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Lecture 14

NURS 342 Lecture Notes - Lecture 14: Infusion Set, Thrombocytopenia, Tourniquet

Course Code
NURS 342

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Nurs 342: Week 1
Mat and Child pg. 1114, 1301
Intraosseous and Subcutaneous (Hypodermoclysis) Infusions
Administering an Intraosseous infusion
Infusion of fluid into the bone marrow cavity of a long bone usually the distal or proximal tibia,
the distal femur or the iliac crest
Bone marrow directly communicates with the circulatory system, fluid reaches the bloodstream
as quickly by this route than if it were administered IV, incl. whole blood or medication
Used in an emergency when it is difficult to establish usual IV access or in a child with such
extensive burns that the usual sites for IV infusion are not available- temporary until usual route
can be obtained, rotate q 2-3 days to minimize risk of infection
Intraosseous infusion is painful as the needle enters the bone marrow cavity. Prepare the child for
Tubing changed every 48 hours, dressing changed every 24 hours
Assess for distal pulse and adequate temp of leg every hour throughout the infusion to ensure
there is adequate circulation to the extremity
If the needle should become dislodged, symptoms of circulatory impairment or pain and taut skin
over the site occur
Occasionally during fluid admin, a bone chip or thick marrow will occlude an intraosseous
needle, and slow the infusion
oif this occurs- a stylet is passed through the needle clears it and allows for continuous
fluid administration
Initiation of Intraosseous Infusion
Skin over the chosen site is cleaned with povidone-iodine and anesthetized with a local anesthetic
A small incision is made into the skin with a scalpel blade
A large hypodermic or bone marrow needle is inserted through the incision into the cavity of the
To ensure the needle tip has reached the bone marrow cavity, a syringe is attached to the needle
and bone marrow is aspirated
When bone marrow is obtained, the syringe is removed and IV tubing, incl. a filter and the fluid
to be administered, is attached to the needle and opened to a gravity flow
A dressing with additional iodine is then applied over the needle site
A restraint is applied to the leg to help the child hold the leg still
Administering a SC (Hypodermoclysis) Infusion
Before safe Iv infusion was perfected for infants, fluid was given to them SC (fluid into SC layers
by IV infusion set)
Used for children with blood disorders who receive a medication such as deforxamine (desferal)
to remove stored iron from their body)
Sites used incl. pectoral region, the back and the anterolateral aspects of the thighs
IV needle is inserted into the SC layer of the skin and the infusion apparatus is opened
Rate is governed by absorption by the SC layer of the skin, not by a set rate
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