Symptoms of clavicular puncture infection

summary

In general, people don't know about subclavian vein puncture, but now because of the complexity of people's condition and the occurrence of diseases, we must use this method to treat them, so it's very necessary for us to learn more about this knowledge. Subclavian vein puncture and intubation method is located at the back and bottom of the clavicle, which is shallow, thick and easy to use Adults are as thick as the thumb, with fast blood flow and often in a filling state, so they are easy to puncture. At the puncture site, the bisector of the angle between the lateral edge of sternocleidomastoid muscle and clavicle was 0.5-1cm away from the apex. The specific operation method is as follows.

Symptoms of clavicular puncture infection

Operation method (1) take all the things to the bed, prepare the infusion bottle with the surrounding intravenous infusion method, and hang it on the infusion rack（ 2) Explain to sober patients, eliminate fear and tension, and get cooperation（ 3) The patient was placed in a low head and high shoulder position (pillow under shoulder) or supine position, with the head turned to the opposite side to reveal the shape of sternocleidomastoid muscle. Use 1% methyl violet to mark the needle entry point and sternoclavicular joint, so as to avoid the difficulty of seeing the puncture point and needle entry direction after laying sterile towel.

(4) Open the puncture bag, wear gloves, and lay a sterile towel after the assistant routinely disinfects the skin（ 5) The water gun and silicone tube were prepared, 0.4% sodium citrate saline was aspirated, and the puncture needle was connected（ 6) With 5ml syringe, 1% procaine was aspirated for local anesthesia at the predetermined injection point. When the needle tip passes through the sternoclavicular fascia, there is a sense of emptiness. Continue to insert the needle. Try to penetrate the subclavian vein to detect the direction, angle and depth of the needle.

(7) The surgeon, holding a water gun, punctured the subclavian vein according to the direction of fitting, and drew back the blood. If dark red blood was seen, it was confirmed that he entered the subclavian vein（ 8) Press the round hole of the water gun of the injection tube and the end of the silicone tube, quickly push the piston, the silicone tube will enter the subclavian vein with the liquid, press the top of the puncture needle, and withdraw the needle. After the needle exits the skin, hold the silicone tube with your left hand and gently pull it out of the water gun（ 9) Connect the prepared infusion catheter with the flat needle, insert it into the silicone tube, and drip it intravenously.

matters needing attention

Ligate the silicone tube, suture and fix the silicone tube on the skin about 1cm away from the puncture point, cover it with sterile gauze, and fix it. After the infusion, 1-2ml 0.4% sodium citrate physiological water was injected into the silicone tube, and then the sterile plug was used to plug the needle bolt hole, and the sterile gauze was used to cover and fix it. When the infusion was performed again, the plug was opened, the needle gun hole was disinfected, and the infusion device was connected. If the infusion is not smooth, rapid negative pressure suction can be used instead of forceful injection of liquid, in order to prevent the clotting in the tube into the blood vessels to form emboli.