5 IV Insertion

INTRAVENOUS FLUID INSERTION

Prepare Materials to be used

Bottle or bag of IV fluid IV needle/cannula/catheter IV tubing or administration set Tourniquet Cotton balls with alcohol Tape Disposable gloves

Preparation for IV insertion

1. Check the patient identification and doctor’s orders

2. Explain in simple terms the procedure to the patient and make her comfortable

3. Organize correct and adequate lighting4. Wash hands to prevent infection or

cross-contamination5. Wear protective gloves6. Place yourself in a comfortable position;

sitting, if possible

Preparing the IV fluid administration set

1. Check the type, clarity, and expiration of fluid.

2. Close the flow regulator, remove protective covering from the spike of tubing set, and insert the spike into the port of fluid bag or bottle.

3. Place the fluid bag or bottle higher, squeeze the drip chamber to fill 1/3 of it, open the flow regulator to flush the air (and bubbles) from the rest of the tubing, and close the flow regulator.

Choosing the site of insertion

Preferred• Hand sites• Larger veins

Alternative• Forearm veins

Last resort• Leg, foot,

ankle

Dorsal metacarpal

Dorsal venous

Cephalic Basilic

Basilic

Cephalic

Median antebrachial

Choosing the site of insertion

Avoid• Areas of joint flexion• Veins close to arteries and deep lying

vessels• Small, visible but impalpable

superficial veins• Veins irritated by previous use

Use distal veins first Use vein on opposite side to the

site of intended procedure

Performing the venipuncture

Apply a tourniquet above the chosen site to create an adequate venous filling. Ask patient to make a fist to maximize vein engorgement.Palpate the vein or tap it to help it dilate.

Clean the entry site with alcohol and allow it to dry.Do not repalpate.

Insert the IV catheter into the skin at 30-45º angle with the bevel up and in the direction of the vein.

Advance the catheter to enter the vein until blood is seen in the “flash chamber” of the catheter.

Advance the plastic catheter on into the vein while leaving the needle stationary.

Apply gentle pressure over the vein just proximal to the entry site to prevent blood flow and remove the needle from the plastic catheter.

Connect the plastic catheter to the previously-prepared IV tubing set and open the flow regulator.

Tape the catheter in place and adjust the flow rate.

Complications of IV insertion

Hematoma Infiltration (pain, swelling, pallor of site, IV

flow rate decreases or stops, absence of backflow of blood into the tubing)

Thromboembolism Air embolism Phlebitis and septicemia Fluid overload

Change the site

Demonstration