Parenteral administration

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universal precautions, prevention

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Parenteral administration

  1. 1. Immediate access to vascular system  Bioavailability is 100%  Route for medications and blood and blood products 
  2. 2. Proper site selection  Proper knowledge of gross anatomy of veins  Identification involves both visual and tactile exploration  The vein may be located as a blue green subcutaneous structure 
  3. 3. Blind attempts are highly unlikely to be successful  Ideally a good sized vein with a straight segment atleast the length of the cannula should be selected 
  4. 4.  For elective cases Easy access  Non dominant side  Avoiding joint areas  Avoiding Lower extremities 
  5. 5. Antecubital fossa  Forearm  Wrist  Dorsum of hand  Mostly used are cephalic , basilic and median cubital vein 
  6. 6.  Veins in the dorsum of the hand can be used if wide bore is not required. The portion of cephalic vein in the region of radial styloid is often called  Student’s vein or Interns vein 
  7. 7. Cannulation is not a good idea  It is more painful , more chance of thrombophebitis 
  8. 8. Originates near the angle of mandible and crosses over the stenocleidomastoid  It can accommodate large bore IV catheter  Useful in those with poor access to arms and those who need large volumes of fluids 
  9. 9.  EJV will be engorged in heart failure patients and thus it is an ideal route for such patients for medications (other veins would be collapsed)
  10. 10.  Central venous pressure monitoring  Volume resuscitation  Cardiac arrest  Lack of peripheral access  Infusion of concentrated solutions  Placement of transvenous pacemaker  Cardiac catheterization, pulmonary angiography  Hemodialysis
  11. 11.  Seldinger technique › › › › › › › Use introducing needle to locate vein Wire is threaded through the needle Needle is removed Skin and vessel are dilated Catheter is placed over the wire Wire is removed Catheter is secured in place

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