Apex Nursing Service

A cannula is a thin, flexible plastic tube inserted into a blood vessel to allow access to the bloodstream. It is commonly used to give IV fluids, medications, blood transfusions, contrast for scans, and for monitoring in emergency or critical care settings.

Basic insertion steps include hand hygiene, vein selection, cannula insertion, and securing the line properly.

Possible complications include phlebitis, infiltration, infection, and air embolism highlighting the importance of proper technique and monitoring.

🩺 This content is for educational and awareness purposes only and does not replace professional training or clinical guidelines.

🚨 CHOKING MANAGEMENT | PENGURUSAN TERCEKIK🚨

🟢 Prinsip Umum
▪ Choking berlaku akibat
Foreign Body Airway Obstruction (FBAO)
▪ Pengurusan bergantung kepada umur mangsa
▪ Heimlich maneuver TIDAK digunakan pada infants
▪ Nilai sama ada mangsa masih sedar & boleh batuk

👶 INFANTS (Bawah 1 Tahun)
❌ Tiada abdominal thrusts
❌ Tiada Heimlich maneuver
❌ Tiada blind finger sweep

✅ Pengurusan Betul
▪ Posisi prone, kepala lebih rendah
▪ Sokong kepala & leher

👉 5 Back Blows
▪ Antara shoulder blades
▪ Guna heel of hand

👉 5 Chest Thrusts
▪ Posisi supine
▪ 2 jari di lower half of sternum (~4 cm)
🔁 Ulang sehingga objek keluar atau infant menjadi unresponsive

🧒🧑 KANAK-KANAK & DEWASA (≥1 Tahun)
Gunakan Heimlich Maneuver jika:
▪ Tidak boleh bercakap
▪ Tidak boleh batuk
▪ Tanda severe airway obstruction

👉 Thrust pantas ke dalam & ke atas
🔁 Ulang sehingga objek keluar / mangsa unresponsive

🤰 Hamil / Obese
▪ Abdominal thrusts contraindicated
▪ Gunakan chest thrusts (lower half sternum)

🚑 Jika Mangsa Unresponsive
▪ Hubungi bantuan kecemasan
▪ Mulakan CPR
▪ Keluarkan objek jika kelihatan sahaja

⚠️ Ingat!
✔ Jangan Heimlich pada infants
✔ Jangan blind finger sweep
✔ Teknik betul ikut umur = selamat
✔ Tindakan awal boleh selamatkan nyawa

❇️ How the Heart Works – Blood Flow Explained

1. Deoxygenated Blood (Right Side of Heart)

→ Deoxygenated blood returns from the body via Superior & Inferior Vena Cava
→ Blood enters the Right Atrium
→ Flows through the Tricuspid Valve
→ Reaches the Right Ventricle
→ Right ventricle pumps blood into the Pulmonary Artery
→ Pulmonary artery carries deoxygenated blood to the lungs

2. Gas Exchange in the Lungs

→ Blood releases carbon dioxide (CO₂)
→ Blood absorbs oxygen (O₂)
→ Blood becomes oxygenated

3. Oxygenated Blood (Left Side of Heart)

→ Oxygenated blood returns via Pulmonary Veins
→ Enters the Left Atrium
→ Passes through the Mitral (Bicuspid) Valve
→ Moves into the Left Ventricle
→ Left ventricle pumps blood into the Aorta
→ Aorta distributes oxygenated blood to the entire body

4. Functional Circulation

→ Right heart → Pulmonary circulation (heart → lungs)
→ Left heart → Systemic circulation (heart → body)
→ Left ventricle has thicker walls due to higher pumping pressure
→ Valves maintain one-way blood flow and prevent backflow

💉 IV Therapy Complications – Quick Guide for Nurses

🩸 Hematoma

What is it?
Blood collects under the skin after vein injury.

Symptoms:

Bruising (ecchymosis)
Painful, firm lump at the site

What to do:

Elevate the affected area

Apply gentle pressure and cold compress

💨 Air Embolism

What is it?
Air bubbles enter the bloodstream through the IV line.

Symptoms:

Rapid heartbeat (tachycardia)
Chest pain
Low blood pressure
Confusion, fainting
Bluish skin (cyanosis)

What to do:

1. Clamp the IV immediately
2. Position patient on left side with head down (Trendelenburg)
3. Noted Dr stat

💧 Infiltration

What is it?
IV fluid leaks into surrounding tissue.

Symptoms:

Swelling, pain, cool or pale skin
No blood return in the line

What to do:

Remove the IV

Elevate the limb
Apply warm or cold compress

Do not massage

🦠 Infection

What is it?
Bacteria enter through the IV insertion site.

Symptoms:

Redness, swelling, or warmth
Fever, chills
Rapid heartbeat
Nausea or vomiting

What to do:

Remove the IV

Collect culture sample

Start antibiotics as prescribed

💧💨 Circulatory Overload

What is it?
Excess IV fluid causes volume overload.

Symptoms:

High blood pressure
Distended neck veins
Difficulty breathing
Wet cough or crackles

What to do:

Slow down IV infusion
Raise the head of the bed
Keep patient warm
Inform the doctor

🔥 Phlebitis

What is it?
Inflammation of the vein, may cause clot formation.

Symptoms:

Redness, heat, and tenderness
Sluggish IV flow

What to do:

Remove the IV line
Inform the doctor
Reinsert IV at a new site

💡 Nursing Tip: Always monitor IV sites regularly for early signs of complications and document your findings accurately.

EDUCATIONAL PURPOSE

🩺 Nursing Math Made Easy

1. IV Flow Rates

Two common units:

mL/hr – for infusion pumps

gtt/min – when using manual IV sets (with drop factor)

Formula:

IV Rate (gtt/min)
=
Volume (mL)
×
Drop Factor (gtt/mL)
Time (min)
IV Rate (gtt/min)=
Time (min)
Volume (mL)×Drop Factor (gtt/mL)
​
Rounding rule: Round to the nearest whole number for gtt/min; for mL/hr, round to one decimal if needed.

2. Medication Dosage Calculations

Core formula:

(D ÷ H) × V = A
(D ÷ H) × V = A

D = Doctor’s order (desired dose)

H = What you have (dose on hand)

V = Volume or tablet that contains the available dose

A = Amount to administer

Always check units, patient safety limits, and rounding (to 1 or 2 decimal places) depending on medication type.

3. Unit Conversions (Quick Reference)

Conversion Formula / Tip
Weight 1 kg = 2.2 lbs
Volume 1 tsp = 5 mL, 1 tbsp = 15 mL, 1 oz = 30 mL
Metric Tips Move the decimal point:
• 1 g = 1000 mg → move 3 places right
• 1 mg = 0.001 g → move 3 places left

💡 Nurse’s Tip:
Always double-check your math, confirm the medication label, and use a calculator or second nurse verification for high-risk drugs (e.g., insulin, heparin).