The Use of Intravenous Indwelling Catheterization Techniques: L0-ethyl 8164 (2001] 01 I] 061-0l Intravenous Indwelling Catheterization Tips Document Code: B Wang. Intravenous catheter sleeve surgery is beneficial for chronically ill patients who need treatment, not only avoiding the pain caused by repeated punctures but also serving as an alternative to phlebotomy. It opens an intravenous access for seriously ill patients while reducing the workload of nurses and improving the efficiency of care. In our department, from 1999 to 2000, we performed this procedure on 101 cases and received good results. Now, I will report on the application results below.
Materials and Methods:
Catheter Object: Our hospital treated 101 patients, with 69 males and 32 females. The oldest was 77 years old, the youngest 10 years old, with an average age of 40 years.
Catheter Parts: First vein in four cases, median cubital vein in 18 cases, middle forearm vein in 46 cases, basilic vein in 14 cases, external jugular vein in 15 cases, great saphenous vein in three cases, femoral vein in two cases.
Material: Produced in the United States, Vialon material vein indwelling catheter No. 16, 18.
Method: Select the desired vein, perform conventional skin disinfection, hold the catheter at a 15-30 degree angle to pierce the blood vessel, see the blood return, then insert the jacket tube into the blood vessels, pull out the needle core, fix the catheter, after infusion seal the tube with heparin solution or saline for re-infusion, use 0.5% povidone-iodine swab disinfection on the heparin or saline cap, and connect appropriate needles to start the infusion.
Results: Out of 101 cases, puncture was successful in 99 cases, with a success rate of 98%. Retention time was between 2-10 days. Due to improper sealing, seven cases experienced blood resistance condensate tubes, four cases had phlebitis, two cases had local pain, three cases experienced local liquid spills and swelling. The rest completed the infusion therapy or had other veins recover elasticity and extubation.
Tips:
(1) Strictly control the indications and contraindications of indwelling needles: Intravenous catheter casing operations are suitable for rescuing critically ill patients, alternative phlebotomy, intravenous nutrition, or patients needing long-term repeated venipuncture infusions. Patients suffering from bleeding disorders such as platelet purpura or coagulation disorders should not use this method.
Author: Yichang City, Hubeo Province, People’s Hospital (Yichang 4430OO)
(2) Trocar Options: Require wall smoothness, softness, and silicone tubes that are not easily deformed in the autoclave. Needles should not be too small; generally, 16 or 18 gauge is appropriate.
(3) Select Appropriate Blood Vessels: Hypertonic, high grain, or other special drugs like chemotherapy drugs can easily cause local phlebitis. Early selection of blood vessels with good elasticity is recommended, especially when peripheral circulation is poor and blood vessels are not optimal.
(4) Strengthen Technical Management: Intravenous catheter casing surgery has higher technical requirements. Care workers should first strengthen their technical management, especially in aseptic technology management, skillfully master indwelling puncture techniques, and strive for sharp catheter punctures once. Retention time should not be too long; 3-5 days is appropriate. Daily dressing changes at the puncture site [7.8J and using 0.5% povidone-iodine swabs on the puncture point for local phlebitis prevention is advised. Some heat or puisne smug golden powder may promote inflammation absorption. For liquid leakage, hot and humid heat or magnesium sulfate deposition can be applied.
(5) Skilled and Correct Operation: The indwelling needle insertion angle with the skin should be 15 to 30 degrees, and the speed of the needle should not be too fast. An angle of 30 degrees could easily puncture the vessel wall; seeing blood return, move the needle slightly, side to side to send back the needle core casing. Excessive refunding of the needle core could lead to a soft casing pipe discount. Ensure the casing is sent entirely into the intravascular or patient physical restlessness, which might cause liquid leakage due to slide-out. Choose a more lasting and stable surface, properly fixing the needle wing; mastering the correct infusion rate and method for blood vessels stimulating drugs such as amino acids, fat emulsion should slow down the infusion rate; planing injury serious heart and lung function of patients lost isotonic fluid speed can be released quickly. Nurses should understand the patient's psychological state before extubation, explain the process to eliminate stress, fear, and other negative emotions, closely observing the condition and infusion site reaction, especially for patients with consciousness disturbance who require timely detection and treatment.