Venipuncture (RADS 210)

RTs can administer contrast and medication by parenteral injection via...

existing vascular access or new one

RTs can adminster contrast...

enterally or via infusion pump or power injector when prescribed

Venipuncture

the process of inserting a needle or catheter into a vein, usually to withdraw blood for analysis

In the imaging dept, venipuncture is used for...

injecting contrast media for examinations

Common administration sites for venipucture

intradermal & intramuscular

intradermal

administered into the dermis on the inner aspect of the forearm (usually less than 0.5 mL)

What does intramuscular mean?

Administered into the muscle.

What are the three common sites for intramuscular injections?

Dorsal gluteal (common), ventrogluteal, and deltoid muscles (common)

What is the safe volume range for intramuscular injections?

1 to 5 mL.

Two types of IV lines

peripheral & central

Peripheral

short catheter placed in hand, forearm, elbow, or foot

central

communicated directly with the hearts right atrium. placed in femoral, subclavian, or internal jugular vein

radiographers are not allowed to use what IV line for drug/contrast administration?

central line

common sites for IV lines?

basilic vein, median cubital vein, cephalic vein

Hub

the part that attaches to the syringe

Bevel

sharp, angulation tip of needdle

shaft

elongated part of the needle

lumen

hollow tube, runs through length of shaft

-lower the number, bigger the gauge

When putting in an IV line the bevel needs to face...

up

Types of needles

butterfly, over the needle catheter, straight through the needle

Vacutainer

used for the collection of more than one sample, suctions blood and prevents it from leaking out

direct venipuncture

thrust the cannula through the skin and into the vein in one quick motion

intrect venipuncture

cannula is inserted through the skin adjacent to the vein, cannula is then advanced and maneuvered to pierce the vein

Procedure for venipuncture

1. identify patient, explain procedure, answer questions, history

2. wash hands

3. apply tourniquet above the injection site tight enough to distend vessles

4. choose site

5. put on gloves

6. cleanse site with alcohol wipe

7. hold skin taut and with bevel side up, puncture is made

8. advance catheter and remove needle

9. release torniquet secure needle with tape

10. aspirate blood into syringe

11. watch site for swelling and make sure pt is not in pain

12. the iv should remain until precedure in complete

Once procedure is complete

remove the catheter and apply pressure to the injection site with a piece of gauze, a piece of tape may be placed over gauze to hold it secure over the site

Tourniquet should be placed...

6-8 in. above the injection site and should be tight enough to distend vessles but not occlude them.

When cleasing the site we should wipe...

at least 3 times and allow the area to dry by waving, not blowing

The pucture with the needle is made at an angle of...

20-30 degrees to the long axis of the vessle

Once the vein is puncturre and their is blod return, decrease the angle of the needle...

15 degrees

Angleing for venipucture is a __________ skill

visual as every pt is different

Infiltration

fluid seeps into the tissues aorund the vein. No damge to tissues. experience pain, swelling and compartment syndrome.

Phlebitis

inflammation caused by an irrritant in the vein, usually the catheter itself. not usually serious, resolves within a few days to a week

-symp.: redness, warmth, tenderness, and swelling around injection site

Air embolism

air bubbles enter the vein and block it. Air can travel ot brain, heart, or lungs. Minor embolisms usually show no to mild symptoms

severe sympt: difficulty breathing, chest pain, hypotension, and cyanosis

Extravasation

fluid leaks into tissue around the injection site. causes damage to tissues

-common in elderly pts.

signs of extravasation

pain, stinging, burning, swelling, redness at site. infusion not flowing freely

Treatment of Extravasation

explain to pt, stop and leave needle in place, aspirate contrast from needle, remove needle, cold compress and elevate part

Extravasation is associated with...

needle placement: hand, foot, ankle, near joints