Venipuncture & Cannulation Procedure PDF

Venipuncture & canulation By Nithin Raj February 12, 2025 February 12, 2025 www.gmu.ac.ae 1 College of Health Priphe...

Venipuncture & canulation By Nithin Raj February 12, 2025 February 12, 2025 www.gmu.ac.ae 1 College of Health Pripheral veins 2  IV Placement IV (intravenous) cannulation is a technique in which a cannula is placed inside a vein to provide venous access. The purpose is to: Obtain a blood sample Administer Fluids Meds TPN Chemo Blood products IV Access Devices Peripheral catheter Peripherally inserted central catheter (PICC line) Central line Jugular Subclavian Femoral IV cannula parts Iv Cannula size Supplies Needed Tourniquet Saline flush 5 mL Cotton balls Saline bag Gauze IV tubing set Alcohol pads IV start kit IV catheter (20 or 22 Sharps container gauge) Extensi on set/con nector Site Selection Factors to consider: Extensive scarring or healed burn areas should be avoided Avoid areas containing trauma IVs should not be placed on the same side as a mastectomy Avoid areas of hematoma Avoid placing an IV in an arm having a cannula, fistula, or vascular graft If patient is going to be transported to a facility for additional medical care, place the IV as distally as possible. Avoid areas where the vein bifurcates 10 11  PROCEDURE FOR VEIN SELECTION 1. Palpate and trace the path of veins with the index finger. Arteries pulsate, are most elastic, and have a thick wall. Thrombosed veins lack resilience, feel cordlike, and roll easily. 2. If superficial veins are not readily apparent, you can force blood into the vein by massaging the arm from wrist to elbow, tap the site with index and second finger, apply a warm, damp washcloth to the site for 5 minutes, or lower the extremity over the bedside to allow the veins to fill. 3. Healthy veins feel soft and bouncy and will refill when depressed Methods to improve venous access 1. Application of a Tourniquet  Promotes venous distension The tourniquet should be tight enough to impede venous return but not restrict arterial flow The tourniquet should be placed about 7 – 8 cm above the venipuncture site. The tourniquet should not be left on for longer than 1 minute as it may result in hemoconcentration or pooling of the blood, leading to inaccurate blood results. Skin preparation Asepsis is vital when performing venipuncture as the skin is breached and a foreign device is introduced into a sterile circulatory system Skin cleaning is a debated subject and it is acknowledged that a quick wipe with an alcohol swab does more harm than good as it disturbs the skin flora. Venipuncture*Procedure Approac Approach and Communication h Introduc Introduce yourself & check patient’s ID e Explain Explain what you would like to do & why. Gain consent for the procedure & check for Gain allergies, shunts, etc. Review the treatment plan & individuals' Review history as necessary Talk the patient through it in a considerate Talk and courteous manner Venipuncture*Procedure Sterility Wash hands Clean and prepare procedure tray according to guidelines Collect equipment into the tray taking care not to contaminate key parts Equipment Skin cleansing wipes – Tourniquet – Gloves – Gauze swabs – Adhesive dressing – Needles – Blood collection tube(s) – Sharps container.  VENEPUNCTURE Preparation: The patient should sit in a suitable chair or be lying down. Support arm on pillow or in other suitable manner & position the patient’s arm as needed. Check for any contra-indications e.g. infection or trauma Select suitable vein Clean site for 30 seconds (DO NOT TOUCH AGAIN) Leave to dry Release Tourniquet Inserting the Needle: Anchor the vein Grasp arm with your non-dominant hand Use thumb to pull skin taut Smoothly and confidently insert the needle bevel up 15 - 30-degree angle Inserting the Device As you continue to hold the skin taut, use the device's push-off tab to separate the catheter from the needle stylet Advance the catheter into the vein, watch for 2nd flashback in catheter Apply pressure on vein beyond catheter tip with finger of non-dominant hand to reduce blood leakage Extension Tubing Release the tourniquet Place 2x2 under the catheter hub Attach the saline flushed extension tubing Make sure connection tight Flush the catheter Dressing Apply a transparent semipermeable dressing the insertion site. Curl the extension set to the side and tape it to the patient's arm Do not place tape over clear dressing window Label the dressing with the current date and time Consider tubular netting to help secure catheter Must pull back netting every 2 hours for site assessment 23 IV Placement Steps (reminder) 1. Use universal precautions for bloodborne pathogens 2. Tie tourniquet on upper arm 3. Palpate and locate a vein 4. Insert the needle into the vein and get “flash” of blood 5. Advance the catheter and withdraw the needle 6. Release the tourniquet 7. Flush the IV with normal saline 8. Attach the IV tubing 9. Anchor the IV at the catheter site I.v cannulation complications: Infiltration and extravasation Infection - is a common complication of IV therapy. Thrombophlebitis - Peripheral Thrombophlebitis is caused by local damage to the venous wall with resultant inflammation and thrombus formation Air embolism Arterial placement Catheter fracture and embolism 25 Let’s practice!! 1. Givan GV, Diehl JJ. Intravenous fluid use in athletes. Sports Health. 2012;4(4):333-339. 2. American College of Sports Medicine; Armstrong LE, Casa DJ, Millard- Stafford M, et al. Exertional heat illness during training and competition: ACSM position stand. Med Sci Sports Exerc. 2007;39(3):5560572 3. References American College of Sports Medicine; Sawka MN, Burke LM, Eichner ER, Maughan RJ, Montain SJ, Stachenfeld NS. American College of Sports Medicine position stand: exercise and fluid replacement. Med Sci Sports Exerc. 2009,39(2):709-731. 4. Ganio MS, Casa DJ, Armstrong LE, Maresh CM. Evidence-based approach to lingering hydration questions. Clin J Sports Med. 2007;26(1):1-16. 5. Eichner ER. Heat Cramps in sport. Curr Sports Med Rep. 2008;7:178- 179.