2. Objectives
• To know main sites of IV access.
• Different types of syringes.
• Indications and contraindications of IV access.
• Steps of IV insertion.
15. Contraindications of syringe IV access
1) Arteriovenous shunt
2) Post mastectomy
3) Burn , infection or fracture over the site
4) Thrombosis
16. Steps of IV insertion
1)
2)
3)
4)
5)
Greeting
Introduction
Consent
Positioning
Equipment preparation:
Should prepare a syringe , tourniquet , alcohol swab , plaster ,
gauze , gloves ( substance to be injected if any ?? )
17.
18. 6) Site preparation: (Vein preparation)
Which Veins ??
1. Look for a vein , the most straight vein (from distal to
proximal).
2. Apply tourniquet (8-10cm above vein).
3. Exercise
4. Tapping of the vein; WHY ??
5. Palpation of the vein. Palpable NOT visible !!
6. Disinfection; HOW ??
20. 7) Skin traction ( Distal to site of puncture )
8) Skin support
9) Insertion :
•
•
•
•
15-30 degrees to skin
Bevel always up
Grading always up
Look for blood in the hub
10) Fixation (With non dominant hand).
11) Aspirate
12) Confirmation (Avoid extravasation).
21. 13) When withdrawing :
• Withdraw enough sample
• Remove tourniquet
• Pull syringe out with pressure on puncture site.
14) Compression on site and plaster (3 minutes).
22. Complications of syringe IV access :
1)
2)
3)
4)
5)
Infection !!!
Extravasation; How to deal with ??
Thrombosis
Arterio-venous fistula
Air embolism
23. Types of blood collection tubes ??
What’s a Vacutainer ??
28. What if ????
•
•
•
•
•
•
•
Swollen hand?
Bleeding that doesn’t stop after syringe ?
Can’t find an IV access ?
Fragile veins in hands ?
You are going to inject local anesthesia ?
Suspected painful insertion??
Resistance during insertion ?