Long Hand Charting for Iv Insertion and Removal, Trach Care and Suctioning with Dressing Change

The procedure was done emergently because of the patient’s critical condition. His right IJ area was prepped in the usual fashion. It was very difficult to visualize his right IJ vein, even though his habitus should have allowed us to do so, but the patient was, I believe, severely intravascularly volume depleted, and his vein was collapsing. I have attempted to access the right internal jugular vein multiple times, both under real-time ultrasound guidance and even later on blindly. I was able to get blood return and hit the vein; however, I was not able to advance the guidewire. I was able to advance it one time and put the catheter in, and it was nonfunctioning. I had to take the catheter out and tried multiple other times on the right IJ vein without success. That procedure was terminated. Pressure was applied. There was no cervical hematoma whatsoever. The patient was uncomfortable because of the length of the procedure but did well otherwise. Hemodynamically, he was unchanged, and his oxygen saturations remained stable.I prepped the IJ vein area in the usual fashion. One percent lidocaine was used for local anesthesia. Again, the left IJ vein was collapsing. With deep inspiration, the vein could be well visualized on the real-time and ultrasound guidance, after which I could get access to the left IJ vein. A wire was advanced without difficulty while the

The work of Burke, et al (2011) reports that a study with the objective of comparing the "efficacy of intradermal bacteriostatic normal saline with that of intradermal buffered lidocaine in providing local anesthesia to adult patients prior to IV catheterization." (p.1) The study concluded that intradermal buffered lidocaine was superior to intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization in this group of predominately white adults and should be the solution of choice for venipuncture pretreatment." (Burke, et al, 2011, p.1) Burke et al reports that surgery is something that most people fear with the fear of the unknown is combined with "apprehension about such anticipated procedures as insertion of an IV line." (2011, p.1) Burke additionally reports that patients admitted for same-day surgery "require IV access. Any venipuncture, including peripheral IV catheterization with a medium-to-large-gauge catheter, can cause some degree of pain. Using local anesthesia prior to IV catheterization has

I- No intervention was utilized, this research study simply surveyed registered nurses to investigate the technique used during IM injections and the incidence of blood aspiration. The population utilized was 164 registered nurses

In researching the question, “In hospitalized adults, how does routine, compared with clinically indicated replacement of peripheral IV catheters affect patients?” the article: Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters: A randomized study (Lopez et al., 2014) provides a randomized study that examined not only the research question of patient complications, but of the clinical cost of adhering to a regime of replacing all peripheral IV catheters (PIVC) after less than 96 hours (regardless of patency or patient’s expected time until discharge), versus replacing PIVCs as needed. (Lopez et al., 2014)

In this paper, we will cover multiple things. I will cover what IV stands for, what peripheral intravenous catheters are and what they are used for. I will even discuss sites for peripheral IV’s. I will explain what a central venous catheter is, what it is used for, and the types of catheters out there. I will explain the procedure on how to insert one, how to change the dressing, the safety guidelines to follow for insertion, and how to discontinue a central venous catheter. Discussion of what a patient needs to know about having a central venous catheter is included. Equipment to have ready for insertion is vital to know. It will explain why sterile procedure is used for insertion and what to monitor when a patient has a central venous

In removing of Indwelling catheter first we need to verify the identity of the patient, then explain procedure to the patient, get her/his consent, check notes to see how much water was being inflated into the balloon, check the scheduled removal date if it is correct, perform proper hand hygiene, gather the equipment, use gloves, provide privacy then we start to do the procedure.

• Bedside reporting • Wound care • IV insertion & venipuncture • Telemetry monitoring • IV medication therapy • TPN administration • Central line dressing changes • Time management PROFESSIONAL EXPERIENCE WEISMAN CHILDREN’S REHABILITATION HOSPITAL OCTOBER 2017-PRESENT Registered Nurse Marlton, NJ • Assess and treat patients from ages 3 weeks to 21 years of age • Administer medications safely • Performwound care • Communicate effectively with report KINDRED HOSPITAL SOUTH PHILADELPHIA OCTOBER 2017 -PRESENT Registered Nurse Philadelphia, PA • Efficient with bedside reporting • Communicate with doctors and verify orders • Perform IV insertion and blood draws • Trained in central line dressing

Smith, B., Neuharth, R., Hendrix, M. A., McDonnall, D., & Michaels, A. D. (2010). Intravenous

When providing care for an indwelling catheter it’s important that you provide patient comfort with minimal exposure of genital areas when needed for privacy and respect towards the client. Before beginning care, you would position a female patient in a dorsal recumbent position and a male in the supine position, followed by placing a waterproof pad underneath the client’s buttock. These positions are necessary in order to ease visualization of the genital area and provide proper care. In addition, you would place a warm blanket only exposing the perineal area along with the catheter for comfort. In order to provide easy access for you to clean around the catheter you should remove the catheter from the securing device while keeping the catheter

Only when it is absolutely necessary should a catheter be inserted into a patient. Every patient is assessed for the need for a Foley catheter. If the Foley is inserted, assessments are also then done daily to see if the need is still valid. If the reason is not justifiable the catheter must be removed from the patient (Joint Commission releases new NPSG for CAUTI, 2011). Nurses must follow guidelines while inserting indwelling catheters as well. Aseptic technique is critical to maintain during this process. The use of sterile equipment and a sterile procedure helps to reduce the risk of CAUTI. If in any way the catheter becomes contaminated during the process of insertion, the nurse should discard of the entire catheter and start with a new, sterile kit. Proper hand hygiene is very important before and after contact with indwelling catheters to decrease risk of infection. Maintenance of a close drainage is system is also important that way bacteria are not able to get in and cause infection (Revello & Gallo, 2013). Decreasing the number of times Foleys are inserted and how long they stay in for can help reduce the risk of CAUTI since the longer a Foley stays in, the higher the risk of infection becomes. Nurses must keep the catheter line patent, with no kinks to allow urine to flow freely through into the collection bag. When a urine sample must be obtained it must be done in a sterile

[3] The nurse’s experience and the emergency medical care provider can explain some difficulties in cannula insertion. Success rate and time to apply intra-venous cannula is mandatory to obtain the best resuscitation of critical patients. Difficult intra-venous cannulation can be challenging even to the most experienced emergency nurse. Central venous catheterization (CVC) is an alternative route for cannulation in patients with difficult intra-venous access. CVC provides a fast effective intra-venous access for flued resuscitation and for Central Venous Pressure monitoring. However, venous thrombosis, catheter associated bloodstream infection, arterial puncture and pneumothorax are most common Central Venous Catheterization (CVC)

A few of the interventions included: proper hand hygiene, appropriate indwelling foley catheter care, and educating the patient on how to care for the incision. The nurse washed her hands and wore gloves before every incision check in order to reduce the amount of bacteria that could enter the site. Once the patient reached the PACU, the nurse immediately cleaned the foley catheter with antiseptic wipes. This action will be performed once a shift until the Foley catheter is removed. The nurse educated the patient on how to care for her incision site and explained to her the signs and symptoms of an

Looking at an example, your medical control states you need to establish an IV on a cardiac patient complaining of chest pressure at a rate of 80 ml/hr using a 500 ml bag of Normal Saline solution. The drip set you choose is a 60 gtts/ml minidrip set. The formula is as follows:

I also discontinue a peripheral IV line on a 10-year old kid. I asked Kristen first if the child received any anticoagulant or antiplatelet before I removed the catheter. I remembered one of our past clinical instructor told us that one time she was removing an IV line and she did not apply pressure on the puncture wound ample of time and, when she removed the pressure, the patient started

CAUTIs are urinary tract infections (UTIs) related to the placement of indwelling catheters and are typically caused by the transfer of bacteria into the urinary tract-either during or after placement (McNeill, 2017). When a catheter is believed to be clinically necessary, using aseptic technique is another preventative measure to avoid CAUTIs (McNeill, 2017). Nurses are the primary health