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Ensuring intravenous lines in children.
BENEŠOVÁ, Nikola
Intravenous cannulation ranks among the basic nursing procedures performed by nurses on everyday basis. The indications for cannulation include particularly infusion therapies, administration of replacement fluids in case of blood loss, anesthesia, long-term administration of antibiotics, parenteral nutrition or monitoring of central venous pressure. In case of children the method prevents frequent unpleasant and painful punctures. Intravenous cannulation is used for peripheral catheterization, central catheterization, umbilical catheterization and PICC. The most frequent is application of peripheral catheters. In absolute majority of cases the procedure is performed by two nurses, while one introduces a catheter and the other holds the child. It should be always made possible for the mother/accompanying person to be present during the procedure. Apart from observation of disinfection, sterility and correct procedure by nurses/ physician, it is very essential to ensure good mental preparation of the child which depends on how much the child is able to understand the provided information. The parent or another accompanying person must be sufficiently instructed in advance about the procedure. In case of introduction of a peripheral catheter in newborns and nurslings no rubber or other tourniquets are used on the limb and the limb is only pressed by the assisting nurse with adequate force. Equally as in adults, visible veins of upper and lower limbs are used for intravenous cannulation but also veins on the child´s head which is a specific place used in little children. Umbilical catheter introduced immediately after the birth is also characteristic for newborns and this procedure can be performed only by a physician, similarly as it is the case with the central catheter. PICC is different in this respect as it can be also introduced by a professionally trained nurse. Aseptic approach is always applied. All catheters must be firmly fixed to prevent their undesired extraction. After the procedure the patient and the puncture area are regularly checked to prevent complications.
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