What are the functions and precautions of intravenous indwelling needles?

The application of venous indwelling needle is a better method for clinical infusion. The venous indwelling needle is easy to operate and is suitable for puncture in any part. At the same time, it reduces the pain of repeated puncture for patients and reduces the workload of nursing staff.

1. Precautions for use

(1) When using intravenous indwelling needles, aseptic technical procedures must be strictly followed.

(2) Closely observe the changes of the patient's vital signs and local conditions. Before and after each infusion, check whether the puncture site and the direction of the vein are red and swollen, and ask the patient whether there is pain or discomfort. If there is any abnormality, the catheter should be removed in time and dealt with accordingly. For those who still need infusion, the limb should be replaced and punctured separately.

(3) The limbs using intravenous indwelling needles should be properly fixed, the activities of the limbs should be reduced as much as possible, and the limbs should not be wetted by water. If you need to wash your face or take a bath, you should wrap the part with plastic paper. For patients who can move on the ground, the intravenous indwelling needle should not be kept in the lower limbs, so as to avoid blood return and blockage of the catheter due to gravity.

(4) Draw back the blood before each infusion, and then flush the catheter with sterile 0.9% sodium chloride injection. If there is no blood return and there is resistance to flushing, the indwelling needle catheter should be considered blocked. At this time, the venous indwelling needle should be pulled out. Remember not to use a syringe to inject forcefully, so as not to push the coagulated thrombus into the blood vessel and cause embolism.

2. user's guidance

(1) Bring the supplies to the patient's bedside, and explain the bed number and name to the patient.

(2) Hang the infusion bottle on the infusion stand, unpack the catheter needle, and wear gloves.

(3) Select the blood vessel. Tie a cuff 10cm above the puncture point, perform local skin disinfection as usual, and let it dry.

(4) Take out the catheter needle, remove the needle cover, and turn the needle center so that the bevel of the needle is upward. Pierce the scalp needle of the prepared intravenous infusion set into the heparin cap, pay attention to exhaust the air, and turn off the switch of the infusion set.

(5) Puncture at an angle of 15° to 30° between the needle and the skin. After blood returns, lower the angle and advance the puncture needle by 0.2 to 0.5 cm to puncture. Instruct the patient to make a fist, tighten the skin with the left hand, and pinch the wings of the catheter needle with the thumb and index finger of the right hand. Fix the catheter needle with the right hand, pull out the center of the needle 0.5-1 cm with the left hand, put the outer cannula into the vein with the left hand, loosen the pulse belt, and instruct the patient to loosen his fist.

(6) Take out the needle core, fix the catheter needle with a special applicator, write the patient's name, indwelling date and time on the applicator, then fix the heparin cap, and take out the cuff.

(7) Take off the gloves, and after checking again, record the time and infusion speed on the infusion card and sign it. Adjust the infusion rate according to the doctor's advice and condition (refer to the intravenous infusion method).

(8) Help the patient lie in a comfortable position, arrange the bed unit, dispose of the supplies according to the intradermal injection method, and wash hands.

(9) Explain precautions to patients, and conduct health education according to the situation.

(10) Tube sealing: After the liquid is transfused, the tube is sealed.

①Routinely sterilize the heparin cap.

②Pierce the needle of the syringe with lock solution (0.9% sodium chloride injection and heparin solution 0.9% sodium chloride injection) into the heparin cap. (Preparation concentration of heparin solution: 1 tube of 12,500 U of heparin is diluted in 125 to 1250 ml of 0.9% sodium chloride injection, that is, each ml contains 10 to 100 U of heparin, and the dosage is 5 ml. The maintenance time of the locking solution is strictly controlled, generally 0.9 % sodium chloride injection for 6 to 8 hours, diluted heparin solution for 12 hours).

③Retract the needle while injecting the sealing solution.

④Clamp the silicone tube of the indwelling needle with a clip.

(11) Re-infusion

① Routine sterilized heparin cap: Loosen the clip, insert the needle of the syringe with 0.9% sodium chloride injection into the heparin cap, withdraw the blood first, and then inject 5-10ml of 0.9% sodium chloride injection.

②Pierce the scalp needle of the infusion set into the heparin cap, open the regulator to adjust the drip rate, and infuse again.

③ Observe whether there is redness and swelling at the puncture site, and whether there is tenderness when touched along the direction of the catheter on the intact dressing surface.