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1. Is it still needed? (Can they convert to oral medications)
2. How urgent is it? (When are drugs next due)
3. What size is required?
- IV fluid
-- Adult 22-20g
-- Paed 24-22g
- blood transfusion
-- Adult 20-16g
-- Paed 24-22g
- IV contrast for CT
-- Adult 20g or larger in forearm or higher
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Their room on the ward is a protected space in which they should feel safe.
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This will reduce the number of retries and reduce patient discomfort.
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#pic #interntip
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Position yourself, usually seated, to avoid bending over.
You will be doing many of these per day and will get back pain if you don't look after yourself.
#interntip
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Injection of local anaesthetic is not "more painful than the cannulation" as long as you inject the local anaesthetic correctly.
These steps below usually result in a very comfortable experience for the patient:
1. Use of a small gauge needle (27g or 29g) eg the terumo insulin-syringe.
2. Inject very slowly
3. Inject only enough local anaesthetic to anaesthetise the dermis (the veins do not have nerve endings).
A volume of 0.02-0.1ml of 1% or 2% lignocaine (as superficial as humanly possible ) is usually enough.
#interntip
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This is assuming you don't hit deeper structures like bone.
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The interstitial fluid is dissappated and often the vein becomes obvious.
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If necessary, to stop the IV dislodging, apply tubifast to limb with a hole cut to allow visual checks of the IV site.
#pic
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