How To Find A Vein
For most medical workers, clinical often encounter can not find the patient's blood vessels, some nurses will use their hands to seize the patient's wrist, and then the patient's hand on the back of the pat "pat! pat! pat!".
The pat can indeed fill the vein, but it will stimulate the nerve endings of the blood vessel wall and cause pain, especially when the flap is performed on the back of the hand that has been punctured, the pain will be more obvious and ultimately lead to the psychological discomfort of the patient and the distrust of the nurse's puncture technique.
This article introduces a better method to promote transvenous fullness and improve puncture success rate.
The nurse fixed the patient's hand into a cup-shaped hand with the left hand to fully expose the blood vessels at the back of the hand.Ask the patient to clench his fist, a few seconds and then let its half clenched fist (Fist heart is empty state.) , can also ask its repeated clench, loose fist.Take repeatedly clenched fist, loose fist, can make the muscles between the fingers contract, promote blood to the heart return, the back of the hand vein filling is obvious.
Finger pressing method
Press the punctured vein gently with your thumb, push it from the proximal end to the distal end, and then push it from the distal end to the proximal end for 3-5 cm.The goal is to fill the vein and make it easy to puncture.See the following figure for specific operation methods and effects.This method can completely replace the method of flapping and can improve the comfort of patients.
Press gently on the vein with your thumb
Push from distal end to proximal end
Local vascular dilatation method
Suitable for emaciation, blood vessels are not fixed, not filling, not exposed, failure, muscle tension drop and weak fist clenching patients.
- External application of vasodilator method: use cotton swabs dipped in 1% nitroglycerin on the back of the hand, and wet hot compress local for about 3 minutes, so that the superficial venules quickly fill.Atropine injection was dipped in the cotton swab and applied to puncture the local skin for 8-12 times. After 2-5 min, local superficial veins were dilated and filled.Warning: infants, glaucoma, cardiovascular patients, high fever convulsions, irritability with caution.Dip a cotton swab in 2% anisodamine and wipe the local skin four times. It is suitable for the blood vessels with poor elasticity, great brittleness, fine blood vessels and unclear blood vessels.
- Hot compress method: you can use the hot water bag for external application, or wet compress with the hot towel, etc. The hot compress time should not be too long, up to 10 minutes.The hot compress increases the temperature of local tissues, improves blood circulation, dilates blood vessels and exposes venous filling.It is mainly suitable for vessels with poor circulation, venous collapse and difficult puncture.
Cuff method of sphygmomanometer
Inflate to 300 mmHg, especially for those with weak blood vessels.A mercury sphygmomanometer is usually required to control pressure and time.
Find the vein with an ultrasound
If you don't have vein detection equipment, ultrasound technology can also help you find a patient's vein.This saves the patient the cost and risk of placing a central vein during surgery.
Using the force of gravity
Let gravity do its job and increase blood flow to your arms and hands.Lie on a bed or couch with your arm hanging down for the injection.Making a slow fist or squeezing the ball and releasing it repeatedly also increases blood flow to the area.
Swing your arms a few times.Centrifugal force will ensure blood enters the arm or hand, dilating the veins and making it harder for blood to leave.
When the body is hydrated enough, the veins slowly dilate.You can have your patient try to drink more fluids the day before the infusion.If the patient doesn't want to drink water, juice is fine.
But be warned: avoid drinking a lot of fluids the night before to make up for a lack of hydration -- you could end up interrupting your sleep by going to the bathroom all night.
Make your patient’s body relaxed
You know, when you're going to put a needle in a patient's vein, it might be easy for us to do that, but the patient is usually nervous, The patient's nervousness can cause his veins to constrict, making the injection more difficult.Perhaps you can play some relaxing music and have the patient breathe in and out calmly. If your patient is having trouble, please don't be too hard on her and give her some time to adjust.
Use two tourniquets
One is tied at the elbow, and the other is tied under the wrist, as shown below, with indigo veins visible on the dorsal side of the forearm.You can feel the elasticity of the veins by horizontally touching the subcutaneous veins with your right index finger.
A relatively straight segment of the vein was selected for the puncture, and the direction of catheter fixation and the influence on patient activity should be taken into account during the puncture.Release the tourniquet when blood returns, as shown below.
The indwelling needle was fixed with 3M transparent application, and the tube was flushed with normal saline and then connected with liquid.
The patient's blood vessels are generally fine and brittle, especially in patients with long-term infusion, venous conditions are not ideal.In the selection of veins to find out the elasticity and thickness of blood vessels, before puncture to carefully see the direction of blood vessels.The principle of vein selection is to look for blood vessels from the distal end to the proximal end and choose thick, straight, elastic and easy to fix veins to avoid blood vessels and venous valves. Under normal circumstances, venipuncture will choose the dorsal vein network of the hand and the palmaral side of the forearm.
If you can't find a vein, try looking for a vein in an unconventional location. You may be able to find a vein for the puncture.
Two tourniquet methods: suitable for emaciation, blood vessels are not fixed, venous filling patients.For some children who cannot actively clench their fists, clenching can be used instead.
Methods: Forearm: a tourniquet was tied at elbow and neiguan point of the wrist.Back of the hand: One tourniquet is tied above the wrist, and the other is tied at the first knuckle of the 2nd to 5th fingers.Dorp: One tourniquet is placed above the ankle, and the other is placed at the 1st to 5th metatarsals of the foot.A tourniquet can be applied with techniques such as placing the tourniquet 15 to 20 cm above the puncture site, placing the hand or foot below the heart and instructing the patient to open and close the fist.If the patient has high blood pressure, it is necessary to be farther from the puncture site.
If the patient has low blood pressure, get as close to the puncture site as possible without contamination.The time of applying a tourniquet should not exceed 2 min and should not be too tight.
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