PARENTERAL ADMINISTRATION

IV

Dr.Gopisankar.M.G

Immediate access to vascular system Bioavailability is 100% Route for medications and blood and

blood products

For successful cannulation

Proper site selection Proper knowledge of gross anatomy of

veins Identification involves both visual and

tactile exploration The vein may be located as a blue

green subcutaneous structure

Blind attempts are highly unlikely to be successful

Ideally a good sized vein with a straight segment atleast the length of the cannula should be selected

For elective cases

Easy access Non dominant side Avoiding joint areas Avoiding Lower extremities

In UL

Antecubital fossa Forearm Wrist Dorsum of hand Mostly used are cephalic , basilic and

median cubital vein

Veins in the dorsum of the hand can be used if wide bore is not required.

The portion of cephalic vein in the region of radial styloid is often called

Student’s vein or Interns vein

LL

Cannulation is not a good idea It is more painful , more chance of

thrombophebitis

External Jugular Vein

Originates near the angle of mandible and crosses over the stenocleidomastoid

It can accommodate large bore IV catheter

Useful in those with poor access to arms and those who need large volumes of fluids

EJV will be engorged in heart failure patients and thus it is an ideal route for such patients for medications (other veins would be collapsed)

Scalp veins

Central venous access

Central venous pressure monitoring Volume resuscitation Cardiac arrest Lack of peripheral access Infusion of concentrated solutions Placement of transvenous pacemaker Cardiac catheterization, pulmonary

angiography Hemodialysis

Seldinger technique› Use introducing needle to locate vein› Wire is threaded through the needle› Needle is removed› Skin and vessel are dilated› Catheter is placed over the wire› Wire is removed› Catheter is secured in place

Thanks….