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Lecture 3
IV, Venipuncture, Injections
| Question | Answer |
|---|---|
| What is venipuncture/IV therapy? | the act of obtaining a blood sample or obtaining venous access for giving medications or fluids; generally performed by phlebotomy/lab, EMS, or nursing |
| Anatomy | Start with distal veins and work proximally. Start choosing from the lowest veins first then work upward. Starting at the most proximal point can potentially lose several sites you could have below it |
| Anatomy veins | cephalic vein, accessory cephalic vein, medial cubital vein, basilic vein, internal jugular vein |
| Indications: phlebotomy | any time that a sample of blood is necessary in quantities larger than those readily available by finger stick methods |
| Contraindications: phlebotomy | obvious area of skin infection, skin sites that have extensive scarring (burns, surgery, injuries, repeated venipuncture) |
| Contraindications: phlebotomy | sites as which a hematoma is present (relative), upper extremity of ipsilateral side of mastectomy (relative), an arm with an IV line for fluids or blood transfusion (relative) |
| phlebotomy potential complications | infection of the skin (cellulitis), infection of the vein (phlebitis), thrombosis, laceration of the vein, hemorrhage of hematoma at site of puncture, vasovagal syncope |
| IV therapy indications | administration of IV fluids, the provision of rapid and efficient delivery of medications, administration of blood products |
| IV Therapy Contraindications | obvious area of skin infection, skin sites that have extensive scarring, upper extremity or ipsilateral side of a mastectomy, distal to any area of preexisting thrombophlebitis |
| IV Therapy Contraindications | lower extremity venipuncture should be avoided in elderly patients, those with pad, venous insufficiency |
| IV therapy complications | thrombosis or thrombophlebitis, location infection, catheter embolization or "Cath shear", septicemia, pulmonary emboli, air embolism, laceration of the vein, hemorrhage of hematoma at site of puncture, vasovagal syncope |
| 14G= color, ext. dia, length, flow rate, indications | orange, 2.1mm, 45mm, 240mL/min, trauma, surgical procedures |
| 16G= color, ext. dia, length, flow rate, indications | grey, 1.8mm, 45mm, 180mL/min, trauma, surgical procedures |
| 18G= color, ext. dia, length, flow rate, indications | green, 1.3, 32/45, 90, trauma, quick blood transfusion |
| pink, 1.1, 32, 60, normal IV or blood transfusion | 20G= color, ext. dia, length, flow rate, indications |
| blue, 0.9, 25, 36, children, older adults | 22G= color, ext. dia, length, flow rate, indications |
| yellow, 0.7, 19, 20, neonates, children, old elderly | 24G= color, ext. dia, length, flow rate, indications |
| Intramuscular IM injections | injected deep into the musculature for distribution thru the vasculature, useful for higher volume medication delivery and some vaccines, common sites are deltoid, vfntrogluteal, and vistas lateralis |
| Subcutaneous | injected into the subcutaneous layer; useful for low volume medication delivery and some vaccinations; upper arm and abdomen are common sites |
| Rights of medication administration | right drug, right dose, right time, right route, right site, right documentation |
Created by:
bluedolphin7
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