To know when to hold a training course or a training course for oncology nurses in the local nursing society or intravenous infusion committee, and obtain the certificate of theoretical training, and then issue the certificate after the clinical independent completion of 5- 10 operation.
At present, Chinese Nursing Association holds two theoretical studies in Peking Union Medical College in April and September each year, which are 1 week respectively. There was an exam before. (See official website of Chinese Nursing Association for details).
4 There is also the international PICC certificate (UNA PICC certificate) from the Vascular Access College of Budd Company.
Peripherally inserted central venous catheter (PICC) is a new technology in recent years, which can establish long-term venous access for critically ill children. Because the puncture point is in the peripheral vein, the vascular selectivity is high, the success rate is high, the trauma is small, the infection opportunity is less, and the nursing is easier.
Method:
1. Commonly used blood vessels include axillary vein, median elbow vein, basilic vein, popliteal vein, great saphenous vein and even smaller peripheral veins, such as neonatal hand vein. There are three methods for PICC, and the required catheters are also different. Commonly used 24G~20G catheter with jacket.
2. Measure the length of the catheter. The right upper arm is extended 90 degrees, the length from the puncture point of the right upper limb to the right sternoclavicular joint is measured, then it is folded vertically downwards, and then it is measured to the third intercostal space (equivalent to the opening of the right atrium), which is the set insertion depth of the catheter. If puncture is made from the left upper limb, the distance between the two nipples should be increased.
3. Choose a suitable puncture box according to the age and weight of children.
4. Install the puncture needle and syringe with heparin saline.
5. Tie a tourniquet on the upper arm, select a suitable puncture site, perform strict aseptic operation, routine disinfection, spread towels, wear gloves and perform local anesthesia.
6. Select the appropriate part of the upper limb and do venipuncture with the inclined plane of the puncture needle downward. After seeing the blood return, lower the angle and move forward slightly to ensure that the tip of the catheter enters the blood vessel.
7. Loosen the tourniquet and take out the needle core.
8. Gently clamp the front end of the catheter with tweezers and send the puncture needle centripetally.
9. When the catheter enters 10 ~ 15 cm, exit the puncture needle and gradually tear off the puncture jacket.
10. Continue to feed the catheter gently and slowly. When the catheter is expected to reach the shoulder, turn the child's head to the puncture side to make the catheter easy to enter the superior vena cava. Send the catheter to the mark and tear off the catheter protective sleeve.
1 1. Fix the catheter end with your left hand, loosen the catheter lock, and gently pull out the guide wire.
12. Rinse the catheter with normal saline, and then seal the catheter with heparin saline.
13. disinfect the puncture point, fix the catheter and cover it with sterile dressing, and connect the catheter with the infusion set through the tee.
14. Take bedside photos to determine the position of catheter.