Peripheral venous catheter

Source: Wikipedia, the free encyclopedia.
Standard catheter.
1. The catheter itself is composed of (a) a tip for insertion into the vein, (b) wings for manual handling and securing the catheter with adhesives, (c) a valve to allow injection of drugs with a syringe, (d) an end which allows connection to an intravenous infusion line, and capping in between uses.
2. The needle (partially retracted) which serves only as a guidewire for inserting the cannula.
3. The protection cap which is removed before use.
A peripheral intravenous catheter in place, fixed to a patient's arm with adhesives and attached to a drip.

In

peripheral vein for venous access to administer intravenous therapy
such as medication fluids.

Use

The catheter is introduced into the vein by a needle (similar to blood drawing), which is subsequently removed while the small plastic cannula remains in place. The catheter is then fixed by taping it to the patient's skin or using an adhesive dressing.

A peripheral venous catheter is the most commonly used vascular access in medicine. It is given to most

radiocontrast, for example. In the United States, in the 1990s, more than 25 million patients had a peripheral venous line each year.[2]

A peripheral venous catheter is usually placed in a vein on the hand or arm. It should be distinguished from a

anaesthetic gel (such as lidocaine) may be applied to the insertion site to facilitate placement.[citation needed
]

Blood sampling can be carried out at the time of insertion of a peripheral venous catheter or at a later time.[3]

Peripheral venous catheters may also be used in the emergency treatment of a tension pneumothorax- they can be placed in the second intercostal space along the mid clavicular line in order to relieve tension before definitive management with a chest drain. [4]

Complications

Infection,

hemorrhage (bleeding) and formation of a hematoma (bruise) may occur. A catheter embolism may occur when a small part of the cannula breaks off and flows into the vascular system. When removing a peripheral IV cannula, the tip should be inspected to ensure it's intact.[5]

Because of the risk of insertion-site infection the CDC advises in their guideline that the catheter needs to be replaced every 96 hours.[6] However, the need to replace these catheters routinely is debated.[7] Expert management has been shown to reduce the complications of peripheral lines.[2][8]

It is not clear whether any dressing or securement device is better than the other on reducing the rates of catheter failures.[9]

Sizes

Sizes of peripheral venous catheters can be given by Birmingham gauge or French gauge. Diameter is proportional to French gauge and inversely proportional to Birmingham gauge.

Birmingham
gauge		 Diameter (mm) Maximum flow rate
(ml/min)[10]		 Color[10]
26 0.46 13-15 Black
24 0.60 36 Yellow
22 0.90 56 Blue
20 1.10 40-80 Pink
18 1.30 75-120 Green
17 1.50 128-133 White
16 1.80 236 Grey
14 2.00 270 Orange

History

The insertion of a plastic cannula and withdrawal of the needle was introduced as a technique in 1945.[11] The first disposable version to be marketed was the Angiocath, first sold in 1964. In the 1970s and 1980s, the use of plastic cannulas became routine, and their insertion was more frequently delegated to nursing staff.[12]

Newer catheters have been equipped with additional safety features to avoid

teflon (hence the often used term 'Venflon' or 'Cathlon' for these venous catheters). In 1950 they consisted of polyvinyl chloride.[13][14] In 1983, the first polyurethane version was introduced.[12]

Additional images

  • An arm board is recommended for immobilizing the extremity for cannulation of the hand, the foot or the antecubital fossa in children.[15]
    An arm board is recommended for immobilizing the extremity for cannulation of the hand, the foot or the
    antecubital fossa in children.[15]
  • Just before inserting.
    Just before inserting.
  • The catheter in between uses.
    The catheter in between uses.
  • Newer catheter with additional safety features.
    Newer catheter with additional safety features.

References

  1. ^ "Management of Peripheral Intravenous Catheters Clinical Care Standard | Australian Commission on Safety and Quality in Health Care". www.safetyandquality.gov.au.
  2. ^
    PMID 9508225
    .
  3. PMID 32523703
    .
  4. ^ Weegenaar, Celestine (2018-08-21). "Pneumothorax | Acute Management". Geeky Medics. Retrieved 2020-01-14.
  5. ^ Doyle, Glynda Rees; McCutcheon, Jodie Anita (2015-11-23). "8.2 Intravenous Fluid Therapy". Clinical Procedures for Safer Patient Care.
  6. ^ CDC Morbidity and Mortality Weekly Report Aug 2002. "Guidelines for the Prevention of Intravascular Catheter-Related Infections". Retrieved 2008-03-13.{{cite web}}: CS1 maint: numeric names: authors list (link)
  7. PMID 9448553
    .
  8. PMID 8852171
    .
  9. PMID 26068958
    – via Cochrane Wounds Group.
  10. ^
    ISBN 9780199202799
    .
  11. PMID 18828978
    . Retrieved 16 April 2019.
  12. ^
    PMID 16265830
    .
  13. PMID 15430460
    .
  14. S2CID 22197895
    .
  15. ISBN 9781455748594
    .

External links
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