Catheter styles and sizes

[justanothergunnut]

I have done some training with catheter insertion for the purpose of giving fluids to a patient. Recently during a field exercise I ran into trouble inserting a catheter that I was not familiar with. For some the terms I use will be known for others they won't so I will explain as I go. First off, IM NO EXPERT... im not a doctor, EMT or even medical professional. Im just some guy on a internet forum so take what I say with a grain of salt. Get training from someone who knows what they are doing!!!!
Catheters come in many sizes and styles. 10GA, 18GA, 20Ga, auto catheter, safety catheter, Angio Catheter, etc. etc. etc. We have in the past trained with the smaller catheters to avoid damaging our victims too much while we fumble with the basics of insertion. I would suggest after you get down the basics that you train with various sizes and styles. I ran into trouble with a 12Ga angiocath. my problem was three fold.

1. The catheter did not have the normal raised lip to assist in advancing the cannula(the actual plastic sleeve that goes into the vein) see RED circle pic #2
pic #3 shows the angiocath without the lip to assist in advancing the cannula
2. The size of the catheter was considerably larger than I had previously used so it required more force to enter the vein and to advance the cannula
3. train under realistic conditions.






It might be good to have some here with more experience weigh in on catheters in more detail and maybe make suggestions on training with them.

[Patriotic Sheepdog]

I have done some training with catheter insertion for the purpose of giving fluids to a patient. Recently during a field exercise I ran into trouble inserting a catheter that I was not familiar with. For some the terms I use will be known for others they won't so I will explain as I go. First off, IM NO EXPERT... im not a doctor, EMT or even medical professional. Im just some guy on a internet forum so take what I say with a grain of salt. Get training from someone who knows what they are doing!!!!
Catheters come in many sizes and styles. 10GA, 18GA, 20Ga, auto catheter, safety catheter, Angio Catheter, etc. etc. etc. We have in the past trained with the smaller catheters to avoid damaging our victims too much while we fumble with the basics of insertion. I would suggest after you get down the basics that you train with various sizes and styles. I ran into trouble with a 12Ga angiocath. my problem was three fold.

1. The catheter did not have the normal raised lip to assist in advancing the cannula(the actual plastic sleeve that goes into the vein) see RED circle pic #2
pic #3 shows the angiocath without the lip to assist in advancing the cannula
2. The size of the catheter was considerably larger than I had previously used so it required more force to enter the vein and to advance the cannula
3. train under realistic conditions.


[ATTACH=CONFIG]2441[/ATTACH]
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[ATTACH=CONFIG]2443[/ATTACH]

It might be good to have some here with more experience weigh in on catheters in more detail and maybe make suggestions on training with them.

Wow! 12g? 10? Are you using these for IV access? If so, you must not like your partner that you are starting this on, lol. That would freaking hurt!

If I want to get fluids moving quick I would start two 16g, one in each arm. When you get above 16g things get much harder. For IV, I believe the largest IV I started in the field was a 14g. To do that, I used the tip of the needle and made a small slice in the skin where I was going to insert the catheter. This aided the large needle to be pushed through the skin. This was shown to me by an ER doc when I was a new paramedic. When I was teaching paramedic students IV insertions, I never let them use anything larger than a 20g to learn the techniques, then advanced to an 18g and towards the end of the paramedic program, I would allow the students to practice with a 16g. I really don't know why you would need a 12g or a 10g for IVs. For medical cases, it's usually a 20g or 18g. When giving blood or when you want to push large volumes of IV fluids quickly, you really should have at least a 16g.

The needle diameter recommended for needle decompression is a 14g.

As far as different types, well, find one you like and practice with that one. Learn the techniques and you will be able to use any type eventually. I've used many different types over the years and haven't had a problem with any, but I prefer the angiocaths. I don't do a one handed technique, despite what the cath was designed for. I'm right handed, so I pull skin taught with left hand, insert with right hand, then slide cath forward with left hand (hope that makes sense), then withdraw needle with right hand while holding catheter in place. Then attach tubing or hep lock, then secure making certain IV remains patent.


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[justanothergunnut]

Thanks for the input psd. As far as the 12ga cath it was the teachers supplies. I didn't. Even know it was part of the scenario. I suspect he chose it on purpose to induce extra stress on me. Funny thing is though. HE was the patient so the joke was on him. I keep several. 14,16,18,20 and 24ga and have practiced with them using the same training ideology you outlined training with the smaller cath's. My wife's veins are very hard to hit and roll easily so the 24ga are for her. Tell you what working with that 12ga angio cath was intimidating. It was like trying to insert a turkey baister. Another take away I got from it was the sequence that you do things is critical in the field becaus you just don't have a clean area to set things down. I'm not talking sterile. Just clean. For example in training I would set the bag down on the table while I prepped. In the field I fumbled with where to put it and ended up dropping it on the ground requiring It to be cleaned.. The most important thing I learned it already knew. Training MUST be realistic or you are just building bad habits..

[Patriotic Sheepdog]

....Training MUST be realistic or you are just building bad habits..

Practice makes permanence. Bad practice just reinforces bad mistakes in the future.



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