Transcript 幻灯片 1

Chapter 13
Intravenous Infusion
and Blood Transfusion
SECTION ONE
Intravenous Infusion
• Definition:IV infusion is a method that a large
volume of solution is infused into vein to
correct fluid and electrolyte disturbance．
solution; passage
(infusion set); vein
Intravenous Infusion
• IV infusion is a serious and complex
responsibility that requires the nurse:
 proficiency in performance
 familiarity with the anatomy involved
 mindful use of principles of asepsis
 expertise in prevention, management of
complications that may occur with treatment
Intravenous Infusion
• Fluids are medications--IV infusion requires a
physician’s order
 the type and amount of fluid administered will be
based on
types of patient’s need
the patient’s age
general health status
the results of laboratory tests
Types of solutions
There are many methods of classification．
• according to their osmolality in relation to
normal blood plasma
Hypotonic fluids
Isotonic fluids
Hypertonic fluids
Nutrient solutions
• according to their purpose
Electrolyte solutions
Volume Expanders
Hypotonic fluids
• have lower osmolality than plasma
• to correct dehydration as they move from blood
vessels into the cells
• examples are 0.45 % NaCl, 0.2 % NaCl, or 5%GS
• excessive infusion can cause water intoxication
Isotonic fluids
• have the same effective osmolality as plasma
•
to expand the intravascular space to correct hypovolemia
as in shock
•
examples are lactated Ringer’s,
0.9 % ( normal ) saline(0.9%NaCl),
5 % dextrose in normal saline(5%GNS).
1.4%NaHCO3
• excessive infusion can cause circulatory overload and
pulmonary edema
Hypertonic fluids
• have greater osmolality than plasma
• to pull fluid from cells and the interstitial space into the
intravascular space to relieve edema
• examples are >5 % dextrose solutions,
colloidal products such as dextran,
3 % saline ( rarely used ).
• excessive infusion can cause cellular dehydration and
circulatory overload or diuresis.
Nutrient solutions
• contain some form of glucose and water
for calories and fluids replacement
• examples are 5％ or 10％dextrose in water
Hypertonic ( >10 percent dextrose ) parenteral nutrition
solutions are irritating to peripheral veins and so must be
infused into central veins.
Electrolytes solutions
• contain varied amounts of cations and anions
• examples are normal saline，Ringer’s solution, and
lactated Ringer’s solution
• commonly be used to restore vascular vo1ume，
particularly after trauma or surgery
•
also be used to replace fluid and electrolytes for patients
with continuing losses，for example，gastric suction or
wound drainage
Volume expanders
• be used to increase the blood volume following
severe loss of blood or loss of plasma
• examples are dextran，plasma，and human
serum albumin
Clinical routine
• In clinic, prepare fluids fall into the following
three categories:
 Crystalloid Solution
 Colloidal Solution
 Parenteral Nutrition Solutions
Crystalloid Solution
• have small molecular weights and stay in blood vessel for a
short time
• maintain the balance of fluids in intracellular and extracellular
• correct the fluids and electrolytes disturbance
• commonly used crystalloid solutions are：
 Dextrose in Water Solutions
 Isotonic Electrolytes Solutions
 Alkaline solutions
 Hypertonic Solutions
Dextrose in Water Solutions
• Be used for fluids and calories replacement，decreasing
the consumption of albumen，and preventing the
production of ketone．
• glucose is decomposed quickly in body, usually doesn’t
cause hypertonic and diuretic effects．
• Clinically there are usually 5％GS and 10％GS
(25%GS; 50%GS rarely used)
Isotonic Electrolytes Solutions
• be used in electrolytes replacement．
• Loss of body fluids usually is accompanied with
disturbance of electrolytes．So, the balance of fluids and
electrolytes must be maintained during fluids
replacement．
• examples are o.9％ NaCl，Ringer’s isotonic solution and
5% GNS．
Alkaline solutions
• NaHC03 in Water Solutions
 Be used in correcting acidosis, and regulating of acid-base
balance．
 NaHC03
Na+ and HCO3HCO3- + H+
H2CO3
C02 +H2 O．
 Commonly used solutions are 5 ％ NaHC03 and 1.4 ％
NaHC03 Solutions.
• Sodium Lactate in Water Solutions
 The concentrations of the solution usually used in clinic are
11.2％ and 1.84%.
Hypertonic Solutions
• be used for diuretic and dehydration purposes
• increase osmolality of blood plasm
plasma
pulling fluids into
reduce the edema of tissues
• can decrease intracerebral pressure and improve the
function of central nervous system．
• Clinically，mannitol 20%，sorbitol 25％ and dextrose
25％-50％ in water solutions are often used．
Colloidal Solution
• have large molecular weight，can stay in blood
for a long time
 can maintain plasma colloid osmotic pressure effectively，
 expand the blood volume，
 improve microcirculation，
 elevate the blood pressure．
• examples are ：dextran
plasma substitutes
blood products
Dextran
• It is water-soluble polysaccharide of high molecular
polymer．

moderate molecular dextran : elevate plasma colloid
osmotic pressure，expand blood volume
 small molecular dextran : reduce the viscosity of blood，
decrease the accumulation of erythrocytes，improve
microcirculation and tissue perfusion volume，and
prevent the formation of thrombosis
Plasma Substitutes
• can expand vascular volume and cardiac output greatly
•
can be used with whole blood in acute massive
hemorrhage
• examples are 706 (hydroxyethylamylum)，povidone and
oxypolygelation
Blood Products
• can elevate colloid osmotic pressure
• expand vascular volume
• provide protein and antibody
• help with tissue repair and enhance immunity
of body
Parenteral Nutrition Solutions
• be intravenously given to the patients who are unable to
get nutrition via gastrointestinal tract or have inadequate
intake of nutrients
•
provide calories，proteins，vitamins and minerals，and
maintain the balance of nitrogen
• main compositions : amino acids，fatty acids，vitamins，
minerals，high concentration of glucose ，and water
• commonly used solutions : multiple amino acids solutions ,
fat emulsions
sequence principle of solution
transfusion
• First crystalloid solutions then colloidal solutions
• First sodium chloride solutions then dextrose in
water solutions
• first fast then slow, rather shortage than overload
• rather acid than alkaline
• Potassium solutions properly
Sites of Venipuncture
• Peripheral Superficial Vein
 veins in dorsal hands : the first choice for adult patients
 median cubital，basilic，cephalic veins :drawing blood
bolus injections of medication
PICC
 The saphena veins in legs and veins in dorsal feet are not the first
choice because of the danger of thrombosis caused by the vein valve．
 Veins in dorsal foot are commonly used for children，but are avoided
in adults because of the danger of thrombophlebitis．
• Veins in the Scalp :for infants
• Subclavian，External Jugular:for central venous access
peripheral intravenous infusion
• Purposes
• Preparation nurse
patient
environment
equipment
• Procedures and Key Points
• Evaluation
VCD
Purposes
• To correct or prevent fluid and electrolyte disturbances
resulted from illnesses, altered fluid intake, or prolonged
episodes of vomiting or diarrhea.
• To increase the blood volume, maintain blood pressure
following severe loss of blood, severe burns, or shock.
• To supply medication to cure diseases for rapid
effectiveness.
• To supply nutrient substances to promote wound healing,
weight gain and positive nitrogen balance for patients with
chronic consuming illness, inability to intake, digest or
absorb a diet.
• To establish a lifeline for rapidly needed medications.
Preparation
• Nurse
1. Review the physician’s order in patient’s record.
2. Evaluate patient’s age and medical status. Evaluate patient’s renal
status and other pertinent lab data (e.g., electrolyte, serum glucose ).
3. Wash hands and wear mask.
•
patient
1. Verify patient’s identity.
2. Explain the procedure and purpose．Ask the patient to
void．
3. Position the patient for comfort and optimal visibility for
skill performance.
Preparation
• Environment:cleanness, commodiousness and brightness
• equipment:
Medical tray
·Antiseptic solution
·Sterile swab
·Tourniquet
·infusion Pad
·Adhesive tape
· File and vial opener
·IV solution and medication
·Bottle bag
·Infusion set
·kidney-shaped tray
Procedures and Key Points
1.Check and right
 the bed number，the patient’s name，medication name，
concentration， dosage， date and usage
 the quality of solution(the cap of bottle, the expiration
date , deposition，cloudiness， foreign matter, any
cranny on the bottle’s body)
2. Complete the medication label and stick it to the solution
container
3. Add medications into solution
4.Insert the infusion set
5. Prepare the equipment and
take them to the bedside．
Check again
6. Discharge air
7.Select the venipuncture site(pad , tourniquet )
8.Sterilize
the
venipuncture
site ． Prepare
adhesive tape.
9.Check again.
10. venipuncture
The wizened
The obese
The elderly
The dropsical (edema)
11.fixation
12. Regulate the flow rate
13. Check again.
14. Disposure after operation
(equipment,patient)
15. Change bottles
16. Disposure after infusion
(equipment,patient)
Cautions
1. Follow the principles of asepsis and check system strictly
to prevent infection and mistakes.
2. Arrange the sequence of IV fluids rationally according to
the patient’s need. Assign medications according to the
therapeutic principles and the half life of medications.
3. Protect and use veins reasonably (usually from small veins)
to patients who need long-term IV infusion.
Cautions
4. Prevent air embolism by ejecting air thoroughly in
infusion set, changing fluid bottles and withdrawing the
venipuncture needle in time.
5. Assess for compatibility of medications. Ensure the needle
have been inserted into vein before administration
irritative or special medications.
6. Master the flow rate strictly.
7. Assess during infusion carefully in order to find the
problems and settle the problems on time. Document the
result after assessment.
Education
1. Tell the patient don’t regulate the flow rate optionally.
2. Introduce the signs and symptoms of complications
with IV reactions, ask patient call nurse in time when
he find the signs of IV reaction.
3. Instruct the patient to report any blood in the tube，a
stoppage in the flow，or increased discomfort．
4. Intensify mental nursing to patient who need long-
term IV infusion.
Evaluation
• Assess the status of the skin and dressing of IV site by
observing whether there is heat，pain，redness，or
swelling
• Whether the IV flows smoothly and whether the flow rate
is consistent with what is ordered
• Check the information to ensure the right medication
administered
• Signs and symptoms of complications with intravenous
infusion
• Patient’s knowledge about medication and infusion
• Ability to perform self-care activities.
Regulating the Infusion Flow Rate
• Calculate the Flow Rate
• Common Infusion Control Device
Calculate the Flow Rate
• Total time of infusion (h) =
Total infusion vo1ume (m1)×drop factor (drops/m1)
Drops per minute×60
• Drops per minute=
Total infusion vo1ume (m1)×drop factor (drops/m1)
Total time of infusion (min)
Calculate the Flow Rate
Slow flow rate is suitable for
•
the elderly，infants and patients with diseases in heart,
1ungs，or kidney．
• When hypertonic solutions，solutions containing
potassium，or solutions containing medications for
raising blood pressure are infused，the flow rate also
should be slow．
When a patient with normal heart and lung
function has severe dehydration，the flow rate
should be rapid．
Common Infusion Control Device
• Clamp:be easy to operate; not precise
• Infusion Pump:
 exert positive pressure on the tubing or on the fluid to
ensure measured amount of fluid is infused uniformly
in a given time
 has a drop sensor, and an alarm that will sound if
drops are not detected at the appropriate rate
VCD
The Usage of Infusion Pump
Assessing during infusion
The responsibilities of nurses in assessment are：
• keeping the system sterile；
• changing solution，tube，and dressings on time；
• assisting the patient with self-care activities so as not to
disrupt the system;
• instruct the patient to report any blood in the tube，a
stoppage in the flow，or increased discomfort．
Common Problems during
Infusion and Methods to Treat
• Slow Flow Rate or No Infusion
• Too Large Volume of Solution in Chamber
• Too Small Volume of Solution in Chamber
• The Surface of Liquid Fall down Automatically
assess the site and the infusion rate
at least once an hour
Slow Flow Rate or No Infusion
• Infiltration
• occlusion of the IV Needle or Catheter
• hyperkinesia of Vein
• Too Low Hydrostatic Pressure
Infiltration
• Cause:the needle dislodge from the vein and fluid
exude in the subcutaneous space
• Signs: insertion site becomes swollen，clammy, and
painful
• Alternative nursing actions: :discontinue IV and
establish a new line at a new site
occlusion of the IV Needle
• causes:
 there are clots at the tip of the needle
 the needle tip is against the vein wall (flexed joint-wrist , elbow )
 narrowing the tubing may exist too-tight IV dressing
a kink in the tubing
• measures:
 assess : lowering the IV container below the level of the IV insertion
site, opening the roller clamp thoroughly, and observing for a blood
return
 Alternative nursing actions:
inspect the area around the insertion site
loose the IV dressing
check the tubing
change the position of the needle handle or extremity
hyperkinesia of Vein
• Causes:
 extremity is exposed in cold environment for a long time
 the temperature of the fluid is too low
• Alternative nursing action: warm the extremity
Too Low Hydrostatic Pressure
Raise the solution container
increase hydrostatic pressure
increase the flow rate
Too Large Volume of Solution
in Chamber
• Causes:compress the drip chamber too many times or too
hard when discharging air from tubing
• Alternative nursing actions: (3 methods)
Too Small Volume of Solution
in Chamber
• Causes:
 compressing chamber with less force or fewer times
 too late when changing the IV solution during continuous
infusion
• Alternative nursing actions:
The Surface of Liquid
Fall down Automatically
• Causes:

the tubing and chamber is not airtight
• Alternative nursing actions:
 check the whole infusion set system to see if there is
untight connection of every part or cranny in infusion set
 if necessary，the tube system should be changed
Complications of Intravenous
Therapy and Intervention
• Fever
• Phlebitis，Thrombosis，and Thrombophlebitis
• Circulatory overload reaction
• Air Embolism
• Infiltration
• Local Allergic Reactions
• Infection or Inflammation at the Insertion Site
Fever
• Causes:
allergic reactions to a medication or IV fluid
impureness of the solution
incomplete sterilization of the equipment
no strict application of aseptic techniques
during starting an IV
• Symptoms and signs: feel cold，trembling and with
increased body temperature to 38℃ to 40℃ or higher．
Systematic reactions may be present，such as nausea，
vomiting，headache，and tachycardia．
Fever
• Preventions
 inspect the quality of solutions，the package of
intravenous set and date of sterilization carefully
• Interventions
 reduce the flow rate or stop infusion and notice the
physician immediately
 Give physical cold therapy to patient with T> 39℃
 Administer the antiallergic medication according to
physician’s order if necessary.
 Keep the residual solution，medication，and equipment
for the laboratory test．
Phlebitis，Thrombosis，and
Thrombophlebitis
• Causes: irritation to the lining of blood vessels
 chemical irritation to tissues by IV solutions or
medications
 mechanical irritation to tissues by the needle or catheter
 localized allergic reaction to the indwelling catheter or
needle
 local infection by undemanding sterile performance
during initiating infusion
Phlebitis，Thrombosis，and
Thrombophlebitis
• Symptoms and Signs
 feel pain in local site，with increased skin temperature
 swelling over the vein
 redness traveling along the path of the vein in some cases
 systemic reactions may be present，such as fever，chill
Phlebitis，Thrombosis，and
Thrombophlebitis
• Preventions
 To follow sterile principles strictly，and protect the 1ocal
site from contamination．
 Irritating medication should be diluted thoroughly and
infused slowly．
 The needle should be secured firmly to prevent the needle
sliding out of the vein．
Phlebitis，Thrombosis，and
Thrombophlebitis
• Interventions
 Discontinue infusion and start IV at another vein．
 Apply
warm
compresses
with
50 ％
magnesium
sulphate．
 Use physical therapy of ultrashort wave on local site．
 If there is infection ， use antibiotics according to
physician’s order．
Circulatory overload reaction
--acute pulmonary edema
• Causes:
 receive a too large volume and a too rapid
administration of IV solutions
a sudden
increase of circulating blood volume and too
heavy cardiac load
Circulatory overload reaction
--acute pulmonary edema
• Symptoms and Signs:
chest pressed ，
shortness of breath ， cough, frothy or pinkish
sputum，facial paleness，diaphoresis，neck vein
distention，rales in the lungs，rapid heart rate，
arrhythmia，rapid weight gain，pitting edema，
and tachycardia
Circulatory overload reaction
--acute pulmonary edema
• Preventions
 maintain the appropriate flow rate during the infusion,
especially for the patient with heart failure，the elderly
and children
 Avoid rapid flow rate at night because of nocturnal
decrease in renal function．
Circulatory overload reaction
--acute pulmonary edema
• Interventions
 slow the rate of infusion or stop the infusion immediately，
notify the physician
 assume a Folower’s position with the feet dangling at the
bedside if the patient’s condition is allowed
 apply oxygen administration with greater flow rate, put 20
％ to 30％ ethanol solution into humidified bottle
 administer the sedative，vasodilators，antiasthma，
digitalis，and diuretics to the patient according to the
physician’s order
 apply tourniquet to limbs of the patient in alternation in
order to reduce the venous return if necessary
Air Embolism
• Causes
 did not eject air in infusion system thoroughly; infusion
set is not air tight， did not eject air in the tubing below
the chamber on time after changing the solution
container
 do not alter the bottle or withdraw the needle on time
when the patient receives pressure infusion or pressure
blood infusion
Air Embolism
• Symptoms and Signs
 feel discomfort in chest or pain under the sternum，
with the presence of decreased blood pressure ，
cyanopathy，tachycardia，increased venous pressure，
and unconsciousness
 Clear
and
auscultated．
continuous
bubble
sound
can
be
Air Embolism
• Preventions
 inspect the quality of infusion set
 connect every part tightly
 ejecting air in tubing thoroughly
 check the tubing below the chamber to make sure no air
after changing the bottle of solution
 appoint a nurse to watch the patient with press infusion
 have patient place head below heart level or perform
Valsalva maneuver while changing tubing on central
venous lines
Air Embolism
• Interventions
 help the patient to turn on left side with head down
 administer oxygen therapy with high flow rate for the
patient
 monitor vital signs and notify the physician
Local Allergic Reactions
• Causes
 Individuals may demonstrate sensitivity to antiseptic
solutions，or tape used to secure the catheter．
 Indwelling catheters and needles may also cause allergic
reaction．
• Preventions and Interventions
 assess allergic history of the patient very carefully，change
some supplies which can cause allergic reactions
 administer antianaphylaxis medication based on the
physician's order if necessary．
Infection or Inflammation at the
Insertion Site
• Causes
 Microorganisms gain access to the tissue and circulatory
system through the tip of needle or cannula device inserted
during venipuncture
 Microorganisms enter later by migration along the
interface between the catheter and tissue
• Symptoms and Signs
 the local tissue may have redness，edema，heat，pain，
and perhaps exudation．The patient may have systemic
reactions，such as fever
Infection or Inflammation at the
Insertion Site
• Preventions
 Using aseptic technique for all IV-related care; keeping
dressing dry; changing dressing on time
• Interventions
 remove IV to another site if necessary
 apply cool compress to site as ordered by the physician
 elevate limb，and observe for signs of sepsis
INTRAVENOUS INDWELLING
NEEDLE INFUSION
• Purposes
• Preparation
• Procedures
• Cautions
Purposes
• Apply to the patients that have difficult to
puncture and need long-term IV infusion.
• Provide
an
easy
access
for
intermittent
infusions or IV administration.
• Protect patient’s veins from damnification of
repeated venipuncture.
Preparation
• Nurse
 Review the physician’s order in patient’s record.
 Evaluate patient’s age and medical status. Evaluate
patient’s renal status and other pertinent lab data (e.g.,
electrolyte, serum glucose ).
 Wash hands and wear mask.
• patient
 Verify patient’s identity.
 Explain the procedure and purpose．Ask the patient to
void．
 Position patient for comfort and optimal visibility for skill
performance.
Preparation
• Environment:cleaning, commodious, bright
• Equipment:
Medical tray
·Antiseptic solution
·Sterile swab
·Tourniquet
·Pad
·Crystal adhesive tape
·File and opener
·IV solution and medication
·Medical card
·Infusion set
·Bottle bag
·Kidney-shaped tray
·Sterile gloves
·Intravenous indwelling needle
Procedures
1. Check and right
2. Complete the medication label
3. Add medications into solution
4. Insert the infusion set
5. Prepare the equipment and take them to the
bedside．Check again
6. Discharge air
Procedures
7. Wear gloves, prepare IV indwelling needle
Check the quality of the IV indwelling needle
take out the indwelling needle
sterile the heparin cap
insert spike of infusion set
into the heparin cap
discharge again
Close the clamp
protect the indwelling needle
Procedures
8. Select the venipuncture site
(1) Place a pad under the extremity
(2) Apply a tourniquet firmly 10 to 15cm above the
venipuncture site．
9. Sterilize the venipuncture site．(>10cm)
10.Check again.
Procedures
11.Intravenous injection
(1) Use the left hand to pull the skin taut against the vein,
hold the needle with right hand, insert the needle and
catheter through the skin and into the vein
(2) Once blood appears in the lumen of the catheter,
reduce the angle of the needle until it is almost parallel
to the skin，advance the needle 0.2cm, then withdraw
the needle 0.5cm, advance the catheter and needle until
the whole catheter is in vein．Hold the catheter shaft
steady, withdraw the needle.
Procedures
12. Fixation
 release fist, tourniquet，and clamp
 Open the sterile adhesive tape bag, take out the crystal
adhesive tape, and secure the injection site hermetically.
 Loop the tubing near the site of entry，fix with adhesive
tape, and write down the date of installation on the
tape．
13. Regulate the flow rate
14. Check again.
Procedures
15. Disposure after operation
16. Change bottles
17. Disposure after infusion
 After infusion，close the roller clamp，withdraw the
needle from the heparin cap,
 sterile the heparin cap and seal the catheter with
0.9%NS in positive pressure
 Close the Luer Lock of primed IV catheter set to
peripheral cannula
 Help the patient to have a comfortable position．
 Record the volume of fluid infused and the time of the
discontinuation
 Dispose of the equipment in proper manner
 Wash hands. Document relevant data
Cautions
1. Follow the principles of asepsis and check system strictly to
prevent infection and mistakes.
2. Keep the injection site cleaning. Observe the injection site
carefully in order to find the complications and settle them
on time.
3. Seal the catheter with positive pressure after infusion to
prevent occlusion of the catheter or thrombophlebitis.
4. The catheter’s indwelling time is commonly about 3 to 5
days
5. Instruct the patient to take self-care. Avoid to energize and
press excessive. Avoid the catheter to be pulled out when
change clothes.
EXTERNAL JUGULAR
VENOUS CATHETER
INFUSION
•
•
•
•
Purposes
Preparation
Procedures
Cautions
Purposes
1. Measurement of central venous pressure (CVP)；
2. Apply a venous access when no peripheral veins
are available；
3. Administration of vasoactive medications which
cannot be given peripherally；
4. Administration of hypertonic solutions including
total parenteral nutrition.
Preparation
• Nurse:
 Review the physician’s order in patient’s record.
 Evaluate patient’s age and medical status. Evaluate
patient’s renal status and other pertinent lab data (e.g.,
electrolyte, serum glucose ).
 Evaluate patient’s mental status and cooperation status.
 Evaluate the venipuncture site.
 Wash hands and wear mask.
Preparation
• patient:
 Verify patient’s identity.
 Explain the procedure and purpose to reduce the patient’s
anxiety and tension.
 Position patient for optimal visibility for skill performance.
• Environment:
must be cleaning, commodious and bright
Preparation
• Equipment: Medical tray
·Antiseptic solution
·Sterile swab
·Crystal adhesive tape
·File and opener
·IV solution and medication
·Medical card
·Infusion set
·Bottle bag
·Kidney-shaped tray
·local anaesthetic
·Sterile venipuncture package
·Sterile gloves
Procedures
Steps 1 to 6 are the same as described
in Peripheral Intravenous Infusion
7. Select the position
8. Select insertion site and sterile the
skin
9. Open the sterile venipuncture
package, wear sterile gloves, and
drap the area
10. Infiltrate the skin and deeper
tissues with local anaesthetic
11. Insert the catheter and cover with
a sterile dressing
12. Connect with infusion set
Procedures
13. Regulate the flow rate
14. Check again.
15. Disposure after operation
16. Change bottles
17. Disposure after infusion
Seal the catheter with a small volume of dilute heparin ( 100
U/ml ) into the lumen.
Clamp catheter lumen using online slide clamp.
Stuff the needle hub hole with a sterile injection cap.
Catheter insertion site protection and stabilization are
accomplished by regular antimicrobial cleaning and sterile
dressing changes every day.
Procedures
18. Infusion again
Remove the sterile injection cap, sterile the needle hub hole,
connect with infusion set, unclamp lumen, then initiate
IV infusion.
19. Withdraw the catheter
The lumen of the catheter connect with a syringe, withdraw
the catheter while pump the syringe, press the insertion
site for several minutes.
Sterile the local skin with 75% ethanol solution, and cover it
with sterile dressing.
Cautions
1. Follow the principles of asepsis and check system strictly
to prevent infection and mistakes.
2. Select the insertion site carefully.
3. Intensify evaluation during infusion. Flush the catheter
with dilute heparin ( 100 U/ml ) if return blood appears
in the catheter to prevent occlusion.
Cautions
4. Seal the catheter with positive pressure after infusion to
prevent occlusion of the catheter. Clot appears in the
catheter should be sucked use a syringe to avoid to be
pushed into blood circulation.
5. To stabilize and protect catheter site to prevent
contamination or dislodgement. Observe the injection
site carefully in order to find the complications and settle
them on time.
SUBCLAVIAN VENOUS
CATHETER INFUSION
(self-study)
INFUSION PARTICLE
CONTAMINATION
(self-study)
END!