What is an Indwelling Catheter?
The use of indwelling needles can reduce the pain and fear of injections caused by repeated venipuncture, reduce parents' anxiety, facilitate clinical medication, rescue medications for urgent and critical patients, reduce the workload of nurses, and reduce the number of children Due to the pain, venous indwelling needles are widely used in clinical practice. Faced with this special group of children, the length of venous indwelling needles and the comfort of children have become the most important issues for nurses and parents. It is also a sign and promotion of the successful use of indwelling needles. Premise.
Catheter
The use of indwelling needles can reduce the pain and fear of injections caused by repeated venipuncture, reduce parents' anxiety, facilitate clinical medication, rescue medications for urgent and critical patients, reduce the workload of nurses, and reduce the number of children Due to the pain, venous indwelling needles are widely used in clinical practice. Faced with this special group of children, the length of venous indwelling needles and the comfort of children have become the most important issues for nurses and parents. It is also a sign and promotion of the successful use of indwelling needles. Premise.
- Chinese name
- Catheter
- Foreign name
- Indwelling needle
- Classification
- Open and closed
- Function
- Reducing children's fear of injections
- Birth time
- 1962
- Scope of application
- Intermittent continuous or daily intravenous infusion
Intravenous indwelling needles are also called venous trocars. The core components include a soft catheter / cannula that can be placed in a blood vessel, and a stainless steel puncture guide needle. During use, the catheter and the needle core are punctured into the blood vessel. After the catheter has entered the blood vessel, the needle core is withdrawn, and only the soft catheter is left in the blood vessel for infusion treatment. [1]
In 1962, the German Braun company invented the first indwelling needle "Braunüle". In the early 1980s,
name | International models | Domestic models | Flow rate | Clinical application |
Indwelling needle Y type | 18G | 12 # | 65ml / min | Rapid / high-dose infusion, routine surgery / transfusion |
Indwelling needle Y type | 20G | 9# | 48ml / min | Routine surgery / transfusion, routine adult infusion |
Indwelling needle Y type | 22G | 7 # | 31ml / min | Routine Adult / Pediatric Infusion, Pediatric Brittle Vein |
Indwelling needle Y type | 24G | 5.5 # | 20ml / min | Pediatric brittle vein |
Scalp needle (#) | 5 | 7 | 9 | 12 | 14 | |
Indwelling needle (G, Gauge) (international model) | twenty four | twenty two | 20 | 18 | 16 | 14 |
Color (International Standard) | yellow | blue | Pink | green | red | |
Choice of catheter
While meeting the needs of infusion, choose the shortest and thinnest catheter. The selected vein must be able to accommodate the length of the catheter and be at least twice the thickness of the catheter to ensure adequate blood flow and to meet intravenous infusion therapy.
The difference between a scalp needle and an indwelling needle
| Scalp needle | Catheter |
Disinfection range | Diameter 5 * diameter 5cm | 8cm in diameter |
Select blood vessels | From small to large | Thick, straight, rich blood flow, good elasticity, no venous valve |
Select puncture point | Blood vessel side | Puncture directly above the blood vessel |
Needle angle | 5-15 degrees | 15-30 degrees |
Needle speed | fast | slow |
After entering the blood vessel | Stop needle or slightly | Insert the needle a little and retract the core 2-3mm, and then enter all the catheters |
fixed | Ordinary tape | Transparent application |
keep time | 2-4 hours | Based on the requirements of the infusion therapy and the professional's assessment of the indwelling situation, adults typically do not exceed 3-4 days. |
Intermittent, continuous or daily intravenous infusion. The use of scalp steel needles should be limited to short-term or single-dose administration. Blood samples are collected or blood or blood products are transfused. Hemodynamic monitoring infusion fluid is at or near isotonic state, normal pH range (irritant drugs: only Intermittent bolus).
Easy puncture, related puncture techniques are easy to learn to protect the patient's blood vessels, reduce patient pain, feel comfortable, improve patient satisfaction and quality of care. There are many different structural products to choose from. There are different lengths of catheters to choose from to improve the efficiency of the nurse's work. Reasonable medication and avoid When the infusion is interrupted multiple times a day, puncture is reduced and medication is not used on time, avoiding reactions between drugs, reducing costs, and reducing the cost of exudation treatment caused by scalp needle puncture.
1. Item preparation: infusion bottle (glass bottle, plastic bag, plastic bottle)
Fixed dressing (tape, transparent film)
Connection accessories (heparin cap, needleless connection)
Flow rate control device (infusion pump, micro pump)
Catheter
Disinfection of iodophors, cotton swabs
Tourniquet
2. Choose blood vessels: choose thick and straight, good elasticity, rich blood flow, avoid venous valves and joints.
3. Disinfect the skin: The disinfection range is 8 * 8cm.
4, tie a tourniquet: 10cm above the disinfection range, not too tight, not more than 2 minutes.
5. Remove the needle guard cap and loosen the needle core: Remove the needle guard cap vertically and loosen the needle core left and right.
6. Connect the scalp needle and vent.
7. Puncture: Tighten the skin, pierce the vein straight, and insert the needle at 15-30 degrees. Slowly insert the needle. See 0.2 cm after the blood is returned.
8. Withdraw core: Hold the needle holder in one hand, and withdraw the core in one hand.
9. Catheter delivery: All catheters are delivered into the vein.
10. Release the tourniquet and adjust the drip rate.
11. Tube sealing and nursing: Sterile transparent stickers are used to fix the puncture point as the center. Keep the puncture point clean and dry, replace it once every 3-5 days with transparent stickers, and replace it once every two days in summer.
12. Record: stick the label on the venipuncture site, sign the puncture date, the operator's name, etc. And record the indwelling situation of the catheter and the name, dose and usage of special medications every day [3]
1. The puncture technique is unskilled and the catheter tip is damaged
2, puncture excessively puncture the posterior wall
3. Only puncture the needle tip into the vein and the outer cannula is still outside the vein wall to fail to deliver the tube
4, the puncture angle is too small, the vein wall is scratched
After the treatment, gently massage the peripheral blood vessels of the extremities and gently rub the backs of hands and feet to promote the return of venous blood. Infants and young children can be wrapped outside the indwelling needles with clean small towels or loose cotton socks to reduce parents' concerns about the children turning over the indwelling needles while sleeping There is a psychological burden of friction and slipping, and it also plays a role in keeping warm in winter. When the indwelling needle is on the head, breastfeeding and sleeping are avoided to the side of the needle. When the indwelling needle is on the lower limbs, hold the child through the hands with both hands to separate the feet and sleep. Place small clothes between legs and small cushions to separate your feet to avoid kicking the indwelling needle. Inform older children to keep the indwelling needle indwelling limbs to avoid excessive movement. When undressing, first wear the indwelling needle-side limb, first remove the indwelling needle-side limb; the indwelling needle does not enter the limb.
The traditional fixing method is generally to take the material on the spot, fold it with an abandoned empty carton, or use a thick plywood (0.5 ~ 0.8cm). The material is too thin or too hard, and the air permeability is poor. The functional position of the child is generally not taken into account when disengaging and fixing. After clinical improvement, we have made a variety of splints, which are comfortable and breathable, easy to sterilize (ultraviolet radiation, disinfection with chlorine disinfectant), and can be used repeatedly. After using the above methods and care, none of them caused skin damage due to improper fixation. For pressure ulcers, 2 cases were extubated by themselves, 3 cases were allergic to tape, 1 case was allergic to 3M film, and healed after timely treatment. Therefore, the author believes that the pediatric indwelling needle is well fixed and properly maintained to ensure the venous indwelling needle indwelling time. At the same time, it also provides comfortable humanized care for children. However, the problem of clinical extubation or mechanical phlebitis leading to extubation needs to be further explored.
1. BD. Peripheral vein indwelling needle puncture manual
2,3. Chen Hezhen. Discussion on the neonatal skin problems caused by the transparent application of intravenous indwelling needles. Chinese Journal of Practical Nursing, 2004; 20 (5): 38
4.Luo Qinghua, Zhifeng, Li Baoli. Observation of sealing effect of intravenous indwelling needle in children. Chinese Journal of Nursing, 2000; 35 (10): 624
5. Jingyi, Yan Xiulan, Guo Ying, et al. Discussion on the replacement time of the protective film of the superficial vein indwelling needle [J] .Journal of Practical Nursing, 2002; 18 (16): 47
6. Li Yumei, Zhu Huifang. Application and experience of intravenous indwelling needle in neonates. Chinese Journal of Practical Medicine, 2003; 3 (2)
