Kinderanästhesie – Der schwierige Venenzugang

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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