As a "big infusion country", venipuncture has become the most difficult task for clinical nurses. The only job of nurses in the "treatment group" of clinical departments is venipuncture, so China has trained a large number of world-class venipuncture experts. Therefore, it is ignorant to complain that nurses' venipuncture skills are not up to standard in China, let alone in China. On the other hand, venipuncture technology has become the first hard index to measure a nurse's "level", especially in pediatrics.
One of the characteristics of China is that the top pediatric venipuncture experts in hospitals at all levels enjoy the reputation as top medical experts. Of course, it also reflects the technical content of venipuncture technology from another side. Different from obtaining blood samples by venipuncture, venipuncture for intravenous infusion not only requires the needle to be inserted into tiny veins accurately, but also ensures that the vein cannot be punctured and must be fixed. The needle is always in the vein during the whole infusion process (from several hours to more than ten hours or even 24 hours) and must be kept in a normal state; This requires that the selected puncture site must be flat, which further reduces the selectivity of this venipuncture to this site and correspondingly increases the difficulty of operation. This is also the reason why "indwelling needle" has become popular in recent years. The so-called "indwelling needle" is to puncture the vein with a metal needle first, and then introduce a soft catheter to fix it successfully, thus avoiding the trouble of "bulging needle" and "water seepage" caused by the second puncture of the vein with a metal needle, and it can be kept for several days after reliable fixation.
As for the procedure of puncture, firstly, the operator is required to wash his hands thoroughly, preferably with liquid with disinfectant, and then with running water. After the puncture point is selected, the patient's puncture point must be vigilant and strictly disinfected. For venous puncture of elbow and hand, a tourniquet should be tied near the heart of the puncture site to promote venous filling and improve the success rate of puncture. Strictly speaking, operators are also required to wear disposable sterile gloves (to protect both parties from the risk of cross-infection) and discard it immediately after the operation is completed (of course, this option).
However, it should be pointed out that if domestic nurses wear gloves during venipuncture, will Wang Mudi people think that domestic nurses dislike her girlfriend's dirty, and will the nurses bleed ten paces because of the emperor's anger?
In the specific operation, most surgeons in China require patients to make fists in order to promote venous filling. In fact, this practice is not appropriate, because many people's subcutaneous veins will be "squashed" in the state of clenched fists, which makes it difficult to puncture. The correct method is to ask the operator to keep the natural state and adjust the degree of skin "tightness" according to the venous filling state. Puncture methods can be divided into primary needle feeding method and secondary needle feeding method. For people with thick and well-filled blood vessels, the puncture needle can be quickly inserted into blood vessels at one time, which is simple to operate and will obviously alleviate the pain of patients. For people whose blood vessels are not so clear and prominent, the success rate of puncture can be improved by multiple punctures, that is, first puncturing the skin, then diving under the skin for a short distance and then puncturing the blood vessels for the second time. Venous puncture usually causes slight pain, or "tingling" or "insect bite", which varies from person to person, on the other hand, it is related to puncture skills. There are many nerves in the skin and vein adventitia, so puncturing these two levels will cause pain, and the skin is particularly sensitive. In order to alleviate the operator's pain, it is required to pass these two stages as soon as possible, on the one hand, it should be fast, on the other hand, it should increase the needle insertion angle and shorten the straight line distance between the two stages. Usually, the textbook requires that the angle of the needle is 20 degrees with the skin, and the needle should pass through the skin and blood vessels several times. For the vein that is easy to puncture, the puncture angle can be increased to 45 degrees, so that the needle can quickly pass through the skin and vein wall at one time, which can minimize the pain of the operator. For the more difficult puncture, it is still necessary to follow the requirements of the textbook step by step, at the cost of giving the operator more pain.
Here, it is necessary to remind people who receive intravenous infusion treatment to pay attention. In the process of infusion (if the vein of the back of hand is punctured), keep your hand flat and relaxed as much as possible, and keep it in a natural state. Therefore, if you are nervous and have a lot of muscles and tendons in your hands, any slight movement may drive the hard metal needle to move in the blood vessels, causing the needle tip to pierce the vein wall or escape from the vein, resulting in so-called "drum needle" and "water seepage".
As for the level of venipuncture of every nurse, besides hard work, practice makes perfect and personal skills, there is also an important factor, that is, the "hands" between different individuals, just like the talent of calligraphy, have innate differences. Many people have said a lot about the growing pains and hardships of nurses, so I won't go into details here. However, many people may not know the unfairness of nurses caused by the system, that is, most young nurses in hospitals at all levels are temporary workers without staffing, also called contract nurses. Their treatment and staffing can almost be described as cloud mud, because most hospitals are so-called state-owned and public institutions, and the staffing of nurses is strictly compiled, which is particularly tense. In fact, as long as the state does not liberalize the monopoly of the medical market, all kinds of disadvantages will inevitably intensify, which is what people need to pay close attention to. Some people say that the semi-market and semi-administrative market is the worst market, and the medical market in China is almost an appropriate footnote to this view. In a word, although everyone has his own frustrations and grievances, Wang Mudi, who complained about the poor venipuncture skills of nurses in China and therefore clamored for hacking and killing people, is a typical "born without knowing happiness".
(Author: prisoners who broke free from shackles)