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The operation of venous indwelling needle is simple, safe and convenient, which not only solves the pain of repeated puncture of patients, protects veins, but also reduces the nursing workload of nurses. It is suitable for elderly patients and unconscious patients, especially critically ill patients, and can take medicine as soon as possible at any time to improve the success rate of rescue.

[Keywords] Intravenous indwelling needle; Operation method; Sealing technology; nurse

Clinical data of 1

From June 2005 to February 2005, 68 patients, aged 48-84, were treated with intravenous indwelling needle, including 34 cases of emphysema, 28 cases of cor pulmonale and 6 cases of asthma. Satisfactory results have been achieved.

2 operation method

2. 1 puncture method

Before puncture, exhaust the air from the infusion set to the filter, check and open the indwelling needle, then directly insert the needle of the infusion set into the indwelling needle heparin cap, and exhaust again. The skin at the puncture site is routinely disinfected, and the operator's right hand holding the indwelling needle is 15? ~30? Pierce the subcutaneous blood vessel and see the angle of depression (about 5? ~ 15? Further 0.2 cm, the left hand pulls out a little from the needle core, and the right hand feeds the sheath into the blood vessel. When pulling out the needle core, the sheath should be inserted, which can prevent the needle core from contacting the blood vessel wall, and the sheath can support the needle core, which can smoothly pass through the skin and improve the success rate of puncture.

2.2 Selection of vascular and indwelling needle models

For patients who use venous indwelling needle, it is advisable to choose blood vessels that are relatively thick and straight, elastic, rich in blood flow, without venous valves, avoiding joints and easy to fix. The incidence of venous thrombosis in lower limbs is three times that in upper limbs. Generally, veins of upper limbs should be used. Under the premise of not affecting the infusion speed, we should choose a shorter indwelling needle, and the relatively small indwelling needle will float in the blood vessel after entering the blood vessel, so as to reduce the damage of mechanical friction to the inner wall of the blood vessel, thus reducing the occurrence of mechanical phlebitis and thrombophlebitis.

3 pipeline sealing technology

Sealing tube is the key to the success of indwelling needle. Reasonable sealing solution concentration and proper sealing method can prolong the indwelling time.

3. 1 Selection of sealing fluid

The main sealing fluids for indwelling needle are diluted heparin sodium saline and normal saline. At present, heparin sodium saline is considered to be superior to normal saline. The preparation method of heparin sodium saline sealing solution is: 250 ml of 0.9% saline is mixed with heparin sodium1.25 u.

3.2 Pipeline sealing method

After infusion, 3 ml of heparin sodium solution was extracted by syringe, and heparin cap was disinfected routinely. Insert the syringe needle into heparin cap for 3 mm~5 mm, slowly push the injection, push it back while pushing it, push it for 2 mm ~ 2.5 mm, and pull out the remaining 0.5 mm ~ 1 mm of the needle to complete the tube sealing. After sealing the tube, blood must be drawn first, and rehydration can only be received after seeing the returned blood. It is not allowed to push blood clots into blood vessels with syringes to avoid blockage. 4 indwelling time of indwelling needle

When there is no phlebitis, the indwelling needle will be kept as a routine for 5 days [3]. Replace the 1 indwelling needle patch every two days, and wipe the needle with iodophor for disinfection. If there is oozing liquid, oozing blood, sweating, air, etc. In the protection patch, it should be replaced immediately. Pay attention to strict sterility in all links during operation to improve the success rate of puncture. Washing the catheter with normal saline before and after infusion of drugs with strong irritation to blood vessels can reduce the occurrence of phlebitis and prolong the intubation time.

5 nursing

5. 1 Before indwelling needle, explain the purpose, importance and necessity of indwelling needle to patients and their families, do a good job of explanation, and obtain the cooperation of patients. During the use of the indwelling needle, attention should be paid to protecting the indwelling needle when turning over and moving, keeping the puncture site clean and dry to prevent falling off, pollution or liquid leakage.

5.2 Skilled in operation technology, check the trocar before puncture, correctly select blood vessels, and change the infusion set/kloc-0 times a day. Every injection and infusion should be strictly sterile, and the tube should be sealed in time after the liquid drops, and the small adjusting clip of the indwelling needle should be closed to prevent air embolism. Heparin cap was wrapped with sterile gauze and fixed with adhesive tape. The tube sealing fluid can only be prepared and used on the same day, and the tube sealing syringe 1, person 1.

5.3 All patients with indwelling needle should be checked in time, and the bedside shift should be carried out to observe whether the patient's body temperature has changed and whether the puncture point is red, swollen or blue. Ask the patient if there is any discomfort. If there is abnormal pain, extubate in time. After extubation, compress with a dry cotton swab for 5 min, and leave without bleeding.

5.4 After sealing the tube, observe whether there is blood returning in the lumen. If there is a large amount of returned blood, 10 ml of normal saline can be injected, and then the tube can be sealed with heparin sodium diluent to avoid lumen blockage.

5.5 Leave the indwelling needle for no more than 7 d to prevent phlebitis caused by long-term stimulation of blood vessels by liquid medicine. If the puncture site is red, swollen, hot and painful, it means phlebitis. The indwelling needle should be pulled out immediately, 50% magnesium sulfate should be continuously hot compressed for 24 h~36 h, and antibiotic ointment should be applied locally.

5.6 After the infusion, the indwelling needle should be properly fixed to avoid coming out. In order to better apply indwelling needle in clinic and patients, we should constantly explore and summarize our work experience, and provide safe and comfortable care for patients, so as to improve the clinical application and nursing level of indwelling needle in clinical medicine in http://www.fWJiA.COm. (2) Welcome to visit Fan, Wen and Jia. Shit oval persimmon jun?

References:

Dai Lili. Prevention and nursing progress of deep vein thrombosis [J]. Journal of Practical Nursing, 2002, 18 (2): 55.

Rao Qinghua, et al. Observation on sealing effect of intravenous indwelling needle in children [J]. China Journal of Nursing, 2000,35 (10): 624.

Li Xiaoyan, Liu Yang. Discussion on conventional indwelling time of trocar [J]. Chinese Journal of Nursing, 2000, 35 (5): 300? 30 1.