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Chapter: Medicine Study Notes : Surgical and Fluid Management

IV Cannulation

Superficial veins of the arm: metacarpal, dorsal venous arch, cephalic (radial – thumb side), basilic (ulnar), median antebrachial, antecubital.

IV Cannulation

 

·        Superficial veins of the arm: metacarpal, dorsal venous arch, cephalic (radial – thumb side), basilic (ulnar), median antebrachial, antecubital


·        Parts of a cannula: bevel, stylet, catheter, hub of catheter, flash back chamber, air vent

 

·        Cannulation procedure: blood return, level off, advance catheter, release tourniquet, pressure upstream remove stylet


·        ¯Haematoma by ¯angle of insertion, ¯force

 

·        Keeping it going: if infusion stopped, blood can track back through cannula and clot. Intermittent flushing with saline helps

 

·        If hemiplegia, or mastectomy, insert in good arm


·        Infiltration/tissuing is leakage into surrounding tissues. Will be pale, cold, boggy, painful. If red and warm then infection


·        Phlebitis = inflammation of the vein.  Caused by

o   Infection

o   Chemical irritation (eg antibiotics, especially erythromycin)

o   Mechanical


·        Consequences of infection: inflammation of skin, cellulites or bacteraemia


·        Minimising infection: hand washing, sterile equipment, site care and regular inspection


·        Always record in notes: date and time of insertion, what gauge, what vein


·        Replace every 72 hours, unless inserted in emergency in which case replace in 6 – 8 hours 


·        Consent: check armband, explain reasons for iv therapy, duration, what‟s being infused, possible complications. Obtain verbal consent


·        Choice of gauge: age, flow required, what‟s being infused.




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