Assisting The Paramedic
Intravenous (IV) Cannulation
Definition - The insertion of a cannula into a vein.
- Alcohol swab
- Correct sized cannula (Needle stick potential. Be careful)
- 5ml syringe
- Sodium chloride flush (Check date)
- Gauze swabs
- Cannula fixing dressing/Tape
- Sharps Box (Dispose of sharps immediately. Do not leave lying around)
Needle Stick - First Aid
- Encourage bleeding by squeezing site of puncture wound. Do not suck.
- Wash the wound with soap and water. Do not scrub.
- Cover wound with waterproof dressing.
- Inform your supervisor or manager immediately.
- Complete an accident report form.
- Attend your local A&E department, you'll be offered Post-Exposure Prophylaxis (PEP).
Cannula Sizes (N.B. the smaller the gauge the bigger the bore)
|Cannula Colour||Cannula Gauge|
A standard IV infusion set consists of a pre-filled, sterile bag of fluids with an attached drip chamber which allows the fluid to flow one drop at a time, making it easy to see the flow rate (and also reducing air bubbles); a long sterile tube with a clamp to regulate or stop the flow; a connector to attach to the access device; and connectors to allow "piggybacking" of another infusion set onto the same line.
Types of Fluid
There are two types of fluids that are used
for intravenous drips: crystalloids and colloids. Crystalloids
are aqueous solutions of mineral salts or other water-soluble
molecules. Colloids contain larger insoluble molecules, such as
gelatin; blood itself is a colloid.
The most commonly used crystalloid fluid is normal saline, a solution of sodium chloride at 0.9% concentration, which is close to the concentration in the blood (isotonic). Ringer's solution or Ringer's lactate is another isotonic solution often used for large-volume fluid replacement.
Intravenous fluids must always be sterile.
Type to be used
That all packaging is intact
The clarity of fluid
That pack is not out of expiry date
Setting up a "Giving Set"
- Remove the "giving set" from it's packaging and check overall condition. Move flow regulator to the closed position.
- Remove safety cover from needle at the chamber end. Push needle into entry port of fluid bag.
- Squeeze the top chamber until fluid half fills it. Next squeeze the bottom chamber until half full.
- Open the flow regulator slowly. Allow fluid to run to the leur lock at the far end of the "giving set" tubing. Check that the tubing is air free.
- Close the flow regulator
- Connect the leur lock to the cannula that your Paramedic has previously inserted.
- Secure the tubing to the patient using tape or a bandage. This prevents accidental removal by the patient.
Endotracheal intubation is a procedure by which a tube is inserted through the mouth down into the trachea. The endotracheal tube serves as an open passage through the upper airway. The purpose of endotracheal intubation is to permit air to pass freely to and from the lungs in order to ventilate the lungs. Endotracheal tubes can be connected to ventilator machines to provide artificial respiration.
- Clearing the airway. (use of suction)
- Preparation of equipment
- Patient monitoring and positioning
- Cricoid Pressure, and or, Sellick manoeuvre. (Manipulation of the larynx to enable the paramedic to see the vocal cords, temporarily occlude the upper end of the oesophagus and prevent the aspiration of stomach contents into the lungs during endotracheal intubation)
- Securing the tube in place.
- Bag and mask
- laryngoscope and blades
- Magill forceps
- Lubricating gel
- Intubation tube pre cut to correct size
- 20ml syringe
- Spencer Wells forceps
- Catheter mount
- Oro-pharyngeal airway
- Tape and ribbon to secure tube