Cannulating cardiac patients

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dreamergirl32

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Hi!!

I was just wondering what peoples views are on cannulation sites for cardiac patients.

On my course we get told to work from hand upwards in any patients but have been told by several paramedics that if the patient is cardiac the ACF should be used.

Does anyone have any suggestions on this??

Thanksx
 
You still get the lowest palpable IV site that will allow proper size for the job. I'm sure you know it but you place IV's by feel not sight.
 
If they look like :censored::censored::censored::censored:, get the biggest line you can. When they code, their BP drops to, well, sh*t/crap, so, you wont be able to get a good one usually. Sick = big IV.

If they're chillin' - and just need a lil' somethin' to get them over (of course, with the exception of Jesus, Moses, the burning bush, etc.) - yeah, a small IV will be fine.
 
i tend to use cephalics on nearly all my patients as its a splinted insertion site and a decent size vein, but this changes from time to to depending on the quality of the pts skin (especially when prednisolone and/or warfarin is being used) and generally i use an 18g.

Im one of those guys who ALWAYS puts an IV in before we move to the truck, just my preference
 
dreamergirl32 said:
Hi!!

I was just wondering what peoples views are on cannulation sites for cardiac patients.

On my course we get told to work from hand upwards in any patients but have been told by several paramedics that if the patient is cardiac the ACF should be used.

Does anyone have any suggestions on this??

Thanksx
Click to expand...

LAC,,,I've always heard this is best place for cardiac pt's. Shortest route to the heart when giving meds.
 
IV sites for cardiac patients

Cardiac patients is a broad category and a non-descript way to approach your IV choice - what was suggested by Maxwell seems right to me and a better way to approach your lines.

Personally I approach lines this way.

* Do I need a line and why?
* The size and location of the line depends on:

- how sick the patient is
- what needs to go into it now and in the near future (incl A&E eg Adenosine>SVT>>Big line cube fossae)
-how fast and how much? Lots of drugs fast and hard or little bits at slow increments?
- relative benefits of intended treatment versus pain for pt, risk of infection from the IV, likelihood of successful insertion etc.

egs

Infarct pt - sick>> one peripheral and one fluid -drugs plus fluid will be needed in treatment>>>two lines>>>pt may arrest etc

Angina pt - anginal pain only stable obs no complications>>>>one peripheral for morph if needed. IV enables extra route for drug admin if needed.

Tip - pts in pain are restless - large forearm IV (16g) better than cube fossae as they tend to crimp them all the time when they are bending their arms. Also forearm more secure with a sick pt.

Hope that helps

MM
 
True. Let the pt's clinical presentation and overall vein condition dictate IV placement. The sicker they are, the largest cathlon as close to the heart as possible should be placed.

If you can't feel it, don't stick it.
 
Ms.Medic said:
LAC,,,I've always heard this is best place for cardiac pt's. Shortest route to the heart when giving meds.
Click to expand...

No ma'am. The shortest route is EJ.
 
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