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Order of draw
- Blood cultures (aerobic then anaerobic)
Procedure for skin prep when drawing blood cultures
- Scrub w/chloroprep x 30 sec
- Do not touch skin after
How often should peripheral IVs sites be changed?
q 5 days
Match IV needle gauge colors and size
- Blue: 22
- Pink: 20
- Green: 18
Must know these before administering IV push meds
- 5 rights
- rate of admission (how fast)
- dilution needed or full strength
- syringe size (PIV v CVC)
- flushes needed
How long to scrub IV hubs before pushing meds?
Match PSI to syringe sizes
- 1 ml: >300 psi
- 3 ml: 25 psi
- 10 ml: 7 psi
Formula for calculating drip rates
(volume x drop factor of tubing) ÷ time for infusion in minutes
Catheter tips in central lines lie here
- SVC (superior vena cava)
- IVC (inferior vena cava)
Short term CVC
Long term CVC
Abbreviations: SL, DL, TL
- single lumen
- double lumen
- triple lumen
Why can incompatibles be administered in the same CVC?
- rapid dilution
- but use separate ports (proximal, medial, distal)
How often should percutaneous CVC dressings be changed?
q 72 h
Venous locations of percutaneous CVCs
- IJ: intrajugular
- SC: subclavian
- FEM: femoral
Peripherally inserted central catheter
What are power PICCs?
- All high powered/rapid injections
- identify by purple lumen
What are Mediports?
- long-term CVC
- implanted in chest wall
- accessed with Huber needle
What are Hickman/Groshong?
- Long term CVC
- subcutaneous insertion via tunneling up chest wall
- advantage: less infection
How to flush a CVC
- 10-20 ml of NS first
- 5 ml Heparin flush if Mediport
- "Push pause" method
Tricks to try if CVC won't flush
Tubing for blood transfusions
Protocol for blood transfusions
- Check product with blood bank paperwork
- Check product with patient's armband/IHIS
- Must be 2 licensed staff
- Consent on chart
- Pre-vitals, 15 min vitals, post-vitals
Most reactions to blood products occurs at this timepoint
- within 15-30 minutes of transfusion start
- stay with patient for first 15 minutes
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