MINISTRY OF PUBLIC HEALTH OF THE REPUBLIC OF BELARUS

EDUCATIONAL INSTITUTION
«GOMEL STATE MEDICAL UNIVERSITY»
Chair of propedeutics of internal diseases

Discussion of the chair«_____» 2018

The protocol № _

METHODOLOGICAL RESEARCH

For carrying out of employment with students of 2rd course

on medical care and manipulation technology

Theme: THE PARENTERAL ROUTE OF DRUG ADMINISTRATION

(INTRAVENOUS (IV) INJECTION)
(infusion therapy using a peripheral venous catheter)

Time: 4 hours
1. 1. STUDY AND EDUCATIONAL GOALS, MOTIVATION,
DEMANDS TO THE INITIAL KNOWLEDGE LEVEL
2. 1.1. The study goal
3. To study parenteral routes of drug administration.
4. 1.2. Motivation
5. It is identified that nursing skills are deficient in the diploma preparation of
doctors. Nursing interventions described here will contribute to rectifying this
deficiency and provide a solid basis for acquiring essential nursing skills. This will
be useful and informative, and that it will contribute to the delivery of high quality
nursing care.
1.3. Requirements to initial level of knowledge
6. The student should know:
1. The technique of intravenous (IV) injection.
2. Technique of using a peripheral venous catheter.
7.The student should be able:
To make intravenous (IV) injection.
2. Control questions from related subjects.
1. Anatomy of blood vessels.
2. Anatomy of skin and musles .
3. Control questions.
1. Intravenous administration of a drug using a butterfly needle infusion device in
small veins.
2. Staging of a peripheral venous catheter.

4. Lesson course.
During lesson control questions are discussed according to lessons themes.

1. Intravenous administration of a drug using a butterfly needle infusion

device in small veins.

The device for infusion into small veins “butterfly needle” (hereinafter - the
device “butterfly needle”) is used in patients with thin, poorly contoured
veins. Two types of butterfly-needle devices are available: for injecting L C
into small peripheral veins with intravenous infusions of up to 6 hours,
taking blood for biochemical and other types of studies.
The injection site is the superficial veins of the elbow, forearm, back of the
hand and foot.

2. Staging of a peripheral venous catheter.

The placement of a peripheral venous catheter (hereinafter referred to as PVC)

allows for infusion therapy without repeated puncture of the peripheral veins.
The manufacturer produces PVC with one or more additional ports and different
sizes: 14G (2.0x45 mm); 16G (1.7x45 mm); 17G (1.4x45 mm); 18G (1.2x32-45
mm); 20G (1.0x32 mm); 22G (0.8x25 mm); 24G (0.7x19 mm); 26G (0.6x19 mm).
The choice of PVC size depends on the purpose of its formulation and the size of
the punctured vein.
PVC is installed for a period of not more than 72 hours. The time for the
introduction of infusion solutions from one vial should not exceed 24 hours
after opening, on the basis of lipids - no more than 12 hours.
After drug administration, the PVC is washed with a 9 mg / ml sodium
chloride solution and filled with a heparinized solution. The heparinized
solution in PVC changes daily, including if drug administration was not
carried out through PVC.
Inspection of the location of the PVC should be carried out daily. If there are
signs of infection, PVC must be removed. Each subsequent formulation of
the PVC is performed proximal to the previous one or on the opposite arm.
For staging PVC, you should choose the veins:
with the presence of a straight section corresponding to the length of the
PVC;
on a non-dominant hand (for right-handers - on the left, for left-handers - on
the right);
on the side opposite to surgery; with the largest diameter in relation to the
diameter of the PVC; well visualized and palpable, with well-developed
collaterals.
Placement - veins in the back of the hand, the inner surface of the forearm.

Technique

Place a roller under the patient's arm.

Place a tourniquet on the arm and treat the venipuncture site with an antiseptic
Handle and wear gloves.
Take the catheter out of the opened package with your left hand.
Remove the cap with the right hand
Spread slightly the wings on the catheter
Put the catheter in the right hand, place the second and third fingers in front of the
wings, the first finger on the support for the first finger.
Remove the cap from the needle guide with the left hand
Fix the vein by pulling the skin in the venipuncture area with the first finger of the
left hand.
Holding the guide needle with the cut up, pierce the skin at a slight angle (no more
than 15 °), position the needle guide parallel to the vein, without changing the
position of the catheter in your hand.
pierce the front wall of the vein and gently push the needle guide along the vein
until blood appears
Move the first finger of the right hand on the cover of the additional port
 Cover the first and second fingers of your left hand with the support for the first
finger.
Hold the needle guide still and hold it with your left hand and gently push the
catheter up to the cannula with your right hand, do not remove the needle guide
completely from the catheter
take off the tourniquet
Take a gauze with the right hand and place below the venipuncture site under the
main port of the catheter
extract needle
introduce sodium chloride solution into the main port
then enter heparin into the additional port
close the catheter
Take the ball with your right hand and moisten it with an antiseptic.
Treat the skin around the PVC with circular movements in the direction "from the
center to the periphery"
Fix PVC bandage . Cover the PVC with a gauze cloth and apply a bandage.

PVK is removed after the expiration of the term of the statement or if there
are signs of infection at the place of its production.
Inform the patient about the upcoming PCV removal, receive verbal consent for
execution required position.
Place the first and second fingers of the left hand on the lid of the additional port of
cateter(PVC), carefully remove the self-adhesive bandage with your right hand.
Remove the left hand from the PVC.
Take the ball in your left hand, moisten with an antiseptic.
Position the first, second and third fingers of the right hand on the additional PVC
port, apply the ball with the left hand to the venipuncture site.
Remove the right hand, slow and careful movement of "on themselves" PVC from
the vein.
Press the ball to the venipuncture site for 3-5 minutes.
Inspect the PCV for integrity and the presence of a blood clot in it (if there is a
blood clot or suspected infection, cut off the end of the PVC with scissors, place it
in a test tube and send it to a bacteriological laboratory for a study prescribed by a
specialist)
Inspect the venipuncture site for signs of infection.
Apply a gauze cloth and a bandage dressing to the venipuncture site.
Inform the patient that the bandage cannot be removed and the venipuncture site is
wetted with water for 24 hours.

Literature
Basic:
 1. Ослопов, В. Н. Общий уход за больными терапевтического про филя :
учеб.пособие / В. Н. Ослопов, О. В. Богоявленская. – 4-е изд., испр. и
доп. – Москва : ГЭОТАР-Медиа, 2015. – 459 с.
2. T.P. Pronko, K.N.Sokolov, M.A. Lis The Basics of Patient Care, Гродно
2013
Additional:
3. Общий уход за терапевтическими больными : пособие для
студентов лечебного и медико-психологического факультетов / К. Н.
Соколов [и др.]. - 6-е изд., доп. и перераб. - Гродно :ГрГМУ, 2013. – 267 с.
4. Основы ухода за терапевтическими пациентами : пособие для студ.
лечеб. и мед.-психол. фак. / К. Н. Соколов [и др.]. – Гродно :ГрГМУ, 2016. –
277 с.
5. Отработка практических навыков и умений. Эталоны
симуляционных модулей оказания медицинской помощи : пособие для студ.
учрежд. высш. образования, обуч. / В. В. Редненко [и др.]. – Витебск, 2016.
– 127 с.
6. Яромич, И.В. Сестринское дело и манипуляционная техника:
учебник / И.В.Яромич. – 4-е изд., - Минск , 2014. – 527 с.
7. Material of lecture.