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Presentation on peripheral iv and central cannulation.pptx
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- 2. ANATOMY Venous Drainage ofUpper Limbs • Superficial venous system- skin and superficial fascia • Deep venous system- deeper fascia, muscles and bones
- 4. CANNULAE • 14G • 16G •18G • 20G • 22G • 24G • Large volume replacement • Rapid transfusion of whole blood or blood components • IV maintenance, surgical patients • IV analgesia, antibiotics • Paediatrics, elderly, difficult venous access • Paediatrics, neonates
- 6. Pre- Requisites • Dressingpack • Gloves (sterile) • Alcoholic chlorhexidine • Transparent semi permeable dressing • Cannula (size depending on need) • Extension set (and prescribed IV fluids) • Syringe 2 ml with 0.9% Normal saline • Tourniquet
- 7. • Check patientfor allergies to medications, cleansing fluids & dressings • Assess the dominant/non-dominant side and check the veins for suitability • Provide a clear explanation of the procedure ASSESSMENT
- 8. • Warm thesite- rubbing, warmed towels, warm water • Apply torniquet • Ask the patient to clench and unclench • Clean the site, let it air dry • Insert the cannula PREPARATION
- 9. POTENTIAL COMPLICATIONS • Extravasation •Haematoma • Occlusion • Phlebitis • Thrombophlebitis • Infection
- 10. Haematoma Localised collection ofextravasated blood, usually clotted, in an organ or tissue. Cause • Blood leaking out of the vein into the tissue due to puncture or trauma Signs & Symptoms • Swelling, tenderness and discolouration Prevention •Pressure over site on removal of cannula Intervention • Apply appropriate pressure bandage, monitor the site
- 11. Phlebitis Inflammation of thevein Cause • Poor aseptic technique • High osmolarity I.V. infusions or drugs • Trauma to the vein during insertion/incorrect cannula gauge • Prolonged use of the same site Signs & Symptoms • Tenderness, redness, heat and oedema • Advanced-induration, palpable venous cord Intervention • Remove cannula • Apply warm compress • Observe for signs of infection • If phlebitis is advanced antibiotics may be required
- 12. Occlusion Cause • Cannula notflushed- fibrin formation in or around the tip of cannula • Kinking of the cannula Signs & Symptoms • Slowing or cessation of fluid • Blood in the line Intervention • Check for kinks in cannula • Raise IV higher • Flush • Remove cannula
- 13. Thrombophlebitis Inflammation and formationof a thrombus in the vein Causes • Injury to the vein • Infection • Chemical irritation •Prolonged use of the same vein Signs & Symptoms • Tenderness/redness • Heat/oedema • Cordlike appearance of the vein • Slowing of the IV infusion Intervention • Remove cannula • Observe for signs of infection
- 14. Infection Pathogen in thetissue surrounding the I.V. site. Cause • Lack of asepsis •Prolonged use of the same site Signs & Symptoms • Tenderness and swelling • Erythema/purulent drainage Intervention • Remove cannula • Antibiotics may be required
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