Presentation on theme: "PERIPHERAL INTRAVENOUS LINE MAINTENANCE for the Indiana EMT-B"— Presentation transcript:
1PERIPHERAL INTRAVENOUS LINE MAINTENANCE for the Indiana EMT-B Ken L. Hendricks, EMT-P, PI MsEd.
2Purpose:The IV maintenance module was developed to assist the EMT-B manage non-critical patients who have a pre-established peripheral IV line already in place when they need transported to in an ambulance. EMT’s may encounter many of these at home, in long-term care facilities, or in a hospital setting. These patients may require transportation to other locations for diagnostic exams, treatments, or emergency care while the IV remains in place.
3ROLE of the EMTSafely Handle and Transport STABLE patients with an Peripheral IV already established.
4Personal Safety Concerns for the EMT-B BSIUniversal Precautions prnAvoid Contact with BloodSeptic TechniquesSafe Sharps HandlingDocumentation of ExposuresFollow Up and Treatment prn
5Required Skills EMT-B for IV Maintenance Adjust and Maintain Drip (flow) RatesChange an IV Bag using Aseptic TechniqueDiscontinue an IV using Aseptic TechniqueStabilize an IV Site, Equipment, and TubingProper Documentation of IV Maintenance
6Goals for the EMT-B in IV Handling Keep IV patent and infusing at ordered rate.Handle the patient in a manner to prevent IV line problems.Monitor the patient and IV equipment that will identify any IV line complications in a timely manner.Complications include: infiltrations, clot occlusions, empty bag, over hydration.Trouble shoot any IV line complications that would arise.Personal Safety
7Secure Enough Fluid to keep the IV patent throughout the trip. IV Transport Considerations for the EMT-BSecure Enough Fluid to keep the IV patent throughout the trip.
8Purpose of IV Solutions Replacement of Lost Fluids (vomiting, diarrhea, dehydration)Maintenance of Fluid and Electrolyte Balance (NPO patients)
9Authorized Solutions for the EMT-B Crystalloid Solutions (D5W, LR, and NS)VitaminsSodium Chloride (less than 0.09% concentration)Potassium Chloride (<= 20meq/l concentration)
10UnAuthorized Situations for the EMT-B Piggy Back Set UpsSecondary Set UpsBlood Products
11Complications of IV Fluid Administration OverhydrationClot OcclusionInfiltration of Fluid into Tissues (exrtravasate)Positional IVPyrogenic ReactionAllergic ReactionInfection
12Types of IV Cannulas (needles) Cannula over Needle (CON)Butterfly14-20 gauge (adults)20 – 25 gauge (pediatric)length depends on gauge from ½ - 3”
13Stabilization of IV Sites Site must be coveredCannula and Tubing Stabilized (using the 2 loop method)Initial Stabilization Done by Sending AgencyShould be on an Armboard
14Flow Rate Concerns Height of the Bag Position of the Patient’s Limb Amount of Fluid in the BagSite Location Relative to the HeartAltitude of the Patient (psi< with altitude)
15Amount of Fluid to be infused x Drip Set Calculation of IV Maintenance Drip RatesAmount of Fluid to be infused x Drip SetTime (in minutes)= gtts/minDrip SetsMini Set = 60gtts/ml (cc)Regular = 10gtts/ml (cc)Regular = 15gtts/ml (cc)Select 3 = Selectable (60, 15,or 10)
16Adjust the Flow Rate Knob to: ExampleOrder: Infuse 120cc/hr of NS using Mini-DripAmount of Fluid to be infused x Drip SetTime (in minutes)= gtts/min120x60 = 7200 = 120 gtts/min120 cc x 60gtts/cc =60 minAdjust the Flow Rate Knob to:120 gtts per min is 2 gtts/sec(use a 15 sec count to get close, then 1 minute count)
17Troubleshooting IV Problems – Not Infusing Constriction above the IV SiteTubing or Attachments are LeakingAir Venting into BottlesFlooded Drip ChamberHeight of IV – Gravity FlowDC if Drip Cannot be ReEstablished
18Required Documentation in IV Handling Initial Assessment (including Vitals and Breath Sounds q 15 or if patient changes condition)Condition of IV Site (q 15 or if changes occur)Amount of Fluid Infused and Remaining in bag qRecord urine or emesis output in cc or ml measuresIV Bag change – time and solution usedRemoval: (if needed) time, size of CON, and reason(s) whyChanges in Patient ConditionProblems with the IVType of Solution and Administration Set