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11 complications possible with veni tech.
- 1. Non-running IV infusion
- 2. Infiltration
- 3. Venospasm
- 4. Hematoma
- 5. air embolism
- 6. Extravasion
- 7. Intra-arterial puncture
- 8. Intra-arterial injection
- 9. Phlebitis
- 10. Thrombophlebitis
- 11. Phlebothrombosis
What to do when Non-running IV infusion (3)
- 1. make sure IV bag is above heart
- 2. make sure touniquet has been removed
- 3. bevel of needle against wall of vein
what happens during infiltration and what do yo need to do?
- Needle disloged during taping/pt movement
- look for colorless swelling
- NEED to put new IV in
what is the air tolerance of a 50 kg adult?
- *children less tolerant
- * average IV set holds 13 ml of air (ELIMINATE ALL FREE AIR)
Tx of air embolism
- place pt on left side
- head down to prevent air entry into pulmonary and cerebral circ
1.what is EXTRAVASION
2.what are symptoms
3.how to tx
- 1. fluid/drugs leak into surrounding tissue
- 2.pain, delayed absorp of drug and tissue damage
- 3. remove IV, apply pressure to stop bleeding & disperse solution??
- May infiltratie several mL of 1% procaine (vasodilates and relieves pain)
How to prevent Intra-arterial puncture?
- 1. palpate (pulse = artery)
- 2. check color of blood return(brighter red) and pulsations
tx intra-arterial puncture tx?
remove needle apply firm pressure for at least 10 mins
complications from Intra art injection?
- arterial constriction
- circ compromise-->tissue damage
4 signs/symptoms of itnra-arterial injection
- 1. severe pain- radiates distarly toward hand
- 2. absence of radial pulse
- 3. loss of normal skin color
- 4. decreased temp to involved limb (white, cold hand)
Tx intra-arterial injection
4 definitive tx
- 1. leave needle in place, inject 1% procain w/o epi (2-10 mL) to decrease pain, vasodilate, and dilute drug
- 2. Hospitalize pt and optain vascular consultation
- Definitive tx
- stellate ganglion/brachial plexus block
- surgical endartectomy
- amputation of gangrenous part
what is PHEBOTHROMBOSIS?
- formation of venous thrombosis w/o inflammation
- immediate, minimal pain
what is PHLEBITIS?
inflammation of a vein
What can cause thrombophlebitis? (3)
- chemical/mechanical irritation of vein/site of v.punture
- 2. technique
- 3. bevel and dullness of needle
WHat is THROMBOPHLEBITIS?
inflammation of vein precedes form of clot
Pain, induration, delayed onset (24-48 hrs)
How to prev thrombophlebitis
- 1. use sharp, sterile needles
- 2. atraumatic technique
- 3. dilution of IV solutions
- use of large veins
- 4. inject slowly into rapid infusion
how to tx thrombophlebitis? (4)
if severe? (3)
- 1. limited activity of limb
- 2. elevation of limb
- 3. moist heat
- 4. NSAIDS
- if severe-
- 1. Abx
- 2. Anticoag
- 3. vascular consultation