select-3”
o Alcohol and Betadine
o Restricting Band
o “Tegaderm” / “Venigard”
o Tape
o Armboard (optional)
o Labels
o Saline Lock (optional)
Gauges
Basilic Needles & Catheters are sized by diameters which are
o Originates from the ulner side of the called gauges.
metacarpal veins and runs along the medial Smaller diameter = larger gauge
aspect of the arm. It is often overlooked IE: 22-gauge catheter is smaller than a 14-gauge
becauses of its location on the “back” of the Larger diameter = more fluid able to be delivered
arm, but flexing the elbow/bending the arm If you need to deliver a large amount of fluid, typically 14-
brings this vein into view or 16-gauge catheters are used.
Page 2 of 6 by jam
Tips on Increasing Flow o If the patient is NOT allergic to latex, using a
Use a large vein latex tourniquet may provide better venous
o Large AC preferred for cardiac arrest, trauma, congestion
adenosine & D50 administration o Avoid areas of joint flexion
Use a short, large bore catheter o Start distally and use the shortest
1/4
o 1 ” 14 g length/smallest gauge access device that will
Use short tubing with large drip set properly administer the prescribed therapy
o Macrodrip (10 gtts/ml) and NO extension set (BE AWARE: Blood flow in the lower forearm and hand is 95ml/min)
Use warm fluid with pressure infuser
Selection of an insertion point.
Venipuncture Procedure: Tips Evaluate the patient veins.
Select the vein and point of insertion remembering:
o cannula should be positioned at the opposite
side of body in respect to the planned surgery
o the median cavitalvein should be reserved for
blood sampling
o the sites previously irritated by injection or
cannulation should be avoided
o the insertion site should be easily approached
and the presence of cannula should not
create patient discomfort.
Page 3 of 6 by jam
Withdraw the needle completely
Press a finger on the vein above the insertion point to
Hold the cannula firmly with three points grip
avoid blood spillage
Such grip minimizes the risk of contamination and
ensures correct positioning between the needlepoint
and the catheter tip.
Page 4 of 6 by jam
of the cannula which can result in mechanical o Neonate (umbilical vein)
irritation of the vein Any drug or fluid that can be given IV may be given by the
Check the correct placement of the catheter by IO route
injecting about 5 ml of sterile physiological saline. Little interference during Resuscitation
Record date and time of insertion
Potential IV sites
For medicine administration and cannula cleaning the
injection port can be used. Port not in use must remain
covered by protection cap.
For repeated injections at short intervals the syringe can
be left in the port
Page 5 of 6 by jam
Intraosseous (IO) Infusion
Procedure
o Same as peripheral IV
o Place leg on firm surface. Locate landmarks
o Grasp the thigh and knee. Do not place hand
behind insertion site.
o Palpate landmarks and identify site of insertion.
o Clean site if time permits
o Insert needle at 90° angle. Apply pressure with
firm twisting motion.
o Stop advancing once needle resistance is
decreased
o Remove stylet.
o Inject saline. Check for resistance or soft tissue
swelling.
o Connect infusion set
o Stabilize
Considerations
o Gravity flow of IV fluids will typically be
ineffective. Use pressure bags if continuous
infusion is required
o Fluid is best administered as a syringe bolus
using an extension set or T-connector
o PROTECT YOUR IO SITE!
Potential Complications
o Sepsis (infection)
o Hematoma
o Cellulitis
o Thrombosis
o Phlebitis
o Catheter fragment embolism
o Infiltration
o Air embolism
Page 6 of 6 by jam