Basic nursing: skills and characteristics of scalp venipuncture in children

Keywords: scalp venipuncture skills in children

Intravenous injection is one of the most basic clinical treatment methods. With the continuous improvement of medical level and infusion requirements, venipuncture technology has become a basic skill that clinical nurses should master skillfully. In contrast, the skill of scalp intravenous injection in children is more difficult to master. Hit the nail on the head, not only alleviated the child's pain, but also won valuable time for treatment and rescue. According to the working experience in recent years, the author thinks that the success of scalp venipuncture in children is closely related to the following points.

1 Scalp characteristics of children

Scalp veins are distributed in a network, and blood can flow back to the heart through internal jugular vein and external jugular vein. Therefore, anterograde and retrograde needle insertion do not affect venous return. The median vein is a large branch of scalp vein, which is straight, large, non-slippery and easy to fix, but easy to extravasate. Retrograde needle insertion can overcome the shortcomings of extravasation. Superficial frontal vein and superficial temporal vein have the advantages of anti-skid, easy fixation, obvious exposure and no extravasation, which are the best places for scalp vein infusion, but these veins are small and technically difficult.

3 light intensity

4 preparation of liquid medicine

Do not add liquid medicine to the liquid before successful puncture, so as to avoid wasting liquid medicine during exhaust and repeated puncture, and the dosage is not allowed to affect the treatment. After successful puncture, add liquid medicine according to the doctor's advice.

5 pediatric head fixation

During puncture, the success rate of puncture depends on whether the child's head is fixed correctly. When fixing, the assistant or family members hold the child's cheekbones, cheeks and mandible with both hands, and the child's hand is placed under the assistant's hand to fix the child's head. Don't oppress the child's body and limbs, so as not to increase the resistance and make it difficult to fix.

6-needle insertion technique

The general puncture method is straight, and the angle between the needle and the skin is 10 ~ 15. After entering the skin, according to the thickness of blood vessels, bend straight, dive into the skin for 0.5 ~ 1 cm, from shallow to deep, slowly enter the blood vessels, and stop the needle insertion after the blood returns.

7 Fixed needle

In view of children's hyperactivity and uncooperative characteristics, needle fixation is very important, which is beneficial to nursing and successful treatment. In practice, it often happens that the needle is improperly fixed after successful puncture, which leads to liquid extravasation and re-puncture. When the needle is inserted, there should be no sweat stains on the skin near the needle. The first strap must be glued to the needle handle, and the following straps can be glued on this basis. The tape should not be too long and too wide, and it should be 4 ~ 5 cm× 1 ~ 1.5 cm. If it's too long, it's not good to waste. Second, sticking to the hair and skin when pulling out the needle causes pain.

8 puncture for special children

For children with dark skin and inconspicuous blood vessel exposure, puncture is more difficult. It is necessary to carefully distinguish the direction and depth of blood vessels, so as to be aware of it, and adopt the method of direct puncture to improve the success rate of puncture, instead of blindly inserting needles and increasing the pain of children. Dehydrated children have insufficient blood volume, sunken scalp blood vessels and poor blood return. Need an assistant to cooperate. Use a disposable syringe of 5 ~ 10 ml to suck the corresponding empty liquid and connect the scalp puncture needle. After the needle enters the scalp skin, suck it while inserting the needle, and stop inserting the needle when returning blood. Push the liquid slowly while fixing the needle to prevent the needle from being blocked by sticky blood.

9 strengthen the inspection during infusion.

When preparing liquid medicine, the dosage should be accurate, attention should be paid to the checking system, and aseptic operation should be strictly observed to avoid mistakes and accidents. Patrol frequently during infusion to observe whether there are any unexpected situations such as adverse reactions of infusion.

As a nurse, in clinical work, we should improve our own quality, study hard, sum up experience, be familiar with scalp puncture skills and characteristics, and improve the success rate of scalp puncture infusion.