Phlebotomy, IV, and IO Flashcards
What is the definition of phlebotomy?
The collection of blood through venipuncture.
What is venipuncture?
Accessing a vein for the purpose of obtaining samples or for the infusion of a substance.
According to CRTO, phlebotomy is…
A basic procedure.
What are the reasons for accessing venous circulation (IV)?
-medication admin (bolus doses through catheter negates need for repeated punctures and permits infusion of drugs)
-maintenance of fluid balance (fluid replacement for those who are NPO)
-maintenance of nutrition
-dialysis shunts (make sure IV is on other side)
-admin of blood and blood products
According to CRTO, insertion of a peripheral IV is…
A basic procedure.
What are some factors to consider where to place an IV?
-length of time required (emergent vs. chronic)
-pt status (mobile vs. c-arrest)
-purpose of line (fluid vs. drugs and types of drugs ex. vasopressors)
-right or left handed
What are the preferred peripheral IV sites?
-posterior surface of hand
-forearm
-antecubital fossa (can be prone to kinking)
What are the sites for central IV placement?
-internal jugular (preferred)
-external jugular
-subclavian (risk of pneumothorax)
-femoral (in emergent situation doesn’t interfere with CPR, but prone to infection and thrombosis)
Are central or peripheral IV’s more efficient for rapid volume resus?
Peripheral
According to CRTO, placement of an internal jugular IV is…
A basic procedure.
Why is central IV the best route for drug admin?
-blood vessels are larger and flow is greater
-faster dilution of medication
-decreased chance of v.cons effects than in periphery
-less chance of extravasation
What is antidote for extravasation of a vasopressor?
Phentolamine
What angle should an IV needle be inserted?
30 degrees
What are some complications of of IV placement?
-interstitial infiltration
-thrombus formation (not a high pr system so not super common)
-phlebitis (infection)
-cellulitis (infection)
-air embolism (rare, don’t want bubbles in the line)
-catheter fragment embolization
Where are intraosseous catheters placed?
Into the marrow of a long bone (usually proximal anterior tibia, other sites include distal femur and sternum).
