IV complications Flashcards
non running IV can be due to?
prob not in the vessel
IV infusion bag too close to the heart level
bevel of the needle against the wall of the vein
tourniquet left on the arm - make sure this is OFF
infiltration
if drop bag below heart
may not be effective
if blood becomes above the bag - not going to flow
needle not a catheter
have bevels – probably not going to flow - can impede flow
venospasm
complication
a protective mechanism
vein collapses and may be accompanied by burning sensation
unpreventable
hematoma
complication
the most common complication associated with venipuncture
can occur with IV placement and also at the time when the catheter is removed
the most common complication associated with venipuncture
hematoma
infiltration
complication associated with venipuncture
fluid is deposited in the tissues surrounding the blood vessel
it is painless, colorless swelling that develops at the site of the needle tip when the IV is started
have to stop the infusion and remove the needle / catheter and place pressure for 5 mins
local venous compications
can develop after IV sedation procedures
most common is due to chemical irritation of the vein wall from the administer medication
air embolism
unlikely to occur in IV sedation
best prevented by removing air from syringes and IV tubing before the procedure and making sure the IV bag does not empty
small children at greater risk
managment - position patient on their left side in the head down position
- trendelenberg
air goes right ventrivel– air goes to lungs
tolerate ___ weight of air in the peripheral venous circulation without adverse effect?
1 ml/ kg body weight
overhydration can ocurr in who more
small children and pateitns with heart failure
broad over view of local complications of drug administration
extravascular drug administration
intraarterial injection
local venous complications
extravascular drug administration
drug is injected into the subcutaneous tissue
- pain
- delayed absorption of the drug
- tissue damage
intraarterial injection
most significant complication if it occurs
medications cause spasm of the artery in the most DISTAL portions
could lead to loss of limb
intraarterial injection prevention
palpate vessel before venipuncture , before placing tournaquet
as needle approaches the artery, the vessel will begin to spasm and has more intense burning sensation
if in vessel - blood return is brighter
once tourniquet is removed, the blood may pulsate in the tubing or back up
management of intraarterial injection
leave needle in place
administer PROCAINE
- 1% solution slowly to a total of 2 to 10 mls
- acts as an anesthetic
- vasodilator (most vasodilating)
- pH of 5 - thus counter balances alkaline pH solutions
- diluent
hospitilize the patient
- seen by vascular surgeon
thrombophlebitis?
can be seen with use of?
local venous complication
- inflammation has preceded the formation of thrombus
features
- edema, inflammation, tenderness and delayed onset
- usually 24-48 hours
seen with DIAZEPAM USE - B/C contains propylene glycol
can also be caused by improper technique , use of a large needle in a small vein
at the site of venipuncture
manage
- limit limb activity
- affected limb should be elevated
- manage with NSAIDs
- anticoagulants and antibiotics are not part of the usual regimen
- resolution in 3-4 weeks
histamine release can be seen with which class of drugs
opioiods
see redness that will go up the arm
emergence delirium with
ketamine
laryngospasm
protective reflex
seen when the protective reflexes are compromised with CNS depressant medications
in deep sedation or ultralight GA - foreign material present in the area of the larynx may provoke a protective reflex in which the vocal cords ADDUCT in an attempt to seal off the trachea from this material
this will also prevent the passage of air into and out of the trachea and lungs
closed together
partial laryngospasm
presence of stridor - hear some breathing noises - defined as an abnormal high-pitched sound
complete larygnospasm
identified by the absence of sound in the presence of spontaneous respiratory efforts
management of laryngospasm
remove any offending material , tonsillar suction
after suctioning - administer positive pressure of oxygen - it is possible to break the spasm by forcing air through the vocal chords
administration of meds like succinycholine - depolarizing muscle relaxer - the
20-40 mg will need to ventilate patient - have to breathe for them
