Veni

punc
tur
e

Outl
i
nes
:

 I
ntr
oduc
tion.

 Bl
oods
ampl
i
ng.

 Admi
nis
ter
ingI
Vinj
ect
ion.

 Cannul
ains
ert
ion.

 Admi
nis
ter
ingI
Vinf
usi
on.

 Cal
cul
ati
onf
lowr
ate.

 Di
scont
inui
ngI
VTher
apy
.

 Compl
i
cat
ionsofI
Vther
apy
.
 I
ntr
oduc
tion

Di
ff
erenc
esbet
weenar
ter
iesand

Ar
ter
ies v
eins

Ar
ter
iesc
arr
yox
ygenat
ed Vei
nsc
arr
ydeox
ygenat
edbl
ood(
wit
h
Ox
ygen bl
ood(
wit
htheex
cept
ionof t
heex
cept
ionofpul
monar
yvei
nsand
Conc
ent
rat
ion t
hepul
monar
yar
ter
yand umbi
l
icalv
ein)
.
umbi
l
icalar
ter
y).

Di
rec
tionofBl
ood Fr
om t
hehear
ttov
ari
ous Fr
om v
ari
ouspar
tsoft
hebodyt
othe
Fl
ow par
tsoft
hebody
. hear
t.

Thi
ck,el
ast
icmus
clel
ayert
hat Thi
n,el
ast
icmus
clel
ayerwi
ths
emi
c
anhandl
ehi
ghpr
ess
ureof l
unarv
alv
est
hatpr
eventt
hebl
ood
Anat
omy
t
hebl
oodf
lowi
ngt
hrought
he f
rom f
lowi
ngi
ntheoppos
it
edi
rec
tion.
ar
ter
ies
.

Ar
ter
iesar
eredbl
oodv
ess
els Vei
nsar
ebl
uebl
oodv
ess
elst
hatc
arr
y
Ov
erv
iew t
hatc
arr
ybl
oodawayf
rom bl
oodt
owar
dst
hehear
t.c
apac
itanc
e
t
hehear
t.r
esi
st
anc
eves
sel
s v
ess
els

Loc
ati
on Deeperi
nthebody Cl
osert
othes
kin

Ar
en'
tpr
esent(
exc
eptf
ors
emi Ar
epr
esent
,es
pec
ial
l
yinl
i
mbs
Val
ves
-
lunarv
alv
es)
 Veni
punc
tur
e

Def
ini
ti
on:

Vei
npunc
tur
eist
hepr
oces
sofi
nser
ti
ngav
einwi
ths
ter
il
eneedl
efort
he
pur
pos
eof

i
ntr
avenoust
her
apyorf
orbl
oods
ampl
ingofv
enousbl
ood.

Pur
pos
e:
 Toobt
ainbl
oodf
ordi
agnos
ti
cpur
pos
es.

 Tomoni
torl
evel
sofbl
oodc
omponent
s.

 To i
ntr
oduc
e s
olut
ions of el
ect
rol
ytes
, nut
ri
ent
s,v
itami
ns, and
medi
cat
ionsdi
rec
tlyi
ntot
hebl
oods
tream.

 Medi
cat
ionsar
eabs
orbedmor
erapi
dlyv
iat
heI
Vrout
ethananyot
her
c
ommonl
yus
edr
out
e.

 Lar
gequant
it
iesofas
olut
ionmaybegi
venI
Vbywayofani
nfus
ion.

 Toc
oll
ectbl
oodf
orl
aterus
es,mai
nlyt
rans
fus
ionei
theri
nthedonoror
i
nanot
herper
son

 Tor
emov
ebl
oodduet
oex
ces
slev
elsofi
ronorer
ythr
ocy
tes(
redbl
ood
c
ell
s).
Cr
it
eri
aforappr
opr
iat
eveni
punc
tur
esi
tes
:

 Us
ethemos
tdi
st
als
it
eint
henondomi
nantar
m.“
Chec
kifpat
ient
r
ightorl
efthandedwr
it
ing”
.

 Av
oidar
east
hatar
epai
nfult
opal
pat
ion.

 Sel
ectav
einl
argeenoughf
orc
athet
erpl
acement
.

 Sel
ectav
einSt
rai
ghtandnon-
tor
tuous

 Choos
eas
it
ethatwi
l
lnoti
nter
fer
ewi
thc
li
ent
’sADLs
.

 Pal
pat
ethev
ein,f
eel
i
ngf
ors
oft
nes
sandf
ull
nes
s

 Av
oids
it
esdi
st
alt
opr
evi
ousv
eni
punc
tur
esi
te,har
denedc
ordl
i
kev
eins
,
i
nfi
l
trat
eds
it
eorbr
uis
edar
eas
.“Suc
hsi
tesc
aus
einf
il
tr
ati
onofnewl
y
pl
acedI
Vli
ne”
.

 Av
oidf
ragi
l
edor
salv
einsi
nol
deradul
t.

Veni
punc
tur
esi
tes
:

For
ear
m Hand

 Bas
il
icv
ein.  Dor
salv
enousnet
wor
k

 Cephal
i
cvei
n.  Ac
ces
sor
ycephal
i
cvei
ns.

 Medi
anc
ubi
talv
ein.  Dor
salmet
acar
palv
eins

 Radi
alv
ein.  Dor
saldi
git
alv
ein
 Bl
oods
ampl
ing

Def
ini
ti
on:

I
sanas
pir
ati
onofamountofbl
oodf
rom v
ein.

Pur
pos
e:

 Obt
aini
ngar
epr
esent
ati
ves
ampl
eofbl
oodf
ordi
agnos
ti
cpur
pos
es
AS(
CBC,Na,K,Ur
ea,Cr
eat
ini
ne,PT,
PTT,
I
NR,SGOT,SGPT,
.
..
..
.
..
..
.
..
..
.ETC)
.
 Moni
tor
ingl
evel
sofbl
oodc
omponent
s
  Tohel
pinmak
ingadi
agnos
is
 Toc
onf
ir
m adi
agnos
is
 Tof
oll
owt
hepr
ognos
isoft
hedi
agnos
is

Cont
rai
ndi
cat
ions
:(r
elat
ivec
ont
rai
ndi
cat
ion)

•I
nfec
tionatt
hes
it
eofac
ces
s,e.
g.c
ell
uli
ti
s.
•Thr
ombophl
ebi
ti
s.
•Tak
ings
ampl
efr
om ‘
dri
par
m’(
stopi
nfus
ionandwai
tforatl
eas
t
2mi
nut
esbef
ores
ampl
i
ng
• Amput
ati
on
• St
rok
e
• Mas
tec
tomyorot
herBr
eas
t/Ly
mphSur
ger
y
• RenalFi
st
ula
• Tr
auma/Fr
act
ures/Bur
ns

Pr
ocedur
e:

St
eps Rat
ional

A)As
ses
sment
: To pr
omot
e good i
nser
ti
on
andpr
eventc
ompl
i
cat
ions
.
1-
Pat
ientmedi
calr
ecor
ds:

 Pat
ient
’s age/hi
st
ory/c
ondi
ti
on and
di
agnos
is

 Hi
st
oryofpr
evi
ousc
annul
ati
onors
ampl
i
ng
  Numberoft
est
sor
der
ed

 Whatmedi
cat
ioni
sthepat
ienton

 Fl
uids
tat
us

 Hi
st
oryofbl
ooddi
sor
der
s

2-
Condi
ti
onoft
hev
ein(
Pat
ient
):

 Pr
esenc
eofs
car
s,br
uis
es,s
wel
li
ng.

 Si
zeoft
hev
ein.

 Sur
ger
yont
heex
tremi
ti
es.

B-
Prepar
ati
on:

1-Forequi
pment:
(Pr
epar
enec
ess
aryequi
pment
.) Tos
avet
imeandef
for
t.

 Sy
ringe(
mor
ethanone)orbut
ter
fl
yneedl
e.

 Spongewi
thal
cohol
.

 Dr
ysponge.

 I
odi
nebowel
.

 Tubesf
orbl
oodneededac
cor
dingt
obl
oodt
est
.

 Tour
niquet
.

 Gl
oves

 Bandai
d

 Saf
etybox

2-Fors
elf
: Topr
eventc
ros
sinf
ect
ion

 Handwas
hing.

 Putondi
spos
abl
egl
oves
.

3-
forenv
ironment
: Tomai
ntai
npat
ientpr
ivac
y.
Cl
osedoor
s,wi
ndowsandpul
lcur
tai
ns.

4-
forpat
ient
: To gai
n pat
ient c
ooper
ati
on
and t
o dec
reas
e f
ear and
 I
dent
if
yandex
plai
npr
ocedur
etot
hepat
ient
.
anx
iet
y.
 Pos
it
iont
hepat
ientwi
tht
hear
m ex
tendedt
ofor
m
as
trai
ght
-l
inef
orms
houl
dert
owr
is
t.

C)I
mpl
ement
ati
on

1-
Sel
ectt
heappr
opr
iat
evei
nforv
eni
punc
tur
e:Thel
arger Tof
aci
l
itat
eveni
punc
tur
e.
medi
an c
ubi
tal
,bas
il
ic and c
ephal
i
cvei
ns ar
e mos
t
f
requent
lyus
ed,butot
hermaybenec
ess
ary

2-
Appl
ytour
niquet4t
o6i
nchesabov
ethei
nser
ti
ons
it
e.

 Tour
niquets
houl
dbet
ightenough.

 Nev
erl
eav
ethet
our
niquetonf
orov
er1mi
nut
e. To i
mpede v
enousr
etur
n but
notoc
cludear
ter
ialf
low.

3-
Way
sforf
ast
ingv
eindi
l
atat
ion:

 As
kpat
ientt
ocl
enc
handopenf
is
tsev
eralt
imes
. Toi
ncr
eas
ethepr
omi
nenc
eof
v
eins
.

Thi
scaus
esv
eint
ofi
l
lmor
e
 Lowerar
mindependentpos
it
ion.
qui
ckl
y.

Heat c
aus
es v
asodi
l
atat
ion.
 Appl
ywar
m pac
kst
oar
mfor10t
o20mi
nut
es. Pr
omot
esv
enousf
il
li
ng.

 Rub pat
ient
’s ar
m or hand t
owar
d t
he
t
our
niquet
s.

NOTE:
I
fal
loft
hes
e met
hodsf
ail
ed t
o di
l
atev
einr
emov
e
t
our
niquet
.Wai
taddi
ti
onalt
ime bef
orer
eappl
yi
ng or
s
elec
tinganot
hers
it
e.

4-
Cleans
ethe punc
tur
esi
te wi
th al
cohols
ponge or Topr
eventi
nfec
tion.
pov
idone-
iodi
ne s
wab i
nci
rcul
armot
ion f
rom s
it
e of
penet
rat
ionout
war
dandal
low t
hes
kint
odr
y. 
 Donot
t
ouc
hthepunc
tur
esi
teaf
terc
leani
ng.

5-
Att
acht
heappr
opr
iat
eneedl
etot
hehubbyr
emov
ing
t
hepl
ast
icc
ap ov
ert
hes
mal
lend oft
heneedl
eand
i
nser
ti
ngi
ntot
hehub,t
wis
ti
ngi
tti
ght
.

6-
Remov
epl
ast
icc
apov
erneedl
eandhol
dbev
elup.

7-
Stabi
l
izet
he v
ein by pul
li
ng t
he s
kin oppos
it
ethe Toi
mmobi
l
izet
hev
ein.
di
rec
tionoft
hev
eni
punc
tur
ewi
tht
humborf
oref
ingerof
non-
domi
nanthand.

8-
Int
roduc
etheneedl
eata20t
o30degr
eeangl
ewi
th To f
aci
l
itat
eas
ucc
ess
ful
,pai
n
bev
elupi
nli
newi
tht
hev
ein. f
reev
eni
punc
tur
e.

9-
Obs
erv
efora“
fl
ashbac
k”ofbl
oodi
ntheneedl
e. Toens
uret
haty
ouar
eri
ght
.

10-
Sli
ght
lyadv
anc
eneedl
eint
othev
ein. To s
tabi
l
izet
he dev
ice wi
thi
n
t
hev
ein.

11-
Stabi
l
izet
hes
yri
ngebynon-
domi
nanthand.

12-
Wit
hdr
aw needed amountofbl
ood i
ntos
yri
nge, Val
i
dat
est
hatneedl
eisi
nvei
n.
r
eleas
etour
niquet
.

13-
Pic
kups
ter
il
eswabandpl
acei
tov
ert
hepunc
tur
e
poi
nt.

14-
Remov
etheneedl
ebutnotappl
ypr
ess
ureunt
ilt
he
needl
ehasbeenf
ull
yremov
ed.

15-
Appl
ypr
ess
ureunt
ilt
hebl
eedi
ng hasbeen c
eas
ed. Topr
eventpai
nonr
emov
al.
As
kthepat
ientt
oappl
ypr
ess
uref
oratl
eas
t2mi
nut
es.
 

16-
Ins
pec
tpunc
tur
epoi
ntbef
oreappl
yi
ngdr
ess
ing. To c
hec
kthat t
he punc
tur
e
poi
nthass
eal
ed

17-
When bl
eedi
ng s
tops
,appl
y a bandage,gauz
e or To c
over t
he punc
tur
e and
t
ape. pr
eventl
eak
ageori
ntr
oduc
ti
on
of bac
ter
ia unt
il heal
i
ng i
s
c
ompl
ete.

18-
Dis
car
dtheneedl
eimmedi
atel
yinneedl
ebox
. Tor
educ
ether
is
kofac
cident
al
needl
einj
ury
.

19-
Trans
ferbl
oodt
oappr
opr
iat
espec
iment
ubeass
oon Topr
eventc
lot
ti
ng.
aspos
sibl
e.

20-
Mixwel
lifbot
tl
econt
ainc
hemi
cals
ubs
tanc
es.

21-
Labelt
het
ubewi
thr
elev
antdat
a: Toens
uret
hats
pec
imenf
rom
t
he r
ightpat
ientdel
i
ver
ed t
o
 Nameofpat
ient
.
t
hel
abor
ator
y.
 Dat
e.

 Ty
peoft
estneeded.

D)Pos
tcar
e:

1-Ret
urnequi
pment
. Topr
eventc
ros
sinf
ect
ion.

2-
Remov
egl
ovesandhandwas
hing.

3-
Ret
urnpat
ientt
ocomf
ort
abl
epos
it
ion.

E-
Doc
ument
ati
on: Pr
ovi
des a r
ecor
dto ens
ure
c
ont
inui
tyofc
are.
-
Rec
ord:

1.Dat
e,t
ime,ands
it
eofi
nser
ti
on.
 2.Nameoft
est
;

3.Ti
meofs
ampl
ewass
entt
olab

4.Any pat
ient
's adv
ers
e r
eac
tions t
o t
he
pr
ocedur
e.

Compl
ic
ati
on:

 Pai
natt
hes
it
eofi
nser
ti
on.

 Hemat
oma.

 I
nfec
tion.

 Di
sl
odgedneedl
e.

 Bl
eedi
ngatt
hes
it
eofi
nser
ti
on.