Registry Skills Review Compiled and presented by IHCC EHS 1999 paramedic students: Matt Nielson Mary...
-
Upload
dominick-parsons -
Category
Documents
-
view
214 -
download
0
Transcript of Registry Skills Review Compiled and presented by IHCC EHS 1999 paramedic students: Matt Nielson Mary...
Registry Skills ReviewCompiled and presented by IHCC EHS 1999 paramedic students:
•Matt Nielson•Mary Sticha•Kerstin Buettner•Krista Hornish
•Kevin Harty•Erin Nosko•Amy O’Dell•Joe Gossman•Nick Sosso
Equipment Needed
Equipment List:GlovesTapeAlcohol Preps4x4 Gauze PadsBand-aidsIV catheterTourniquetIV fluid and drip setSharps container
Critical Criteria These are actions that will result in automatic
failure of station!• Exceeding the 6 minute time limit in establishing a
patent and properly adjusted IV• Failure to take or verbalize infection control
precautions prior to performing venipuncture• Contaminates equipment or site without
appropriately correcting situation• Any improper technique resulting in the potential
for catheter shear or air embolism• Failure to successfully establish IV within 3 attempts
during 6 minute time limit• Failure to dispose/verbalize disposal of needle in
proper container
Catheter/Administration Set
• Choose appropriate gauge catheter for: – medications– volume replacement
• Choose appropriate drip set– macro (10, 15, 20
gtts/min)
– micro (60 gtts/min)
Connect Drip Set to IV Bag
• Connect set to bag by removing plastic cover from bag port and piercing it with tubing spike.– Be careful not to
contaminate the tubing spike or bag port.
Fill Chamber/Flush Line• Ensure chamber
is 1/2 filled with fluid prior to flushing line to prevent air from entering tubing.
Cut or Tear Tape• Cut three pieces
of tape prior to starting venipuncture for easier securement of the catheter once the IV is in place.
Body Substance Isolation
• Take/Verbalize Infection Control Precautions.
• Check For Proper Fit, Tears or Holes.
*Prior to venipuncture
Apply Tourniquet
• Apply tourniquet above elbow to back up blood in veins, this causes the veins to pop up making it easier to choose potential sites.
Cleanse The Site• Clean the site
with a circular motion widening out from the chosen site with an alcohol swab.– Be careful not to
touch the site once it has been sterilized.
Perform Venipuncture
• Insert stylette while holding tension on vein.
• Note/Verbalize flashback of blood into flash chamber.– This verifies proper
placement into vein
Advance Catheter• Advance catheter
into vein.• Remove tourniquet• Tamponade vein
proximal to catheter.
• Place 4x4 under needle port and remove stylette.
Connect IV Tubing
• Ensure IV tubing is securely connected to catheter and twist or lock into place.
Assure Patent Line
• Adjust rate dial to allow fluid to run through line.
• Make sure fluid is running.
• Check for fluid infiltration and d/c fluid if evident.
Secure IV Catheter• Secure IV catheter
Using two sections of tape
• Place U-Shaped chevron beneath IV catheter hub.
• Place second piece of tape above IV catheter hub and secure to hand and skin
Secure IV Tubing
• Loop tubing so that the injection port is secured near IV site.
• Continue tubing up patients arm, securing once more with tape.
Dispose of Needle
• Assure safe disposal of the needle in a proper sharps container.
• Avoid recapping the contaminated needle
Critical CriteriaThese are actions that will result in automatic
failure of station!• Failure to begin administration of medication within
3 minute of time limit• Contaminates equipment or site without
appropriately correcting situation• Failure to adequately dispel air resulting in
potential for air embolism• Injects improper drug or dosage (Wrong drug,
incorrect amount, or pushes at inappropriate rate)• Failure to flush IV tubing after injecting medication• Recaps needle or failure to dispose/verbalize
disposal of syringe and needle in proper container
22
Selects Medication/Concentration
• Selects correct medication
• assures correct concentration of drug
• Check for expiration date
24 24 24
Infection Control
• Continues infection control precautions
• Cleanses injection site (Y-port or hub)
26
Ready For Injection
• Reaffirms medication for patient
• Stops IV flow (pinches tubing from IV bag)
• Administers correct dose at proper push rate
Flush and Adjust
• Flushes tubing (runs wide open for brief period)
• Adjust drip rate to TKO (KVO)
• Adjust to protocols or medications
Dispose and Observe
• Voices proper disposal of syringe and needle
• Verbalizes need to observe patient for desired effect or adverse side effects
Critical Criteria
These are actions that will result in automatic failure of station!
• Failure to begin administration of medication within five minute time limit.
• Contaminates equipment or site without appropriately correcting situation.
• Administers improper drug or dosage.• Failure to flush I.V. tubing of secondary line
resulting in potential for air embolism.• Failure to shut off flow of primary line.
31 31 31 31 31
31
Selects Medication/Concentration
• Selects correct medication
• assures correct concentration of drug
• Check for expiration date
33 33 33
Inject Medication
• Injects correct amount of medication into IV solution given scenario.
34 34 34 34 34
34
Connect/Set Up Drip set
• Connects appropriate administration set to medication solution
• Prepares administration set (fills drip chamber and flushes tubing)
35 35 35 35 35 35 35 35 35 35 35 35
Infection Control
• Continues infection control precautions
• Cleanses injection site (Y-port or hub)
36 36 36 36 36 36 36 36 36 36 36 36
Insert Piggyback Needle
• Insert needle into proper port without contamination
37 37 37 37 37 37 37 37 37 37 37 37
Connect Piggyback
• Inserts needle into port without contamination
38 38 38 38 38 38 38 38 38 38 38 38
Adjust Medication Flow
• Adjusts flow rate of secondary line as required
• Stops flow of primary line
39 39 39 39 39 39 39 39 39 39 39 39
Tape Needle
• Securely tape needle to prevent movement and possible loss of site
40 40 40 40 40 40 40 40 40 40 40 40