IV Cannulation & Wound Dressing Procedures PDF

**IV Cannulation** **Equipment Needed:** **Item** **Size/Type/Color** **Purpose** ---------------------- --------------------------------------------------- -------------------------------------------------------------------------------------------...

**IV Cannulation** **Equipment Needed:** **Item** **Size/Type/Color** **Purpose** ---------------------- --------------------------------------------------- -------------------------------------------------------------------------------------------------- **IV Catheter** Gauges/14G, 16G, 18G, 20G, 22G, 24G (color-coded) Different sizes for varying patient types (larger for trauma, smaller for pediatric or elderly). **Tourniquet** Elastic, adjustable Used to engorge veins and make them more visible/palpable. **Antiseptic Swabs** Alcohol swabs or Chlorhexidine wipes Disinfects the insertion site to prevent infection. **Gauze** 2x2 or 4x4 gauze pads Used to clean the skin or absorb blood after cannulation. **Saline Flush** 10mL or 20mL syringe, saline solution To check catheter patency and maintain catheter lumen. **IV Line/IV Set** Primary IV line (with drip chamber) To administer fluids/medications via the IV catheter. **Dressing** Transparent dressing or gauze (with tape) To secure the IV catheter in place. **Gloves** Non-sterile (unless opening sterile pack) Protects from contamination and maintains aseptic technique. **Procedure & Rationale for IV Cannulation:** **Step** **Rationale** -------------------------------------------------- --------------------------------------------------------------------------------------------------- 1\. **Prepare the equipment** Ensure you have all necessary items to reduce delays or errors during the procedure. 2\. **Explain the procedure to the patient** Helps the patient feel informed and reduces anxiety. 3\. **Select a suitable vein** Choose a vein that\'s straight, accessible, and large enough for the catheter. 4\. **Apply tourniquet** Engorges veins to make them more visible and palpable for easier insertion. 5\. **Clean the insertion site with antiseptic** Reduces the risk of infection by sterilizing the area. 6\. **Insert the IV catheter** Proper insertion technique ensures correct placement in the vein. 7\. **Check for blood return** Confirms that the catheter is in the vein (flashback of blood). 8\. **Advance the catheter and secure it** The catheter needs to be secured to prevent dislodgement, and advancing ensures proper placement. 9\. **Flush the IV line with saline** Ensures patency of the catheter and removes air from the line. 10\. **Dispose of used equipment and document** Safe disposal of used equipment prevents contamination and ensures accurate medical records. Different IV catheter sizes ranging from smallest (24g \[Left\] to 14g \... **2. Wound Dressing (Clean/Contaminated)** **Equipment Needed:** **Item** **Size/Type/Color** **Purpose** ----------------------------- --------------------------------------------------------------------- ------------------------------------------------------------------- **Clean or Sterile Gloves** Sterile gloves for contaminated wounds Protects the wound and clinician from infection. **Sterile Dressing** Gauze pads (2x2 or 4x4), non-stick dressing, hydrocolloid dressings Protects and absorbs exudate while preventing infection. **Antiseptic Solution** Saline, Chlorhexidine, or iodine Used to cleanse the wound to reduce bacterial load. **Sterile Bandage/Tape** Adhesive tape or rolled bandages Used to secure the dressing in place without causing skin damage. **Scissors** Medical scissors Used for cutting tape and dressings to the appropriate size. **Gauze or Cotton Balls** 2x2 or 4x4 pieces Used to clean and dry the wound. **Procedure & Rationale for Wound Dressing:** **Step** **Rationale** -------------------------------------------------- ----------------------------------------------------------------------------------------------- 1\. **Prepare the equipment** Ensures you have all items ready to perform the dressing change quickly and safely. 2\. **Wash hands and wear gloves** Hand hygiene and gloves prevent contamination and infection. 3\. **Remove old dressing** Careful removal ensures minimal disruption to the wound and avoids contamination. 4\. **Assess the wound** Observing for infection or complications helps guide future treatment. 5\. **Clean the wound with antiseptic solution** Cleaning the wound prevents infection and prepares the tissue for healing. 6\. **Apply new sterile or clean dressing** Ensures the wound is protected and provides an optimal environment for healing. 7\. **Secure the dressing** Secure dressing prevents movement, reduces exposure to contaminants, and aids in healing. 8\. **Dispose of used materials and document** Proper disposal ensures safety, and documentation tracks the wound status and treatment plan. The solution used for wound dressing depends on the type of wound (clean, contaminated, infected) and the specific needs of the patient. Here are some commonly used solutions for wound cleaning and dressing: **1. Normal Saline (0.9% Sodium Chloride)** - **Purpose**: Most commonly used to irrigate and clean wounds. It's isotonic, so it does not disrupt the natural balance of cells, making it ideal for **clean wounds**. - **Use**: - **Cleaning**: Helps remove debris or foreign material. - **Hydration**: Keeps the wound moist, which promotes healing. - **Non-irritating**: Safe for most wounds and skin types. **2. Antiseptic Solutions** - **Chlorhexidine (e.g., Hibiclens)**: - **Purpose**: A broad-spectrum antiseptic used for cleaning the skin and wounds, particularly for **contaminated wounds**. - **Use**: - Reduces bacterial growth, preventing infection. - Often used for **surgical wounds** or when contamination is suspected. - Avoid using full-strength chlorhexidine on deep or open wounds (diluted solutions are better). - **Povidone-Iodine (Betadine)**: - **Purpose**: Antiseptic that is used for cleaning wounds to reduce the risk of infection. - **Use**: - Often used for **dirty or infected wounds** or **surgical sites**. - Can cause skin irritation or delay in wound healing if overused. - Typically used in dilute concentrations for wound care. - **Hydrogen Peroxide (3%)**: - **Purpose**: An oxidizing agent that helps clean and disinfect wounds. - **Use**: - Sometimes used for **cleaning superficial wounds**, but it should be used sparingly as it can damage healthy tissue, delaying healing. - Not generally recommended for routine wound care. **3. Ringer's Lactate Solution** - **Purpose**: Similar to normal saline but contains additional electrolytes like calcium, sodium, and potassium, making it useful for **more severe or fluid-depleted wounds** (e.g., burn wounds). - **Use**: - **Hydration** and **electrolyte balance** for larger or more severe wounds (like **burns** or **abrasions**). - Less common for routine wound cleaning but used when there is significant fluid loss. **4. Acetic Acid Solution (Diluted Vinegar Solution)** - **Purpose**: Used primarily for **infected wounds** caused by **Pseudomonas aeruginosa**, a bacterium that often infects chronic wounds (e.g., diabetic foot ulcers). - **Use**: - Helps clean the wound and reduce bacterial growth in chronic infected wounds. - Usually diluted (e.g., 1 part acetic acid to 10 parts water) to prevent irritation or damage to surrounding healthy tissue. **5. Silver-Based Solutions or Dressings** - **Purpose**: Antimicrobial properties that help prevent infection, particularly in **chronic wounds** or **infected wounds**. - **Use**: - Often used for **chronic, non-healing wounds** like **venous ulcers**, **diabetic ulcers**, and **pressure sores**. - Silver has broad antimicrobial activity and is used in ointments, dressings, or solutions. **6. Honey (Medical-Grade)** - **Purpose**: A natural solution with antimicrobial properties, used for **chronic wounds** or **infected wounds**. - **Use**: - Promotes healing by keeping the wound moist and providing a barrier to bacteria. - Often used for **chronic wounds**, burns, and **diabetic ulcers**. **7. Hypertonic Saline (3% or 5%)** - **Purpose**: A stronger saline solution, used primarily for **chronic wounds** with excessive edema or **wound debridement**. - **Use**: - Draws out excess fluid and helps reduce swelling. - Often used in **non-healing wounds** or **abscesses**.  **3. Blood Transfusion** **Equipment Needed:** **Item** **Size/Type/Color** **Purpose** ------------------------------------- ------------------------------------------------------------------ ------------------------------------------------------------- **Blood product** Packed RBCs, platelets, or plasma (depending on patient's needs) Provides essential blood components to the patient. **IV Set with Filter** 20-22G for blood transfusions (always with a filter) To prevent blood clots or debris from entering the IV line. **Normal Saline** 0.9% Saline Used to prime the IV line and flush the blood product. **Blood Transfusion Set** Tubing with filter For safe administration of blood products with a filter. **Vital Sign Monitoring Equipment** BP cuff, thermometer, pulse oximeter To monitor patient's reaction to the transfusion. **Blood Transfusion Record** Documentation sheet Ensures correct product, patient, and procedure tracking. **Gloves** Non-sterile To maintain hygiene and prevent contamination. **Procedure & Rationale for Blood Transfusion:** **Step** **Rationale** ---------------------------------------------------- ---------------------------------------------------------------------------------------------------------- 1\. **Prepare equipment** Ensures readiness for the procedure and prevents delays. 2\. **Verify patient identity and blood type** Double-checking prevents transfusion errors and ensures compatibility. 3\. **Establish IV access (or check existing IV)** Ensure a large-bore catheter is in place for safe blood administration. 4\. **Prime the IV line with saline** Ensures no air is present and prepares the line for blood transfusion. 5\. **Connect blood bag to IV line** Ensures that the blood product flows smoothly and safely into the patient's bloodstream. 6\. **Start transfusion slowly** Helps detect any adverse reactions early by administering at a controlled rate. 7\. **Monitor for reactions** Monitoring helps detect reactions such as fever, rash, or anaphylaxis early. 8\. **Post-transfusion care and documentation** Proper documentation ensures the transfusion was successful and that the patient's reaction is recorded. **4. IV Fluid Administration** **Equipment Needed:** **Item** **Size/Type/Color** **Purpose** ----------------------- -------------------------------------------------------------------- ------------------------------------------------------------- **IV Fluid Bag** 0.9% saline, Ringer\'s Lactate, D5W (or as per doctor's orders) Provides fluids or electrolytes to maintain balance. **IV Set** Standard primary IV tubing with drip chamber and roller clamp Used to administer fluids from the IV bag to the patient. **IV Catheter** 18G, 20G, 22G (size depends on patient's condition and fluid rate) To establish venous access for fluid administration. **Normal Saline** 0.9% Saline Used to prime the IV line before the fluid infusion. **Gloves** Non-sterile Used to maintain aseptic technique when setting up the IV. **IV Pole** Adjustable IV pole Holds the IV bag at an appropriate height to regulate flow. **Flow Rate Control** Drip rate controller or infusion pump Used to regulate the fluid infusion rate accurately. **Procedure & Rationale for IV Fluid Administration:** **Step** **Rationale** --------------------------------------------------- ---------------------------------------------------------------------------------------------------- 1\. **Prepare the equipment** Ensures that everything is ready and reduces the chances of errors or delays. 2\. **Verify the doctor's order for IV fluid** Confirms the correct type and volume of fluid to administer. 3\. **Establish IV access (if not already done)** To ensure a secure and effective route for fluid administration. 4\. **Prime the IV line with saline** Prevents air embolism and ensures the line is free from air bubbles. 5\. **Connect the IV bag to the catheter** Ensures the safe and controlled delivery of fluid to the patient. 6\. **Regulate the flow rate** Ensures the correct volume of fluid is administered as per medical orders. 7\. **Monitor the patient** Regular checks ensure the IV site is intact and fluid is being administered without complications. 8\. **Document the procedure** Records the type and amount of fluid administered and any patient reactions.