Presentation on theme: "VENIPUNCTURE DMI 63. Senate Bill 571 Filed on 8/26/97 Allows technologist’s to perform venipuncture under general supervision of a physician Technologist."— Presentation transcript:
Senate Bill 571 Filed on 8/26/97 Allows technologist’s to perform venipuncture under general supervision of a physician Technologist must obtain 10 hours of accredited education on venipuncture Technologist must perform 10 successful injections under direct supervision of a physician, registered nurse, or CRT w/venipuncture certification
Before you stick, know: Right patient? Right contrast (medication)? Right concentration? Right amount? Right site? Labs? Conflicting meds? Allergies?
Informed Consent The patient has a right to know and participate in his/her own health care Patient must be informed of the following: The nature of the treatment/procedure Any risk, complications, expected benefits or effects of such treatment Any alternatives to the procedure and their risks and benefits
Types Of Consent Consent is the affirmation to have one’s body touched by others Implied consent By action Expressed consent Verbal Written consent All are binding in court
Who May Consent Any person over 18 who is declared conscious and competent Spouse’s consent Spouses have no authority to consent for each other Minor’s consent Can only consent if emancipated Only parents and legal guardians can consent The state can consent if life threatening or during regular school hours
Terminology Heparin lock An IV device plugged on the hub end Used to maintain venous access w/out adding fluids Parenteral Not by mouth Total parenteral nutrition All nutrition needs met by parenteral routes Catheter A tubular, flexible, hollow instrument for withdrawing or injecting fluids Angiocatheter A catheter used specifically for blood vessel Butterfly needle An IV device with a rigid metal needle and a short segment of tubing
Infection Control Universal Precautions Hand washing Non-sterile gloves Gowns Protective eyewear Needles and syringes Sharp instrument containers All blood must be considered potentially infectious
If Needle Stick Occurs Immediately wash with soap and water Follow institution protocols These should include: Report incident within 24 hours Report incident immediately to supervisor Notify infection control officer
Site Selection And Anatomy Never use an arm with any of the following: Fistula Shunt Decreased sensation Edema On the side of a mastectomy Begin as distal as you can Anything distal to insertion site is unusable for 24 hours
Site Selection And Anatomy Best insertion site: Hand for patients under 60 Best insertion site: Cephalic or basilic for patients over 60 Veins should be pliant and resiliant Most common veins used are: Basilic, cephalic, and metacarpal
Special Considerations There must be a physician’s order A radiologist must be within the immediate area Emergency equipment must be available Allergies must be checked for prior to injection BUN and Creatinine must be checked within 72 hours
More Special Considerations Normal BUN - 5 - 25 Normal Creatinine - 0.5 - 1.4 If values abnormal, notify radiologist Explain procedure to patient Check all medications for expiration dates Check to see that all emergency drugs are present Obtain a baseline blood pressure prior to injection – rarely done, but a real good idea
Possible Side Effects Infiltration/Extravasation Swelling, tenderness, redness Adverse reaction to contrast Mild - hives, nausea, vomiting Severe - shortness of breath, shock
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