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Control of peripheral catheters


Insertion technique of peripheral catheters

Insertion of a peripheral catheter for vascular access.

Objective:

– To maintain venous access for therapeutic, diagnostic and emergency purposes.

Equipment:

– Vessel. – 1 Compressor. – Sterile drape. – Sharps container.

Material:

– 1 Intravenous needle. – Peripheral intravenous catheters of different gauges. – 3-lumen extension cords and 3-step wrench. – 1 pair of sterile gloves. – Sterile adhesive strips. – Alcoholic hand disinfection solution. – Sterile dressings. – Sterile gauze. – 1 syringe 5 ml. – Physiological saline solution. – Antiseptic solution. – Anti-allergic plaster. – Sterile fixative dressing. – 1-2 sterile obturators. – Nursing records.

Procedure:

– Perform hand washing. – Prepare the necessary material. – Preserve the patient’s privacy. – Inform the patient of the procedure to be performed. – Ask for the patient’s cooperation.

– Place the patient in a comfortable position according to the puncture site. – Select the most appropriate vein according to: the patient’s condition, characteristics of the solution to be infused, catheter caliber, make sure that the point chosen will not hinder the patient’s daily life activities and choose veins that are easily palpable, soft, full and unobstructed, if possible. – Proceed to alcoholic disinfection of the hands. – Place the compressor 10-15 cm above the puncture site. The tourniquet should be tight enough to stop venous circulation but not arterial circulation. – Use the index and middle fingers of the non-dominant hand to palpate the vein. – Disinfect the area from the center outward and allow to dry. – Put on gloves. – Remove the catheter sheath and grasp the catheter with the dominant hand. – Fix the skin with the non-dominant hand to prevent the vein from moving. – Insert the catheter. – Continue inserting the catheter until blood reflux is observed. When the blood refluxes, advance the catheter a little and introduce the cannula at the same time that the guide or needle is withdrawn. No resistance should be felt. – Remove the compressor. – Check the permeability of the catheter by introducing physiological saline solution, about 2-3 c.c. observing that there is no obstruction or extravasation of the introduced liquid. – Connect the infusion set or obturator. In biosafety equipment, the obturator ensures catheter patency. – Place a sterile gauze under the catheter-equipment connection and obturator to avoid skin lesions. – Secure the catheter with sterile dressing. – Fix the infusion set to the skin to avoid traction. – Dispose of sharps in the appropriate container. – Collect the material. – Leave the patient in a comfortable position. – Remove gloves. – Wash hands. – Record in the nursing documentation: procedure, reason, date and time, catheter size, number of venipuncture attempts, incidents and patient response.

Observations:

– The veins generally used for intravenous treatment are the basilic, cephalic and interosseous veins.

– Avoid veins in flexion zones. Do not use veins with phlebitis, infiltrates, sclerosed, hard, the veins of the limb that has undergone a mastectomy or has an arterio-venous fistula, the veins of the lower limbs or the limb affected by a stroke. – In children, the veins of choice are those of the feet and scalp. – If the patient has a large amount of hair, do not shave, cut the hair with scissors. – At each insertion attempt, use a new catheter.

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