As an "infusion country," venipuncture has become the most onerous task for clinical nurses, and almost the only job for nurses in the "treatment team" of a clinical department is to perform venipuncture, which has resulted in a large number of world-class venipuncture experts in China. Therefore, complaining that a nurse's venipuncture skills are not up to par in China is not understanding the world, let alone China; on the other hand, venipuncture skills have become the first hard indicator of a nurse's "level", especially in pediatrics.
It's one of China's specialties that the top phlebotomists in pediatrics at all levels of hospitals enjoy as much prestige as the top medical specialists. Of course, it also reflects the technical content of venipuncture techniques in another way. Unlike venipuncture for obtaining blood specimens, venipuncture for the purpose of intravenous infusion requires not only accurate insertion of the needle into the tiny vein, but also ensures that the vein cannot be punctured, and that the needle is immobilized so that it remains in the vein throughout the entire infusion process (which can take as little as a few hours, or as long as tens of hours, or even 24 hours uninterruptedly), but also maintains its usual state; this requires that the site of the puncture chosen must be flat, which further reduces the need for the needle to be inserted into the vein. This further reduces the choice of site for this type of venipuncture, and accordingly increases the difficulty of the procedure. This is also the reason for the popularity of the so-called "retention needles" in recent years, which are used to puncture a vein with a metal needle and then introduce a soft catheter for fixation, thus avoiding the secondary puncture of the vein by the metal needle and causing a "bulging needle" or a "bulge". This avoids the trouble of "bulging" and "oozing" caused by the secondary puncture of the vein by the metal needle, and can be retained for several days after reliable fixation.
As for the protocol of puncture, the first is to require the applicator to wash his hands thoroughly, preferably with a liquid with disinfectant and then rinse with running water, after the selected puncture site, the recipient puncture site then must be alerted to strict disinfection. Elbow and hand venipuncture should also be tied with a tourniquet at the proximal end of the puncture site to promote venous filling and improve the success rate of puncture. When operating during the puncture, the operator is also strictly required to wear disposable sterile gloves (to protect both parties from the risk of cross-infection), which are discarded immediately upon completion of the operation (this is optional, of course).
However, it should be noted that if the domestic nurses wear gloves when performing venipuncture, Wang Mudi will not feel that the domestic nurses are disgusted with her girlfriend dirty, but also to show the "wrath of the son of God" to make nurses bleed ten steps?
Specifically, most domestic operators require patients to clench their fists, the purpose is also to promote venous filling. In fact, this practice is not appropriate, because many people's subcutaneous veins in the tight fist state will be "flattened" but to the puncture caused by the difficulty, the correct method is to ask the operator to maintain a natural state, based on the state of venous filling to adjust the need for the skin "taut" degree. The correct method is to ask the surgeon to maintain a natural state and to adjust the degree of skin "tautness" required according to the state of venous filling. For people with thick, well-filled veins, a one-time needle insertion into the vein is simple and significantly reduces the patient's pain; for people whose veins are not so clear and prominent, a split puncture improves the success rate of the puncture by first puncturing into the skin and then entering the vein with a second puncture after a short dive under the skin. The second puncture enters the blood vessel after a short subcutaneous dive. Venipuncture is usually associated with mild pain or a "pins and needles" or "bug bite" sensation, which varies from patient to patient and is related to the technique of the puncture. The skin and the tunica albuginea have a high distribution of nerves, and therefore pain can be felt when piercing these two layers, with the skin being particularly sensitive. To minimize the pain felt by the surgeon, this requires crossing these two levels as quickly as possible, partly by being quick and partly by increasing the angle of entry to shorten the straight line distance of the needle between these two levels. Usually, the textbook requirement is to enter the needle at an angle of 20 degrees with the skin, and puncture through the skin and blood vessels in several passes. For veins that are easy to puncture, you can raise the angle of the puncture to 45 degrees, and puncture through the skin and vein wall in one pass, which can minimize the pain felt by the surgeon. For difficult punctures, it is still necessary to follow the textbook step-by-step procedure, at the cost of more pain for the surgeon.
There's one thing to remember for people getting IV fluids: During the infusion (if you're puncturing a vein on the back of your hand), try to keep your hand as flat and relaxed as possible, and keep it in a natural position so that if you're tense and there are many muscles and tendons in your hand, any movement, even small, can drive the stiff metal needle through the blood vessel and cause the tip of the needle to pierce the wall of the vein or come out and cause what is known as a "bulge" in the vein. This can cause the tip of the needle to puncture the wall of the vein or to come out of the vein, resulting in what is known as "bulging needles" and "seepage".
As for the "level" of each nurse's venipuncture, in addition to hard work, practice makes perfect, and some personal skills, there is also an important factor which is the "handiness" of different individuals, just like the talent of calligraphy. There is an innate difference in talent, just as in calligraphy. As for nurses, many people have already talked about the troubles and hardships of growing up, so I am not going to repeat them here. However, there is one point due to the system caused by the injustice to the nurses may be many people do not know, that is, at present, most of the young nurses at all levels of hospitals are not established temporary workers, also known as contractual nurses, their treatment with the establishment of the very hospital staff can be almost described as mud, the reason is that the vast majority of hospitals are the so-called state, is still part of the institutions, the staff is a strict establishment of nurses. The establishment is particularly tight. In fact, as long as the State does not liberalize the monopoly of the medical market, various shortcomings are bound to intensify, and this is what requires the public to be highly concerned. It has been said that a half-market, half-administratively regulated market is the worst kind of market, and China's healthcare market is almost an apt footnote to this view. In short, while everyone has his or her own grievances, Wang Mudi, who complains about the poor venipuncture skills of nurses in China and calls for hacking and killing as a result, is a typical example of a person who "doesn't know what it's like to be born in the middle of a blessed country.
(Written by: Prisoner breaking free from chains)