Thursday, November 18, 2010

Bedside trick - getting peripheral venous access

In fast pace ICU enviroment central venous access has become a norm and basic skill of inserting peripheral IVs is lost somewhere in action. Before jumping to insert central line it is important to give good try in obtaining peripheral IVs for various reasons including avoidance of catheter related infections. Also short peripheral IV access with large bore is better than long central line for fluid resuscitation. Remember, the flow through a cannula is governed by the radius to the power 4 (r4) and the length of the cannula (Poiseuille's Law).

In case peripheral IV is hard to stick then you can try a quick trick. Get a small cannula (20-22 G) in a distal vein and then put a tourniquet higher up the arm and run in some IV fluid. This lead to the veins becoming visible in the ante-cubital fossa, and you can now get the large bore cannula in.

No comments:

Post a Comment