The pros and cons of indwelling needles

In hospitals, it is common to see people receiving intravenous infusions with an indwelling needle on the back of their hands. This is to facilitate the next intravenous injection. With an indwelling needle, there is no need for injections every day. This is especially beneficial for children. Of course, when using an indwelling catheter, everyone should understand the pros and cons of the catheter in detail. More importantly, it is about how to care for the situation with an indwelling catheter, and be careful during use.

Before the operation, the patient's physical condition, veins, body nutrition, illness and medications should be evaluated, and then the appropriate injection site and blood vessel should be selected according to the needs. Generally, it is advisable to choose blood vessels that are relatively thick, straight, elastic, have abundant blood flow, have no venous valves, avoid joints, and are easy to fix. Usually, superficial veins of the limbs are selected for puncture, and the veins of the lower limbs should be avoided as much as possible. If there are special circumstances or the condition requires puncture of the lower limb veins, the lower limbs can be raised 20°~30° during infusion to speed up blood return, shorten the retention time of drugs and fluids in the lower limb veins, reduce their stimulation to the lower limb veins, and reduce the chance of lower limb venous thrombosis. In addition, the blood vessels of the elderly have poor elasticity and are more brittle, and their resistance to chemical and mechanical damage is reduced. Therefore, when placing a cannula, blood vessels with a diameter ≥ 3 mm should be selected as much as possible.

Puncture: When placing a venous needle, strict aseptic technique should be followed. Routinely connect the infusion device and exhaust. The nurse should wash her hands and disinfect the thumb and index finger of her right hand holding the needle before inserting the catheter, and keep the needle wings disinfected. Routinely disinfect the puncture site. If the diameter is >10cm and exceeds the dressing area, rotate and loosen the outer sleeve to eliminate the adhesion between the sleeve and the needle core. Check whether the tip of the indwelling needle is bifurcated or damaged, adjust the bevel of the needle tip, tighten the skin to fix the vein, hold the needle wing of the indwelling needle with the right hand, and insert the needle above the blood vessel at an angle of 15°~30° to the skin. The needle insertion speed should be slow. After seeing the blood return, lower the puncture angle and push the puncture needle 2 mm in the direction of the vein to make the tip of the outer cannula enter the blood vessel completely. Use the needle core as support to send the cannula into the vein, then remove the needle core, loosen the tourniquet, open the regulator, fix the indwelling needle with a sterile transparent dressing, fix the infusion tube with tape, and adjust the infusion drip rate. Indicate the time of catheterization on the dressing. The puncture is the key to the success of intravenous indwelling needle, so you must complete the steps patiently and carefully according to the procedures.

Management of indwelling needles after infusion: The length of time the indwelling needle is retained is closely related to whether the sealing technique is appropriate. There are two commonly used tube sealing methods in clinical practice: positive pressure tube sealing with a clave connector and tube sealing with sealing liquid.

Note: In general, the retention time of intravenous catheter should be within 96 hours. Bathing is prohibited during the retention period. Keep the puncture site dry and clean to prevent infection and spread of the puncture site. The dressing should be changed daily. When removing the dressing, be careful to remove it from bottom to top to avoid pulling out the needle. Then routinely disinfect the puncture point area so that it is not smaller than the dressing area. The puncture time should still be noted after replacement. In addition, during intravenous needle indwelling, the order of infusion of drug solutions should be arranged reasonably. Irritating liquids and liquids with high viscosity should be placed in the middle of the sequence and should be spaced apart from each other to avoid excessive stimulation to the blood vessels causing fluid extravasation. In addition, nurses should strengthen their patrols to observe whether the infusion is smooth, whether the connections of the infusion tube and other parts are loose, and whether there is local swelling, exudation, etc.