外周静脉穿刺规范(美国德州大学)

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　　美国德克萨斯州立大学健康科学中心麻醉系的讲座，Naveen Vanga MD主讲，推荐。

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yangxuewei1974

真标准，但是我们由护士扎静脉，也该练练了，感叹！

stw0509

外周静脉穿刺规范（美国德州大学）

Peripheral intravenous catheter placement

Hi I am doctor naveen vanga, and I am going to expain the steps of intravenous catheter placement

Let’s Expaining the steps , its important to realize that supplies ,and techniques may vary in other institutions ,but the overall ,method is the same.

Materials

As with any anesthetic precedure ,the key of success is adequate preparation ,let’s take a look at some supplies we can need 4by4’s, antiseptic prep material ,a tourniquet, saline flush,
cap for the catheter, the catheter itself, the tegaderm, and optionally local anesthetic,

Selecting a location

Selecting location of intravenous catheter should involve some considerations, its best to avoid regions involving the precedure, for example ,the patient is presenting for left elbow surgery, peripheral IV placement of the left arm should be avoided; certain medical conditions should also be considered, for example ,IV placement of lower extremities usually be avoided in diabetics ,or patients with the history of left mastectomy should have intravenous catheters placed on the contralateral side.

Placing the catheter

After a vein has been selected, apply the tourniquet and identify the vein, After a vein has been selected, prep the skin generously, apply the local anesthetic creating a 5mm skin wheel with care not to puncture the vein, now we are ready to place the catheter, first apply traction to the skin, then insert the catheter through the skin approaching the vein, as you entered the vein ,the blood will enter through the catheter and what is called the flush ,advance the catheter 1 to 2 more mm, and then thread the catheter, the vein has been successfully cannulated.

Let’s pause for a moment and take a look at some of the errors that commonly made. first commonly error is that the needle pass too far going entirely through the vein placing the catheter outside the vessel another common error is the needle has entered the vein causing a flush, but the catheter tip is not in the lumen of the vein preventing the catheter from threading properly, proper placement
cause for the needle to be inserted the entire catheter tip is in the lumen of the vein, and then the vein can be cannulated.

Back to the procedure

Remove the tourniquet , optionally apply some 4by4’s under the catheter to keep the area clean, replace the catheter cap, and then flush the IV. we are now ready to dress the catheter, methods for dressing catheters are going to vary, but the very least apply tegederm to the side .

The patient now has successfully placed IV catheter, learning place IV catheter can be challenging, and even frustrating, but what enough pratices it is the skill that certainly can be matered.