Introduction to IV Cannulation
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Questions and Answers

What is the main cause of needlestick injuries according to the content?

  • Lack of personal protective equipment
  • Improper disposal of needles
  • Double handling during procedures (correct)
  • Use of retractable safety IVs

Which of the following statements about retractable safety IVs is true?

  • They require additional training for their use.
  • They are not recommended for use in clinical settings.
  • They eliminate the risk of needlestick injuries completely.
  • They still pose a risk of needlestick injuries. (correct)

When should a needle be disposed of to reduce the risk of injury?

  • At the end of the procedure only
  • During the procedure every few minutes
  • Immediately after the procedure is performed (correct)
  • Only after a needlestick injury occurs

What treatments might be required for a person who suffers from a bite injury?

<p>Antibiotics and tetanus toxoid (A)</p> Signup and view all the answers

How can the occurrence of needlestick injuries be effectively reduced?

<p>Through proper training and immediate disposal of needles (D)</p> Signup and view all the answers

Where is the epidermis thickest?

<p>On the palms of the hands and soles of the feet (A)</p> Signup and view all the answers

What is the primary function of the epidermis?

<p>To act as a barrier against infection (B)</p> Signup and view all the answers

Which layer of blood vessels contains smooth muscle and responds to temperature changes?

<p>Tunica media (B)</p> Signup and view all the answers

What structural feature is unique to veins to facilitate blood flow?

<p>One-way venous valves (B)</p> Signup and view all the answers

What percentage of the vessel diameter does the tunica intima account for?

<p>10% (C)</p> Signup and view all the answers

What type of tissue primarily makes up the tunica externa?

<p>Connective tissue (A)</p> Signup and view all the answers

How many venous valves are typically found between the hand and axilla?

<p>40 (D)</p> Signup and view all the answers

What is the outermost layer of blood vessels called?

<p>Tunica externa (D)</p> Signup and view all the answers

What aspect of vein insertion is highlighted as a key consideration in the video?

<p>Advancing and pulling out the needle simultaneously. (B)</p> Signup and view all the answers

What is recommended to do with sharps immediately after use?

<p>Dispose of them in a designated sharps container. (A)</p> Signup and view all the answers

What is the potential risk if the needle is not fully retracted into the barrel before disposal?

<p>Needle-stick injury could occur. (A)</p> Signup and view all the answers

What should one ensure before advancing the catheter?

<p>The catheter is properly primed. (D)</p> Signup and view all the answers

Which best describes the approach to working with the vein as mentioned in the video?

<p>Creating a plan for vein selection and insertion. (C)</p> Signup and view all the answers

How is the packaging suggested to be used in vein insertion procedures?

<p>To place equipment into for ease of access. (B)</p> Signup and view all the answers

What is NOT a recommended practice while handling needles during IV insertion?

<p>Pulling the needle out simultaneously with the catheter without a firm grip. (B)</p> Signup and view all the answers

Documentation discussed in the video focuses on what aspect of the procedure?

<p>The detailed steps taken during the IV insertion. (A)</p> Signup and view all the answers

What was the percentage of peripheral vascular access (PVA) placements that were unused in the pre-hospital setting?

<p>46% (D)</p> Signup and view all the answers

What proportion of the unused PVAs were associated with patients having a lower case severity?

<p>66% (D)</p> Signup and view all the answers

During the study period, what percentage of patients had a PVA inserted?

<p>26% (A)</p> Signup and view all the answers

Approximately how many patients had a PVA placed over the 12-month study period?

<p>4000 patients (B)</p> Signup and view all the answers

What does the study suggest about the expectation of EMS personnel regarding catheter use by hospital staff?

<p>Hospital personnel can place catheters under better conditions. (A)</p> Signup and view all the answers

What was the case severity score threshold that indicated lower case severity in the study?

<p>&lt; 4 (B)</p> Signup and view all the answers

What is a possible reason for the high percentage of unused peripheral vascular access?

<p>Patients were transferred before hospital arrival. (B)</p> Signup and view all the answers

Which statement best summarizes the findings related to the placement of PVAs?

<p>A significant portion of PVAs placed were not used. (A)</p> Signup and view all the answers

Which site is the most appropriate for locating a venepuncture for IV insertion?

<p>Antecubital fossa (C)</p> Signup and view all the answers

What characteristics must a suitable vein have for IV cannulation?

<p>It should be engorged and elastic (A)</p> Signup and view all the answers

Why is it important to select veins that are proximal to previous IV sites?

<p>To prevent complications from previous attempts (A)</p> Signup and view all the answers

Which of the following veins is NOT ideal for IV cannulation?

<p>Veins that are hard and bumpy (B)</p> Signup and view all the answers

What is the best strategy when selecting a vein for IV cannulation?

<p>Aim for the most distal part of the limb and work proximally (B)</p> Signup and view all the answers

Which statement about vein characteristics is true for IV cannulation?

<p>Veins should be supported by elastic skin for better stability (A)</p> Signup and view all the answers

What type of veins should be avoided for IV cannulation?

<p>Veins that are flat and hard (A)</p> Signup and view all the answers

Which condition is important for veins selected for IV cannulation?

<p>They should not have any visible valves (B)</p> Signup and view all the answers

What can lead to the introduction of skin flora into the system during cannulation?

<p>Improper site swabbing and preparation (A)</p> Signup and view all the answers

Which of the following is a method to prevent infection in medical procedures?

<p>Using in-date sterile equipment (B)</p> Signup and view all the answers

What does inadequate flushing of an IV device contribute to?

<p>Increased risk of bacterial colonization (B)</p> Signup and view all the answers

Which factor is crucial for preventing contamination of the catheter hub?

<p>Aseptic technique during handling (B)</p> Signup and view all the answers

What practice should be followed when handling infusates to avoid infection?

<p>Checking for clarity and expiry (A)</p> Signup and view all the answers

What is essential during cannulation preparation according to best practices?

<p>Constant awareness of equipment use (B)</p> Signup and view all the answers

What does the term 'non-touch technique' refer to in infection prevention?

<p>Post-swab technique minimizing contact (D)</p> Signup and view all the answers

What role do paramedics play in the context of hospital-acquired infections?

<p>They can both improve and worsen infection management. (A)</p> Signup and view all the answers

What is a major risk associated with contamination of an infusate?

<p>Increased potential for infection (C)</p> Signup and view all the answers

What is emphasized as crucial to developing a good cannulation technique?

<p>Preparation of the cannulation area (D)</p> Signup and view all the answers

Flashcards

IV insertion video

A video demonstrating the process of inserting an intravenous catheter.

Extension Leur device

A device used to extend the length of an intravenous catheter.

Needle advancement & retraction

Simultaneous pushing and pulling the needle to remove it from vein.

Sharps disposal

Immediate proper disposal of used sharps to prevent needle-stick injuries.

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Needle-stick injury

A puncture wound from a contaminated needle that can transmit bloodborne pathogens.

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Immediate sharps disposal

The crucial need to immediately and properly dispose of used sharps.

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Documentation

Important part of IV procedure, recording the process.

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Proper vein selection

Technique of choosing suitable veins for IV insertion.

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Epidermis Thickness

Thickest on palms/feet, thinnest on extremities; varies by age and sun/wind exposure.

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Epidermis Function

First skin line of defense against infections.

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Dermis Layer (description)

Thicker, more sensitive layer with nerves, blood vessels, hair follicles, glands, and muscles.

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Blood Vessel Structure

Veins/arteries have three layers (tunics): External, Middle, and Inner.

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Tunica Externa

Outermost layer of blood vessel; supportive connective tissue.

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Tunica Media

Middle layer of blood vessel; primarily smooth muscle, nerves for contraction/relaxation, responding to stimuli.

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Tunica Intima

Innermost blood vessel layer, less muscular and thin, consisting of epithelium, basement membrane, and elastin fibres.

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Vein Valves

One-way valves in veins that direct blood flow, often near branches.

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Unused PVAs

Peripheral vascular access (IV or IO) placed in a pre-hospital setting, but not used.

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Patient Case Severity

A measure of the seriousness of a patient's condition (NACA score).

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Low Case Severity

Patients with a lower NACA score (<4) were more likely to have unused PVAs.

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PVA Placement in Study Period

About 26% of patients received a PVA during the 12-month study.

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Number of Patients

Nearly 4000 patients over a 12-month period.

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Hospital PVA Placement

Hospitals are better suited to IV insertion due to proper conditions and simultaneous blood draws.

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Pre-Hospital PVA Usage

EMS teams inserting Peripheral Vascular Access (IV or IO) while in the pre-hospital environment

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Unused PVA Percentage

About 46% of pre-hospital PVAs were unused.

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Needlestick injury prevention

Properly disposing of needles immediately after use can significantly reduce the risk of needlestick injuries.

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Double handling

Handling needles in a way that increases the risk of a needlestick injury.

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Retractible safety IVs

IVs designed to reduce, but not eliminate the risk of needlestick injury.

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Antibiotics for bites

Antibiotics and tetanus toxoid may be necessary to treat a person bitten by something potentially contaminated.

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Immediate sharps disposal

The critical action of immediately disposing of used needles.

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Hospital-acquired Infections

Infections that develop after a patient is admitted to a hospital or other healthcare facility.

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Contamination of IV site

Introduction of pathogens into the patient's system through the IV access site.

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Aseptic Technique

Methods used to prevent contamination and infection, crucial for IV procedures.

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Contaminated Catheter Hub

A contamination source for IV lines, if sterile technique is not followed.

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Infusate Contamination

Infections result from unclean IV fluids or drugs.

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Hematogenous Colonization

Infections spreading through the bloodstream to the IV device.

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Sterile Equipment

Equipment that is free of microorganisms and used to prevent infections.

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Non-touch Technique

Avoiding direct contact with skin or equipment when handling IV sites.

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Cannulation Preparation

Thorough preparation and site care are essential in the IV technique.

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Paramedic's Role (IV)

Paramedics are crucial in either worsening or improving hospital-acquired infections with their actions.

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Ideal Vein for IV

Round, firm, elastic, and engorged veins in the antecubital fossa, forearm, or hand's back, proximal to previous attempts.

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Poor Vein Characteristics

Veins that are hard, bumpy, flat, not smooth, or don't have good elasticity are unsuitable for IV cannulation.

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Distal Vein Selection

Starting with the furthest point (distal) of a limb, moving towards the body (proximal) as needed for IV insertion.

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Antecubital Fossa

The inner elbow crease, a common site for choosing veins for IV and blood draws due to its accessible veins.

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Venepuncture Site

The area where a needle is inserted for drawing blood or inserting an IV.

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IV Cannulation Site Selection

The process of carefully choosing the best and appropriate vein for inserting an IV line.

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Vein Properties for IV

Soft, straight, elastic, easily palpated, stabilized, supported by stable skin, and free of valves (no obstructions).

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Previous IV Site Avoidance

Choosing veins that are above or not close to previous IV insertion points or prior phlebotomy procedures.

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Study Notes

Introduction to IV Cannulation

  • IV cannulation is a core skill for paramedics.
  • It involves inserting a catheter into a vein to deliver fluids and medications directly into the bloodstream.
  • The introductory material covers the theory and background information required before practicing IV cannulation.
  • Successful completion of a summative assessment allows for supervised practice.

Study Goals

  • Describe the anatomy and physiology of blood vessels, including the three layers and function of each layer.
  • Understand the structure and function of veins, how they differ from arteries and venous valves, and the location and function of nerves in the peripheral limbs, especially the arms and hands.
  • Understand the crucial role of infection control, emphasizing asepsis and hand hygiene, for safe IV practice.
  • Identify the importance and indications of IV cannulation, especially for specific populations like the elderly or children.
  • Know and apply safe practices for selecting and accessing veins in different scenarios and locations, avoiding compromised areas.
  • Be familiar with potential risks and complications like needle-stick injuries or thrombosis

Anatomy and Physiology Review

  • Blood vessels, like veins and arteries, are composed of three layers ('tunica').
  • The outermost layer is the tunica externa, which supports the vessel.
  • The middle layer (tunica media) contains smooth muscle for blood vessel contraction or relaxation.
  • The innermost layer, tunica intima, is a thin layer that lines the vessel lumen.
  • Veins contain one-way valves to prevent backflow of blood.

Infection Control

  • IV cannulation breaches the skin's protective barrier and carries a risk of infection.
  • Maintaining strict infection control protocols during and before insertion is vital.
  • Aseptic technique is mandatory during preparation, procedure, and post-procedure.

Vein Selection

  • Proper vein selection is essential to success.
  • Ideal veins are soft, straight, elastic, easily palpated and stabilized.
  • The antecubital fossa is the most common location, but other suitable veins exist up the arm.
  • Veins used before need to be considered, and areas like mastectomies/CVA hemiparesis, AV fistulas, or lower extremities require caution.

Preparing the Patient

  • Patients must provide informed consent for procedures.
  • Prior to cannulation, consider the patient's circumstances and position to reduce anxiety and increase the chances of success.
  • Proper positioning, preparation, and communication are essential.

Cannulation Technique and Safety

  • Detailed cannulation techniques have been covered in available videos.
  • Safety precautions outlined by the text include sharps disposal and maintaining appropriate care standards throughout.
  • Comprehensive documentation of each cannulation procedure is required for quality assurance.

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Description

This quiz covers the fundamental concepts of IV cannulation, a vital skill for paramedics. It includes the anatomy of blood vessels, infection control practices, and the specific needs of different populations. Successfully completing this assessment prepares you for supervised practice in IV cannulation.

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