Lecture 1 IV Access Flashcards
1
Q
What you need to know before you stick
A
- What is the planned surgery?
- What side?
- Planned positioning?
- Major blood loss possible?
- Labs needed?
2
Q
Where to stick it
A
- Avoid upper extremity side that drains to a lymph node dissection site
- Make sure you can access during surgery
- Start distal
3
Q
What size IV?
A
- Large bore (16G-18G) when pt is asleep
- Small bore (20G-22G) to induce
4
Q
Antecubital Vein: Pro
A
- Easy/less painful
- Large
5
Q
Antecubital Vein: Con
A
- Not useable during prone spine surgery
- Uncomfortable for pt
- Difficult to detect if infiltrated
6
Q
Catheter size for normovolemic pt
A
22G
7
Q
Catheter size for slightly hypovolemic pt
A
- 20G
8
Q
Catheter size for elective blood transfusion
A
- 20G
9
Q
Catheter size for moderately likely moderate bleeding
A
- 18G
10
Q
Catheter size if massive transfusion/fluid replacement is likely
A
2 X 16G
11
Q
What happens if you miss your best option for an IV?
A
- Central line
12
Q
Complications associated w/ Central Lines
A
- Infection
- Arterial puncture, hematoma, stroke
- Pneumothorax
- Hemothorax, chylothorax
- Air embolism
- Cardiac trauma
- Dysrhythmia
13
Q
Where does the tourniquet go?
A
- Close to the puncture site
- Proximal is okay as longs as the vein stands up
14
Q
What defines a good stick?
A
- Being able to advance the catheter to the hub
- Good backbleed
- No infiltration
- ABility to push a large bolus rapidl
