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Intravenous Access
Surgical puncture of a vein to deliver medication or withdraw blood. AKA Cannulation
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Indications for Venous Access
- -Fluid/Blood replacement
- -Drug Administration
- -Obtaining venous blood specimens for lab analysis
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Peripheral Venous Access
Surgical puncture of a vein in the arm, leg or neck.
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Central Venous Access
Surgical puncture of the internal jugular, subclavian or femoral vein
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Peripherally Inserted Central Catheter (PICC)
Line threaded into the central circulation via a peripheral site
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Intravenous Fluid
Chemically prepared solution tailored to the body's specific needs
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Colloid
Intravenous solutions containing large proteins that cannot pass through capillary membranes
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Crystalloid
Intravenous soultions that contain electrolytes but lack the larger proteins in colloids
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Isotonic
State in which solutions on opposite sides of a semipermiable membrane are in equal concentration
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Hypertonic
State in which a solution has a higher solute concentration on one side of a semipermiable membrane that on the other side.
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Hypotonic
State in which a solution has lower solute concentration on one side of a semipermiable membrane than the other
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Crystalloid Classes
- -Isotonic
- -Hypertonic
- -Hypotonic
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Common IV Fluids
Lactated Ringers: Isotonic electrolyte solution with Sodium Chloride, Potassium Chloride, Calcium Chloride, Sodium Lactate in water.
Normal Saline: Isotonice electrolyte solution with .9 percent Sodium Chloride in water
5% Dextrose (D5W): Hypotonic glucose solution used to keep vein open and supply glucose
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IV Fluid Packaging
- -Label with fluid type and expiration date
- -Medication Administration Port
- -Administration Set Port
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Administration Tubing
Flexible, clear plastic tubing that connects the solution bag to the IV cannula
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Cannula
Hollow needle used to puncture the vein
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Microdrip Administration Tubing
Administration tubing that delivers a relatively small amount of fluid
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Macrodrip Administration Tubing
Administration tubing that delivers a relatively large amount of fluid
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Spike
Sharp-pointed device inserted into the IV soultion bag's administration set port
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Drip Chamber
Clear plastic chamber that allows visualization of the drip rate
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Drip Rate
Pace at which the fluid moves from the bag into the patient
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Drop Former
Device that regulates the side of drops
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Medication Injection Port
Self-sealing membrane into which a hypodermic needle is inserted for drug administration
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Needle Adapter
Rigid plasted device specifically constructed to fit into the hub of an intravenous cannula
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Extension Tubing
IV tubing used to extend a macrodrip or microdrip setup
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Measured Volume Administration Set
IV setup that delivers specific volumes of fluid
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Burette Chamber
Calibrated chamber of Berutol IV administration tubing that enables precise measurement and delivery of fluids and medicated solutions
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Blood Tubing
Administration tubing that contains a filter to prevent clot or other debris from entering patient
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Over-The-Needle Catheter/Angiocatheter
Semiflexible catheter enclosing a sharp metal stylet
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Hollow-Needle Catheter
Stylet does not have a Teflon tube but it itself is inserted into the vein and secured there
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Catheter Inserted Through The Needle
Teflon catheter inserted through a large metal styler
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Venous Constricting Band
Flat rubber band used to impede venous return and make veins easier to see
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Extravasation
Leakage of fluid or medication from the blood vessel that is commonly found with infiltration
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IV Troubleshooting
- -Tourniquet in place still?
- -Edema at site?
- -Cannula abutting valve or vein wall?
- -Administration set control valve closed?
- -IV bag too low?
- -Completely filled drip chamber?
- -Catheter patent?
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IV Access Complications
- -Pain
- -Local infection
- -Pyrogenic reaction
- -Allergic reaction
- -Catheter shear
- -Inadvertent arterial puncture
- -Circulatory overload
- -Thrombophlebitis (vein inflammation)
- -Thrombus formation
- -Air embolism
- -Nerosis
- -Anticoagulants
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Pyrogen
Foreign protein capable of producing fever
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Embolus
Foreign particle in blood
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Circulatory Overload
An excess in intravascular fluid
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Thrombophlebitis
Inflammation of the vein
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Air Embolism
Air in the vein
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Necrosis
The sloughing off of dead tissue
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Anticoagulant
Drug that inhibits blood clotting
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Saline Lock
Peripheral IV cannula with distal medication port used for intermittent fluid or medication infusions. Saline is injected into the device to maintain its patency
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Heparin Lock
Same as Saline Lock only with Heparin
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Venous Access Device
Surgically implanted port that permits repeated access to central venous circulation
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Huber Needle
Needle that has an opening on the side of the shaft instead of the tip
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Infusion Controller
Gravity-flow device that regulates fluid's passage through and electromechanical pump
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Extravascular
Outside the vein
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Infusion Pump
Device that delivers fluids and medications under pressure
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Blood Tube
Glass container with color-coded, self sealing rubber top
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Vacutainer
Device that holds blood tubes
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Multidraw Needle
Long, exposed needle that screws into the vacutainer and is inserted directly into the vein
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Blood Tube Colors
- -Red: No anticoagulant
- -Blue: Citrate
- -Green: Heparin
- -Purple: EDTA
- -Gray: Fluoride
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Hemoconcentration
Elevated numbers of red and white blood cells
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Hemolysis
The destruction of red blood cells
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Intraosseous
Within the bone
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Trocar
A sharp, pointed instrument
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Intraosseous Access Complications
- -Fracture
- -Infiltration
- -Growth plate damage
- -Complete insertion
- -Pulmonary embolism
- -Infection
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Contraindications to IO
- -Fracture near site
- -Osteogenesis imperfecta
- -Osteoperosis
- -Establishment of IV
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