Basic IV Therapy and review of Phlebotomy. Megan Kennedy Cochise County Jail Medical. Agenda for the day……. Discuss purpose and uses of class Anatomy & physiology Identifying the purposes of IV infusions IV solutions Setting up an IV IV catheters Selecting the IV site
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Basic IV Therapy and review of Phlebotomy
pediatric or adult victims
Besides epithelial cells and connective tissue cells, the skin also contains delicately entwined nerves and blood vessels.
Depending on the task and the location of the artery, its middle layer may be dominated by smooth muscle or elastic fibers.
The veins are the blood vessels which transport blood towards the heart.
The wall layers of the veins are thinner than those of the arteries, yet contain more connective tissue.
The muscle layer is less marked.
The diameter of veins are larger than that of arteries.
exchange material and Water with their
- Waste matter
from stem cells at a rate of 2-3
million cells per second.
─ Hemoglobin 95% of a red cell
Isotonic – IV fluids that approximate the osmolaity of blood plasma. I.e.: 0.9% Normal Saline (note the biconcave shape of the cells as they circulate in blood.)
Hypotonic – IV solutions that have a lower osmolarity than blood plasma thus drawing fluids into the cell. I.e.: D5W. (note the cells are visibly swollen and have lost their biconcave shape, and at 100 mOs, most have swollen so much that they have ruptured, leaving what are called red blood cell ghosts.
In a hypotonic solution, water rushes into cells.)
Hypertonic – IV fluids that have a higher osmolality than normal blood plasma thus drawing fluids out of the cells and they get irritated when infused.I.e.: D50 (note water has flowed out of the cells, causing them to collapse and assume the spiky appearance you see.)
Combinations of Normal Saline, Lactated Ringers, and D5W are often common.
All fluids come in 250cc, 500cc, and 1000cc bags.
You will need:
The correct IV solution
The correct administration set
An IV catheter
An IV start pack
Opsite or equivalent
(the rate of flow they produce)
the fluid back into the bag)
In a code arrest use the antecubital vein as it is closer to the central circulation. Fluids and medications do not have as far to travel to reach the central circulation.
The most favorable venipuncture sites are:
- veins in the dorsum of the hand
- antecubital vein
- basilic vein
- cephalic vein
Be sure the vein can accommodate the catheter used.
** If the IV still does not run after all the above have been checked, then it should be discontinued and restarted! **
A few key points to review for Phlebotomy.
Let’s do some drip calculations
Volume to be infused (ml) X drip factor of tubing
Time (min) to be infused
i.e.: 1000ml X 10
= 166 gtts/min
Do IV flow rate calculation sheet now