|
 


|
    
 


     
   
|
 


Assessment
Factors to be considered:

h Condition of the vein

h Type of fluid or medication to be infused
h Duration of therapy
h Patient·s age and size
h Whether the patient is right- or left-handed
h Patient·s medical history and current health status
Assessment
Attributes of an ideal vein are:

h Engorged, bouncy & soft

h Refill after it has been depressed
h Feel round
h Be well supported by surrounding structures
h Be straight & ¶free of valves·
h Not hard, flat, or bumpy
—ethods for improving venous access:

h Apply a tourniquet
h Lower the level of the arm below the heart
h Ask the patient to open and close their fist
h Light tapping / rubbing of the veins
h Warm compresses over the selected vein
h Warm water
h Relax the patient / consider the environment
Oeins to be avoided:
h Thrombosed, fibrosed or sclerosed
h Inflamed or bruised or painful
h Thin or fragile
h —obile
h Near bony prominences and joints
h Near sites of infection or edema
h Avoid the valves
Oein selection
h Arm veins are most
commonly used.
h The metacarpal,
cephalic, basilic, and
median veins and their
branches are
recommended sites
because of their size
and ease of access.
h Leg veins are rarely used
because of high risk of
thromboembolism.
Oein selection
Antecubital Fossa

 

Ö

 

Ö


 


 



 


 

     
 








 
 





 

 


Ö

 
 
Oein selection
h The antecubital fossa is avoided, except as a last resort.
Close proximity with other arteries
Flexion of elbow may displace cannula

h The veins in the dorsal hand may be utilized if large bore

access (18 gauge or larger) is not required. Care must be
taken to find a vein that is straight and will accept the entire
length of the catheter.
|
    
Intravenous Cannula
h A intravenous cannula is a flexible tube which when
inserted into the body is used either to withdraw fluid or
insert medication.
h Cannulae normally come with a trocar (a sharp pointed
needle) attached which allows puncture of the body to get
into the intended space.
A venous cannula is inserted into a vein, primarily for the
administration of intravenous fluids, obtaining blood
samples and administering medicines.
Intravenous Cannulation
 
   


  !"

## 
$%  

$

& !'

## 
$%  


  ( )) Ö
#

*+ ) &) ,#$Ö-

Ö " Ö-$
 
 #

.   ' Ö 
$/  

#$0 
 
*  & 0 
 
 
!|"
Oenesection

h Oenesection is the generic term for a procedure that

involves the cutting of a vein in any way, but it most
commonly refers to the drawing of blood from a vein.
h Oenous blood is usually taken from the median cubital vein,
which is located on the arm, opposite the elbow.
Oenesection

h Blood donation is also usually done out of this vein, but

blood drawn for testing, which is the main purpose
of venesection, is normally taken in quantities of about 0.17
to 0.84 fluid ounces (5 to 25 ml).
h Oenesection is also known as phlebotomy and
venipuncture.
Oacutainer
h Oacutainer is a registered brand
of test tube specifically designed
for venipuncture.
h The test tubes are covered with a
color-coded plastic cap. They often
include additives that mix with the
blood when collected (see below),
and the colour of the tube's plastic
cap indicates which additives that
tube contains.
Benefits:
h Quicker collection than other methods
h Closed system
h Exact amount of blood obtained
h Reduces the risk of haemolysis of the sample
h Reduces the risk of needle stick injury
mrder of draw
The order of draw refers to the sequence in which these tubes
should be filled.

h Containers containing coagulants

h Gold or 'Tiger' Red/Black top: Clot activator and gel for
serum separation
h Red top PLASTIC tubes: Contains a clot activator and is
used when serum is needed
h mrange or Grey/Yellow 'Tiger' Top: Contain Thrombin,
a rapid clot activator, for STAT serum testing
mrder of draw
h Containers containing anticoagulants
h Green - Contains Sodium Heparin or Lithium Heparin
used for plasma determinations
h Light Green or Green/Gray 'Tiger': For plasma
determinations in chemistry
h Grey - These tubes contain fluoride and oxalate.
Fluoride prevents enzymes in the blood from working,
so a substrate such as glucose will not be gradually
used up during storage. mxalate is an anticoagulant.
mrder of draw
h Purple or lavender - contains EDTA (the potassium
salt, or K2EDTA). This is a strong anticoagulant and
these tubes are usually used for full blood
counts (CBC) and blood films. Lavender top tubes are
generally used when whole blood is needed for
analysis. Can also be used for some blood bank
procedures such as blood type and screen, but other
blood bank procedures, such as crossmatches must be
in a pink tube in most facilities.
mrder of draw
h Light blue - Contain a measured amount of citrate. Citrate
is a reversible anticoagulant, and these tubes are used
for coagulation assays. Because the liquid citrate dilutes the
blood, it is important the tube is full so the dilution is
properly accounted for.
h Dark Blue - Contains sodium heparin, an anticoagulant.
Also can contain EDTA as an additive or have no additive.
These tubes are used for trace metal analysis.
h Pink - Similar to purple tubes (both contain EDTA) these
are used for blood banking.