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How to use I.V. catheter
Feb 22, 2018

1.Advantages of IV catheters

*It is easy to puncture I.V. catheters, and the related puncture technique is easy to learn. 

*Protect the patient's blood vessels, relieve the patient's pain, feel comfortable, improve the patient's satisfaction and the quality of nursing.

* There are many I.V. catheters with different structures that can be selected. There are different lengths of catheter to choose to improve nurses' working efficiency and rational drug use, so that they can avoid puncturing without frequent medication and avoid drug reactions. 

*Reduce the cost of exudative treatment by scalp needle puncture.

Scope of I.V. catheter application.jpg

2.Usage of IV catheters

(1)Preparations: infusion bottle (glass bottle, plastic bag, plastic bottle) ,infusion device;

 Fixed dressings (adhesive tape, transparent film);

 Connecting parts (heparin cap, needle free connection);

 Flow control device (infusion pump, micropump);

 IV catheter;

 Disinfectant iodophor, cotton swab;


(2) Select the blood vessel: choose the  straight blood vessel with big diameter, good elasticity and rich blood  flow.Avoid venous valve and joint.

(3)Disinfection of the skin: the scope of disinfection is 8*8cm.

(4)Ligation of tourniquet: 10cm above the scope of disinfection.It should not be too tight and should not more than  2 minutes.

(5) Remove the needle cap and loose the needle core: remove the needle cap vertically and loose the needle  core.

(6)Connect the scalp needle, exhaust.

(7)Puncture: pull skin tight, pierce the needle into the vein at 15-30 degree slowly, further insert needle 0.2cm after  seeing blood return .

(8)Withdraw needle core:hold needle seat with one hand and return needle core with another hand.

(9) Delivery of I.V. catheter: all the catheter shall be sent into the vein.

(10) Relax the tourniquet and adjust the speed of dripping.

(11) Sealing the tube and caring: fix it with puncture point at the center with the aseptic and transparent dressing.  Keep the puncture point clean and dry, change the transparent dressing one time every 3-5 days . In summer , it  can be shortened to 2 days.Change it in time when the dressing is not sticky or there is pollution in the dressing.

(12) Record: stick sticker on the site of venipuncture, write the date of puncture, and sign operator's name, etc. The  status of IV cannula and the name, dose and usage of for special medication shall be recorded every day.

3.Failure cause of IV cannula puncture

(1) The catheter tip is damaged as the puncture technique is unskilled.

(2) Excessive puncture and posterior wall of the vein is pierced. 

(3) Only the tip of the needle is inserted into the vein and the outer wall of the outer wall of the coat tube is not in the  tube. 

(4) The puncture angle is too small and the wall of the vein is scratched 

4.The tube sealing and nursing of IV catheters

(1)Aim: to pour residual irritant liquid into the blood flow, avoid stimulating local blood vessels, maintain venous access, and avoid clotting and clogging of the ends of hoses at the next connection.

(2) Positive pressure sealing method: injection needle edge method of pulling out the injection needle.

Withdraw needle while injecting.Pull out the injection needle.

(3) Sealing liquid:

Isotonic saline: 5-10ml, once in 6-8 hours.

Diluted heparin solution: 10-100 units of heparin per milliliter, 2-5ml. The anticoagulant effect lasted for more than 12 hours.

(4) The steps of correct punching and sealing: SASH: S --physiological saline, A-- adding medicine, S --physiological saline, H --diluted heparin solution.

5.Flushing and nursing of IV catheters

(1) Sterilize heparin cap before a second time’s infusion.Connect syringe needle after flushing the IV catheters. 

(2)Objective: To pour residual liquid into the blood vessels with saline so as to avoid chemical phlebitis caused by stimulating local vessels, and reduce the incompatibility between drugs. It is used between infusion of two kinds of drugs, or before the closure of IV catheter. 

(3)Method:Injection with syringe. Adopt the pulse flushing method--push syringe one time and stop one time, so that normal saline in the catheter form small eddy,which helps to clean up residual drugs in tube of IV catheters.

(4) The minimum amount of washing liquid should be 2 times the capacity of the catheter and the additional device. 

6.Common complications of I.V. catheter

(1) Exudation / necrosis: symptoms are sore, swollen, tight and bright skin. Puncture site or end temperature is low, no blood or light pink back to blood, puncture point seepage fluid


*Adopt indwelling catheter with soft material; 

*Stable fixing; 

*Correct selection of puncture point and avoid joint puncture;

*Correct puncture technique ; 

*Close observation and early judgment; 

*Correct needle speed and angle, avoiding damage to Intima of vena cava,understand and grasp the venous intima;

(2) Phlebitis: inflammation of the intima of the wall of the veins. It is divided into five kinds : mechanical phlebitis, chemical phlebitis, bacterial phlebitis, thrombotic phlebitis and phlebitis after pulling needle. 

INS classification (International venous tissue): 

Level 0: no symptoms 

Grade 1: redness with or without pain in the part of the infusion 

Grade 2: pain in the infusion site with redness and redness 

Grade 3: the formation of the 2 grade, the stripe, and the touch of the stripe like vein 

Grade 4: Grade 3, palpable cords vein length greater than 1 inches, there is pus outflow 

Prevention: choose soft material indwelling catheter, avoid joint puncture, stabilize catheter and infusion tube, reduce mobility with skilled puncture technology, adequate hemodilution, slow down infusion speed, strictly perform aseptic operation and regularly observe puncture site. 

(3)Obstruction of the catheter: a blockage caused by the formation of an embolus in the venous catheter. 

Prophylaxis: intermittent infusion or positive pressure tube flusing; Grasp the incompatibility of drugs;Saline should be used to flush tube between the two drugs; Regular observation of liquid infusion;Avoid catheter discounts, correctly select puncture points;Check regularly.

(4)Systemic complications: 

Catheter embolism: the catheter is damaged and dropped into the circulatory system and can be moved to the thoracic cavity, located in the pulmonary or right ventricles. 

Prevention: needles should not be inserted into the catheter again ; avoid the use of scissors or other tools near the catheter. 

(5)Air embolism: 

Prevention: exhaust, use spiral connection, pressure infusion is guarded by people. 

Seal tube with10u/ml heparin tube;  Observe everyday if there is red and swollen situation or trabs at the position of IV catheter ;Check if there is small thrombosis, or if the tube falls off, or if there is kinking in the tube; Check if there is curling, floating or falling of in the fixing tape or transparent film; If there is any skin breakage or  pressure ulcers, it shall be dealt with immediately; The transparent dressing shall be changed if there is pollution inside (a fluid, air bleeding, sweating, etc.) 

7.Routine maintenance of venous indwelling needle

After the medication, gently massage the extremities blood vessels and rub the back of hand and foot to promote venous blood return.For infant patients, when they are sleeping, nurses can wrap IV catheters with clean towels or clean and loose cotton socks,which relieves parents of psychological burden that IV catheter needles might slip out due to friction.This can also keep warm in winter. When IV cannula is in the head, avoid to sleep toward the intravenous needle side; When indwelling needle is in the lower extremities, parents shall pay attention to separate two legs at any time. When kids are sleeping, parents can put some clothes between two legs and two feet.indwelling needle indwelling told the older children to avoid excessive limb activity, induced by indwelling infants limb reduction flap indwelling needle, avoid too long to stand or walk; wear off underwear to wear, take off the limbs of the indwelling needle without limbs indwelling needle; indwelling needle body water.Tell older kids to keep from excessive activities.When parents dress or undress the kids, first dress the extremities without I.V. catheters and first undress the extremities without I.V. catheters.Extremities with I.V. catheters shall not be put inside water for bath.

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