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IV Therapy.pptx
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- 2. IV Statistics 85%of all hospitalized patients have some type of IV therapy 118 million IV catheters inserted yearly
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- 4. PHLEBITIS Inflammation ofthe vein wall—precursor to sepsis What causes phlebitis? IV left in too long Cannula too large Vein in poor condition Acidic solution or high osmolality Infusion rate too fast
- 7. Preventions Choose vein appropriately Location Size Soft, spongy, resilient No pain or tenderness or redness with injection
- 8. INFILTRATION Leaking ofnonvesicant fluid into tissues surrounding the vein Check IV site every two hours Complications Nerve compression requiring fasciotomy
- 10. EXTRAVASATION Inadvertent administrationof vesicant drug into surrounding tissues Calcium Magnesium Phenergan Potassium chloride Antibiotics Chemotherapy drugs Vasopressors (Dopamine, epinephrine) Dextrose > 10% Lorazepam Dilantin
- 12. INFECTION Cellulitis: Anacute, spreading, bacterial infection below the surface of the skin characterized by redness (erythema), warmth, swelling, and pain. Usually localized. Sepsis: clinical symptoms of systemic illness, such as fever, chills, malaise, hypotension, and mental status changes. Sepsis can be life threatening.
- 13. INFECTION > 200,000infections per year More than 60,000 patients die annually from bloodstream infections caused by intravenous therapy Cost for one patient is $56,000 Annual US total = $2.3 billion
- 14. Causes Poor insertionsite Squad starts Unsterile start IV left in too long— change q 96 hours! Hub contamination
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- 17. Prevention Hand washing Sterile technique Catheter size Insertion site Site inspection every two hours Encourage patient to report any discomfort
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- 22. Other sites toavoid include: • veins below a previous I.V. infiltration • veins below a phlebitic area • sclerosed or thrombosed veins • areas of skin inflammation, disease, bruising, or breakdown • an arm affected by a radical mastectomy, edema, blood clot, or infection • an arm with an arteriovenous shunt or fistula.
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- 24. STARTING AN IV Talkwith patient Gather equipment Set up fluid and tubing on pump Check patient order and ID band & allergies Wash your hands!! Select a vein Select a catheter size
- 25. 1. Apply tourniquet5-6 inches above insertion site 2. Never leave tourniquet on longer than one minute 3. Then Remove tourniquet and prepare equipment
- 26. STARTING AN IV(CONT.) Open equipment and connect flush to J- loop Loosen caps of IV and J-loop but leave in place for sterility. (They should just slide off when you pick up the device). Cleanse skin with chlorhexidine gluconate solution in back & forth motion X 30 seconds Allow to dry for 30 seconds
- 27. 1. Put onGloves!!!
- 28. Immobilize vein Position needle10-15 degree angle over site Insert cannula bevel up Watch for blood backflow Advance cannula Only try twice before calling another RN to help STARTING AN IV (CONT.)
- 33. Advance cannula whileholding stylet stationary Release tourniquet!!
- 34. 22. Withdraw styletwhile putting pressure on vein above injection site Stabilize the hub of the canula
- 35. 23. Insert tubingor prn adaptor Apply pressure above insertion site to slow bleeding Stabilize the hub of the canula while inserting the tubing Saline flush is already attached and tubing flushed and ready
- 36. It may getmessy sometimes, but with experience this will be minimized
- 37. • Flush withsaline to clear tubing and insure IV has not infiltrated. 3. Stabilize tubing with tape to prevent IV from pulling out while applying the sterile dressing.
- 38. 1. Apply clearsterile dressing. Cover site and hub, not tubing Leave the end of the hub of the canula outside the dressing so that tubing can be changed without removing the dressing.
- 39. 27. Date, timeand initial site and tubing
- 40. STARTING AN IV(CONT.) 3. Document!
- 41. What is wrong withthis picture?
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- 50. CONTINUOUS INFUSION: SECURINGTHE NEEDLE When starting a continuous infusion, you must secure the right-angle, non-coring needle to the skin. If the needle hub is flush with the skin, apply a transparent semipermeable dressing over the entire site. If the needle hub isn’t flush with the skin, place a folded sterile dressing under the hub, as shown. Then apply adhesive skin closures across it. Secure the needle and tubing, using the chevron-taping technique with sterile tape.
- 51. Apply a transparentsemi-permeable dressing over the entire site. medisim@lww.com. http://www.youtube.com/watch?v=tfQbbCx6xFU&feature=related http://www.youtube.com/watch?v=ZcCWTEsEqPg&feature=related