Special reminder on venous indwelling needle
First, the most important point is aseptic operation. In order to ensure the safe application of venous indwelling needle, aseptic operation technology must be strictly implemented during venous indwelling needle puncture.
The specific method is: disinfect the skin twice with 2% Iodophor cotton balls in a circular or parallel manner. The diameter of the disinfection range should be less than 8cm. After 2% Iodophor cotton ball is used for daily infusion to disinfect the heparin cap and venous indwelling needle plug twice, remove the heparin cap and connect the infusion set. After the infusion, the heparin cap shall be fastened with 3ml heparin saline (1:100) in strict accordance with the sterile operation technology, and then the heparin cap edge and the trocar wing shall be bound and fixed with sterile gauze.
Secondly, the user's intravenous indwelling needle operation must be skilled. The needle entry angle of venous indwelling needle should be 15 ° ~ 30 °, and the needle entry speed should be slow. It should be directly inserted into the blood vessel. If the needle is inserted too fast, it is very easy to puncture the vein, resulting in puncture failure and additional pain to the patient.
At the same time, pay attention to the timing and operation method of pipe delivery. After the venous indwelling needle is inserted into the needle, the blood return cavity shall be observed in time. When there is blood return, the puncture angle shall be reduced, and the indwelling needle shall continue to move 1 ~ 2mm along the blood vessel before sending the tube. It is forbidden to send the tube immediately after seeing blood return.
During pipe delivery, only 3 ~ 4mm long catheter is left outside the skin, so it is not easy to turn or pull out the hose. Blood vessels should not be selected too close to the joint, otherwise it is easy to leak during activity. Patients with agitation should absolutely prohibit puncture near the joint.
Finally, the indwelling time of trocar of venous indwelling needle also needs attention. In the nursing of using venous indwelling needle trocar, its indwelling time is a very important problem. Prolonged indwelling time can increase the risk of local complications; If the retention time is too short, it will increase the patient's drug cost and the pain caused by puncture. Yike suggests that the retention time of trocar is 3 ~ 5 days. However, it has been reported that the longest retention time is 27 days, with an average of 8 ~ 9 days. Phlebitis usually occurs 6 ~ 7 days after catheterization, while the incidence of phlebitis within 5 days is 0. Therefore, 5 days should be used as the retention time of conventional trocar.
