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Anästhesiol Intensivmed Notfallmed Schmerzther 2013; 48(4): 258-263
DOI: 10.1055/s-0033-1343761
Fachwissen
Topthema: Kinderanästhesie
© Georg Thieme Verlag Stuttgart · New York

Kinderanästhesie – Der schwierige Venenzugang

The difficult venous access
Jochen M Strauß
,
Andrea Denk
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Publikationsverlauf

Publikationsdatum:
30. April 2013 (online)

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Zusammenfassung

Venenpunktionen bei Kindern sind schwierig. Manche Faktoren sind kaum beeinflussbar, beispielsweise ein gut entwickeltes Unterhautfettgewebe. Technische Hilfsmittel helfen bei der Identifikation unsichtbarer Venen. Mit Hilfe des Ultraschalls können tieferliegende periphere Venen an Hand- und Fußgelenk dargestellt und punktiert werden. Heftige Gegenwehr eines Kindes vereitelt jeden Punktionserfolg. Kinder sollten deshalb ausreichend sediert werden, wenn nicht auf eine Maskeneinleitung ausgewichen werden kann. Fehlender Übung der Venenpunktion sowie unzureichender Kenntnis geeigneter Punktionsorte kann durch Üben und Lesen leicht begegnet werden. Die Möglichkeit zur intraossären Punktion gehört heute zum Standard der anästhesiologischen Versorgung von Kindern. Mit ihr kann innerhalb weniger Sekunden ein sicherer Zugang geschaffen werden.

Abstract

Venipuncturein childrenare difficult.Somefactorscan hardly be influenced, for example,a well-developedsubcutaneous fat tissue. Technical devices may help to identifyinvisibleveins. With the helpof ultrasounddeepperipheral veinson the wrists andanklescan be presentedand punctured.Stiff resistanceof a childthwartsanysuccessful puncture. Childrenshould therefore beadequatelysedated, ifcan not beinduced bymask.Missingpracticevenipunctureand inadequateknowledge of appropriatepuncturesitescan be meteasilyby practicingand reading.The possibility ofintraosseouspuncturetoday is standardofanesthesiacare for children. Within in a few seconds, a secure accessto the vein system can be created.

Schlüsselwörter:

Venenpunktion - venöser Zugang - intraossär - schwieriger Venenzugang

Key words:

vein puncture - venipuncture - venous access - intraosseous - difficult venous access

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  • Literatur
 

  • Literatur

  • 1 Orlowski JP. My kingdom for an intravenous line. Am J Dis Child 1984; 138: 803-803
    PubMedGoogle Scholar
  • 2 Stovroff M, Teague WG. Intravenous access in infants and children. PediatrClin North Am 1998; 45: 1373-1393
    PubMedGoogle Scholar
  • 3 Sperb P. Das Schädel-Hirn-Trauma bei Kindern. Retrospektive Auswertung der DIVI-Notarztprotokolle aus Bayern. Dissertation von Pia Sperb (2006) Universität Würzburg
    PubMedGoogle Scholar
  • 4 Bagnasco A, Pezzi E, Rosa F et al. Distraction techniques in children during venipuncture: an Italian experience. J Prev Med Hyg 2012; 53: 44-48
    PubMedGoogle Scholar
  • 5 Wang ZX, Sun LH, Chen AP. The efficacy of non-pharmacological methods of pain management in school-age children receiving venepuncture in a paediatric department: a randomized controlled trial of audiovisual distraction and routine psychological intervention. Swiss Med Wkly 2008; 138: 579-584
    PubMedGoogle Scholar
  • 6 Hughes T. Providing information to children before and during venepuncture. Nurs Child Young People 2012; 24: 23-28
    PubMedGoogle Scholar
  • 7 Kolk AM, van Hoof R, FiedeldijDop MJ. Preparing children for venepuncture. The effect of an integrated intervention on distress before and during venepuncture. Child Care Health Dev 2000; 26: 251-260
    CrossrefPubMedGoogle Scholar
  • 8 Liam Mahoney, Susan Ayers, Paul Seddon. The association between parent's and healthcare professional's behavior and children's coping and distress during venepuncture. JPediatrPsychol 2010; 35: 985-995
    PubMedGoogle Scholar
  • 9 Abad F, Díaz-Gómez NM, Domenech E et al. Oral sucrose compares favourably with lidocaine-prilocaine cream for pain relief during venepuncture in neonates. ActaPaediatr 2001; 90: 160-165
    PubMedGoogle Scholar
  • 10 Arts SE, Abu-Saad HH, Champion GD et al. Age-related response to lidocaine-prilocaine (EMLA) emulsion and effect of music distraction on the pain of intravenous cannulation. Pediatrics 1994; 93: 797-801
    PubMedGoogle Scholar
  • 11 Lal MK, McClelland J, Phillips J et al. Comparison of EMLA cream versus placebo in children receiving distraction therapy for venepuncture. ActaPaediatr 2001; 90: 154-159
    PubMedGoogle Scholar
  • 12 Lurngnateetape A, Tritrakarn T. Placebo effect of eutectic mixture of lidocaine and prilocaine (EMLA) cream in reducing venepuncture pain in children. Ann Acad Med Singapore 1994; 23: 465-469
    PubMedGoogle Scholar
  • 13 Tak JH, van Bon WH. Pain- and distress-reducing interventions for venepuncture in children. Child Care Health Dev 2006; 32: 257-268
    CrossrefPubMedGoogle Scholar
  • 14 Chapman LL, Sullivan B, Pacheco AL et al. VeinViewer-assisted Intravenous catheter placement in a pediatric emergency department. AcadEmerg Med 2011; 18: 966-971
    PubMedGoogle Scholar
  • 15 Kim MJ, Park JM, Rhee N et al. Efficacy of VeinViewer in pediatric peripheral intravenous access: a randomized controlled trial. Eur J Pediatr 2012; 171: 1121-1125
    CrossrefPubMedGoogle Scholar
  • 16 Perry AM, Caviness AC, Hsu DC. Efficacy of a near-infrared light device in pediatric intravenous cannulation: a randomized controlled trial. PediatrEmerg Care 2011; 27: 5-10
    PubMedGoogle Scholar
  • 17 Panebianco NL, Fredette JM, Szyld D et al. What you see (sonographically) is what you get: vein and patient characteristics associated with successful ultrasound-guided peripheral intravenous placement in patients with difficult access. AcadEmerg Med 2009; 16: 1298-1303
    PubMedGoogle Scholar
  • 18 Riera A, Langhan M, Northrup V et al. Remember the saphenous: ultrasound evaluation and intravenous site selection of peripheral veins in young children. PediatrEmerg Care 2011; 27: 1121-1125
    PubMedGoogle Scholar
  • 19 Witting MD, Schenkel SM, Lawner BJ, Euerle BD. Effects of vein width and depth on ultrasound-guided peripheral intravenous success rates. J Emerg Med 2010; 39: 70-75
    CrossrefPubMedGoogle Scholar
  • 20 Simhi E, Kachko L, Bruckheimer E, Katz J. A vein entry indicator device for facilitating peripheral intravenous cannulation in children: a prospective, randomized, controlled trial. AnesthAnalg 2008; 107: 1531-1535
    PubMedGoogle Scholar
  • 21 Cuper NJ, Klaessens JH, Jaspers JE et al. The use of near-infrared light for safe and effective visualization of subsurface blood vessels to facilitate blood withdrawal in children. Med EngPhys [Epub ahead of print] 26.07.2012; 107
    PubMedGoogle Scholar
  • 22 Cuper NJ, de Graaff JC, Verdaasdonk RM, Kalkman CJ. Near-infrared imaging in intravenous cannulation in children: a cluster randomized clinical trial. Pediatrics 2013; 131: 191-197
    CrossrefPubMedGoogle Scholar
  • 23 Larsen P, Eldridge D, Brinkley J et al. Pediatric peripheral intravenous access: does nursing experience and competence really make a difference?. J InfusNurs 2010; 33: 226-235
    PubMedGoogle Scholar
  • 24 Kitamura N, Kaneko K. Effective and efficient method of painless venepuncture in children. RinshoByori 2007; 55: 257-261
    PubMedGoogle Scholar
  • 25 Eich C, Weiss M, Neuhaus D et al. Handlungsempfehlung zur intraossären Infusion in der Kinderanästhesie. Anästh Intensivmed 2011; 52: 46-52
    PubMedGoogle Scholar
  • 26 Heyder-Musolf J, Giest J, Strauß J. Kasuistik –Intraossärer Zugang bei einem 1300g schweren septischen Neugeborenen. Anästhesiol Intensivmed Notfallmed Schmerztherapie 2011; 46: 654-647
    PubMedGoogle Scholar
  • 27 Neuhaus D, Weiss M, Engelhardt T et al. Semi-elective intraosseous infusion after failed intravenous access in pediatric anesthesia. Paediatric anaesthesia 2010; 20: 168-171
    PubMedGoogle Scholar
  • 28 Aliman AC, Piccioni MDA, Piccioni JL et al. Intraosseous anesthesia in hemodynamic studies in children with cardiopathy. Revistabrasileira de anestesiologia 2001; 61: 41-49
    PubMedGoogle Scholar
  • 29 Neuhaus D, Henze G, Frotzler A, Weiss M. Stellenwert der intraossären Infusion in der Kinderanästhesie – Eine internet-basierte Umfrage. Anästh Intensivmed 2010; 51: 20-29
    PubMedGoogle Scholar