c. Particulate Matter. Hold a bottle or bag of intravenous solution up in front of
a light. See how it is sparkling clear. Actually, small particles called particulate matter
are present in the solution. Standards allow extremely small particles to be present in
the solution in certain concentrations. Intravenous solutions or admixtures should never
be administered to a patient when the products contain visible particulate matter. A
product that is cloudy might actually be cloudy because of suspended particulate
matter. Even though filters are available which can filter most particulate matter from
intravenous products, do not use a cloudy solution.
SITE FOR VENIPUNCTURE
a. Selection. Site selection for venipuncture depends on:
(1) Accessibility of the vein. A vein should be relatively easy to feel and to
stabilize for venipuncture. If this task is too difficult, select another vein.
(2) General condition of the vein. If the vein is in good condition, it will
easily take the venipuncture. If the vein is poor, it may collapse upon puncture.
(3) Type of fluid to be infused. If the fluid used is especially irritating, a
different site will be suitable from the sites, which can be used for non-irritating fluids.
(4) Period the intravenous line is expected to be in place. Long-term
intravenous therapy will often require a different site from the ones that can be used if a
single bottle or bag of fluid will be used.
b. Preferred Sites. The following sites are generally used and preferred for use
by most physicians in the clinical setting it is possible to select preferable veins for
puncture. On the battlefield and keeping with the tenants of Tactical Combat Casualty
Care (TC3), you should puncture a high percentage vein such as antecubital or external
(1) Distal to the antecubital area (that is, cephalic, basilic, antebrachial veins
in the lower arms).
Veins on the back of the hand.
(3) Veins in the lower extremities when necessary although danger of
thrombophlebitis is considerably greater.
Select the largest vein, if possible, when injecting intravenous drugs that
may produce sloughing/necrosis injury to the tissues.