ChapterIKeyPointsofPeripheralIVPractice-ForMedical.pptVIP

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Need to Know: Patient Education Patients may be sent home with different instructions for care of a tunneled catheter. Refer to FYWBs – e.g. Care After Placement of Your Tunneled Catheter x38157. Hospital * Need to Know: Topical Skin Refrigerant Refer to Appendix B and C of the policy for methods of topical anesthesia application for pain control (saline, lidocaine, ice, etc.). Note that there is a new procedure for topical anesthetic skin refrigerant. Topical Refrigerant KEY POINTS MD order NOT required. Wash selected site with soap and water; dry. Disinfect the area. Hold the container 3 to 7 inches away and spray an area as big as a quarter until it turns white (4 to 10 seconds). Perform needle stick procedure within one minute. Advise patient thawing may cause discomfort. Gebauer’s Pain Ease Hospital * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * CVC – Flush Using Push-Pause Method Where indicated, use a Push-Pause pulsing method of flushing catheter lumens to create turbulence within the lumen. A push-pause-push technique causes turbulence in the catheter and flushes out blood and drug more effectively, thus preventing blood or fibrin adherence to the lumen wall and tip. Push-pauses are done in rapid succession, instilling 1 to 2 mL of flush solution each time force is exerted with a push on the syringe plunger ending with positive end pressure on the catheter lumen. Remove the syringe from the end cap and then close the clamp. If your patient has a groshong-type PICC or a tunneled Groshong CVC, use a rapid flush technique to open the valve. Hospital * CVC Caps - Access and Flushing A positive pressure access system (e.g., Max Clear, Flolink or PosiFlow) will be used for all central lines (except CVP lines). Before accessing, remember to use friction and scrub the caps for a full 15 seconds with alcohol and allow to dry. Hospital Scrub the Hub for 15 seconds prior t