How Nurses Can Perform a Venous Cutdown Procedure

Venous cutdown is a critical medical emergency procedure for nurses to help trauma patients exposed their vein by surgical methods using the steps described below:

Requirements needed on top shelf of the Trolley:

  • A sterile receiver with lid containing plain catgut tube 2/0 or 00
  • Small bowl with lid containing sterile water for rinsing catgut
  • Kidney receiver with lid for syringe and needles
  • Sterile bowl containing a dressing towel
  • Needles and cannulae as required
  • Local anesthetic agent

Instruments drum containing:

  • Bard parker handle
  • Fine scalpel
  • Curved cutting needle
  • Nylon thread /silkworm gut
  • 2 pairs of scissors one should be fine and sharp pointed
  • 2 pairs fine dissecting forceps
  • Toothed dissecting forceps
  • 2 pairs mosquito artery forceps
  • Aneurysm needle
  • Blunt hook retractor

HOW TO CARRY OUT A VENOUS CUTDOWN

  • The nurse should explain the procedure to the patient or patient’s relatives to make the feel at ease before this process is carried out.
  • The trolley is wheeled to the patient’s bedside
  • The site for the procedure is selected e.g the leg (saphenous vein) or the elbow (cubital fossa), and the patient is placed on a comfortable position
  • The doctor washes his hand and ties a mask
  • The nurse opens the sterile tray and using a cheatle forceps hands a sterile towel to the doctor who might have scrubbed his hands. The nurse provides sterile gloves for the doctor, and then pours out the antiseptic lotion for cleaning the skin.
  • The subsequent procedure is mainly carried out by the doctor who makes a horizontal cut 2cmdiameter and the veins are identified. This is done by palpitation.
  • An artery pulsates; nerve is cool like in texture while a vein is identified after eliminating an artery and a nerve.
  • The identified vein is cut half way through with a pair of scissors.
  • The lower part of the vein is ligatured with silk while the upper part of it is loosely tied with silk and the lumen left intact.
  • The tiny peadiatric butterfly needle with the headdetachedorthe tiny peadiatric nasogastrictube is introduced into the proximal end of the vein.
  • The loosely tied silk is now firmly knitted to avoid the tube slipping out.
  • The intravenous infusion is hanged on a drip stand and the given set is connected to the tube introduces into the vein.
  • The infusion is allowed to flow as required.
  • The skin is sutured with silk.
  • A dry sterile dressing is applied by the nurse and a tape neatly applied.
  • All used apparatus are washed and sent to the sterilization for repacking and sterilization.
  • The client is made comfortable and the screen removed.

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