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Techniques for insertion and withdrawal of indwelling needles

Jan 08, 2023 Source: Cainiu Health
Dr. Yang Shuwen
Introduction
An indwelling needle is a relatively soft intravenous infusion device. When inserting the indwelling needle, a blood vessel with abundant blood flow and good elasticity should be selected. During needle withdrawal, local block therapy should be performed, along with pressure dressing at the site. After needle removal, some patients may experience difficulty in wound healing at the puncture site due to a large puncture hole or poor skin elasticity, potentially leading to bacterial infection. In such cases, it is recommended to seek medical treatment at a hospital as early as possible.

　　An indwelling catheter is a relatively soft intravenous infusion device. When inserting the catheter, a blood vessel with abundant blood flow and good elasticity should be selected. After needle withdrawal, local closure treatment should be performed along with pressure dressing at the site. The use of an indwelling catheter must be operated by trained medical professionals. The specific procedure is as follows:

　　1. The patient rolls up their clothing to expose the area 10 cm above the intended puncture site. Healthcare personnel apply a tourniquet at this location and perform rotational disinfection at the puncture site, ensuring the disinfected skin area exceeds 5 cm in diameter.

　　2. Open the sterile transparent dressing from the outer packaging of the indwelling catheter, remove the catheter cap, adjust the needle position, and firmly grasp the fist to expel air from inside the catheter.

　　3. Use one hand to stretch the patient's skin tightly while using the other hand to insert the needle at an angle. After insertion, check for blood backflow.

　　4. Before removing the indwelling catheter, healthcare personnel use their left hand to remove the dressing covering the catheter while using their right hand to stabilize the catheter on the patient’s hand.

　　5. Disinfect the surface of the catheter insertion site, then gently press a sterilized cotton ball over the puncture point, and slowly withdraw the indwelling catheter with the other hand.

　　After needle removal, some patients may experience difficulty healing at the puncture site due to a large puncture hole or poor skin elasticity, which could lead to bacterial infection. In such cases, it is recommended to seek medical treatment at a hospital as early as possible.

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There is a blood line inside the indwelling catheter, which is mostly due to backflow of blood from the blood vessel. A small amount usually indicates minor reflux of venous blood into the catheter and generally requires no intervention. However, if there is a significant amount of blood or local skin discomfort, it is recommended to consult a doctor promptly for re-evaluation or removal of the catheter. If bleeding occurs in the indwelling catheter during infusion, it may be due to excessive infusion volume, and the catheter should be replaced.
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How to use an indwelling needle on the second day
Before using the indwelling catheter on the second day, first examine the condition of the catheter, disinfect the connection site, then attach the infusion tubing to the end of the indwelling catheter. Observe whether the fluid flows properly. If not, consider the possibility of catheter occlusion. For mild blockage, flush with normal saline; for severe blockage, consider replacing the indwelling catheter.
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Why is the indwelling needle inserted one day earlier?
An indwelling needle usually refers to an intravenous (IV) indwelling catheter. Under normal circumstances, placing the IV indwelling needle one day prior to the procedure may be due to reasons such as reducing patient discomfort, preoperative laboratory tests, surgical preparation, venous access preparation, and intraoperative medication administration. Specific details are as follows: It should be noted that the exact timing of catheter placement may vary depending on hospital regulations, type of surgery, and individual patient conditions.
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What is the insertion angle for an indwelling needle?
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Which factors are not related to mechanical venous injury?
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