Causes of failed venipuncture

Venipuncture is quite common in our daily life. The reason why venous puncture is needed is mainly because some patients need long-term infusion. At this time, the peripheral veins are prone to hardening. In this case, intravenous infusion is more difficult, so intravenous indwelling is required. If venous puncture fails, on the one hand, it is related to the patient himself, and it may also be caused by improper operation.

Indications

1. Those who need long-term infusion but whose peripheral veins are difficult to puncture due to hardening or collapse; 2. Those who need total parenteral nutrition; 3. Emergency treatment of critically ill patients and patients with difficulty in blood drawing; 4. Central venous pressure measurement.

Preoperative preparation

1. Understand and be familiar with the patient's condition, talk to the patient or his family, do a good job of explaining, and strive for the cooperation of conscious patients. 2. If the area requires, local skin preparation can be performed first. 3. Instrument preparation cleaning tray, puncture needle bag.

Procedure

Take femoral vein puncture as an example 1. The patient lies supine with the puncture lower limb slightly abducted and externally rotated. The puncture point is 1.5 to 3.0 cm below and inside the center of the inguinal ligament and on the inner side of the femoral artery pulsation. 2. The operator wears a hat and mask and stands at the side of the patient, disinfects the local skin, wears sterile gloves, and lays a sterile drape. Gently compress the skin and femoral vein at the puncture point and slightly secure them. 3. Hold the syringe in your right hand and insert the needle into the fixed puncture point on the index and middle fingers of your left hand. The direction of the needle should be at an angle of 30 to 45 degrees to the skin at the puncture site, in line with the direction of blood flow or in a perpendicular direction. Insert the needle slowly while aspirating. 4. When the puncture needle enters the femoral vein, venous blood will flow back into the injection needle tube. After the needle is inserted for another 2 to 4 nHn, blood can be drawn or drugs can be injected. 5. If blood cannot be drawn out, puncture deeper first, and aspirate while withdrawing the needle until blood is drawn out; or adjust the puncture direction, depth or puncture again. 6. After the puncture is completed, pull out the needle and disinfect the skin, cover it with a small sterile gauze, apply local pressure for 3 to 5 minutes to prevent bleeding, and then fix it with tape.

Precautions

1. Strict aseptic operation must be followed to prevent infection. 2. If bright red blood is drawn out, it means that the needle has entered an artery by mistake. It should be removed immediately and the puncture point should be compressed for 5 minutes. 3. Try to avoid repeated punctures. Generally, punctures should be stopped if they are unsuccessful three times. 4. After puncture, proper compression should be applied to stop bleeding and prevent local thrombosis.