Today our topic of discussion is Intravenous Cutdown.
Intravenous Cutdown
INTRAVENOUS CUTDOWN
Cutdown is a small incision to insert a cannula or catheters directly into the vein or artery. Whenever the blood vessels become collapsed and invisible, the veins will have to expose opened and a metal cannula or a piece of fine polythene tubing is inserted into the vein to start an infusion (Figs. 28.26A and B).
Purpose
- To restore and maintain the child’s fluid and electrolytes balance
- To maintain body homeostasis when the oral intake is Inadequate to serve this purpose
- To measure central venous pressure
- To administer larger fluid, eg, cardiac arrest.
Principles
- This procedure should carried out by a doctor assisted by a nurse
- Aseptic techniques must be adhered throughout all intravenously procedures to prevent bacterial contamination
- The single most effective aseptic procedure is good hand washing technique
- If asepsis is not maintained, local infection, septic phlebitis or septicemia may result.
Preliminary Assessment
- Check the physician’s order for vein cut down.
- Take written concern from the patient.
- Explain the procedure to the patient .
- Win the cooperation of the patient.
- Arrange all the articles and make sure that it is available in the unit.
Preparation of the Patient
- Explain the procedure to the patient and attendant of the patient.
- He should conscious to win his confidence and cooperation.
- The site of cutdown is prepared as for any major surgery .
- If any hair is present get the site shaved and cleaned.
- The bedding and garments are protected with a Mackintosh and towel.
- Prepare all the articles and strict aseptic technique should be followed.
Equipment
- IV Solutions.
- Betadine solutions .
- Alcohol solution 70°C.
- Hypoallergenic tape 1.2 cm, 2.5 cm
- Splint.
- Sterile gauze.
- Sterile cotton wool.
- Sterile drapes.
- Sterile cut down tray.
- Syringes 2 ml and 5 ml.
- Needle 25 and 20 gauge.
- The 4/0 black silk suture.
- Assorted size of stereopolyethylene tubing.
- Local anesthesia as prescribed.
- Normal saline 0.9%
- Sterile gloves according to doctor’s .
- Restraining devices.
- Sterile gown.
- Gallipol.
- Hand towel.
- Window towel.
- Knife handles No. 15 blades.
- Forceps.
- Scissors.
- Gauze and cotton.
- Needle holders.
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