start

Starting an IV - for Nurses

hey everybody this is Aaron Reed with

nurse mastery comm and today I'm going

to show you how to start an intravenous

angio catheter if you're anything like

me you get a little bit nervous during

this process so I wore my sweat bands so

that I can perspire and get down to

business so we're going to talk about

the supplies involved preparing your

patient we're going to show you the

actual procedure and then how to clean

up when you're all done and comfort your

patient all right so what we're going to

do now is look at our supplies thanks

identify the patient ask the patient to

state their name and date of birth

explain the procedure tell the patient

that there is an order from your

physician to start an IV ask the patient

do you know what an IV is explain to the

patient that a catheter will be inserted

into your vein to give you medications

this will avoid having to stick you

repeatedly with needles later on when

medications are needed for various

reasons ask the patient do you have any

allergies to medications fluids tapes or

cleansers gather appropriate equipment

you will need gloves and angio catheter

a tourniquet a Tegaderm an IV extension

set also known as a saline lock alcohol

or antiseptic cleanser at NCC normal

saline flush an IV label a TV syringe

and lidocaine keep in mind that the IV

start kit may contain a bundle of

supplies including the Tegaderm

tourniquet tape label and gauze perform

hand hygiene and observe any specific

infection control precautions prepare

equipment unwrap the angio catheter and

test the independent movement of the

plastic catheter away from the needle by

disengaging and sliding it away from the

base before returning it to its original

position open the IV start kit prepare

the tape used to secure the IV by

splitting it and placing it within reach

squeeze and fracture the dividing

chamber of the topical anesthetic

tincture which saturates the sponge at

the end of the unit unwrap and place the

tourniquet within reach expose the

Tegaderm and place it within reach as

well set aside the IV label expel the

small amount of air from the normal

saline syringe and instill normal saline

into the saline lock leave the syringe

attached

withdrawal 0.5 ccs of lidocaine into a

TB syringe and set it aside for later

use

prepare the patient provide privacy for

the patient by closing the door or

pulling the curtain assist the patient

to a comfortable position with their arm

at a dependent angle below the level of

the heart place the towel or chucks

underneath the extremity to protect the

linens from blood dilate the vein with a

tourniquet by placing it six to eight

inches above the anticipated

venipuncture site explain to the patient

that the tourniquet may feel tight

encourage the patient to clinch and

unclench their fist to further dilate

the vein which helps with visualization

lightly tap the vein with your

fingertips if necessary use the

patient's non-dominant hand if possible

look for veins that are relatively

straight and remove the tourniquet clean

and begin venipuncture approach perform

hand hygiene and apply gloves reapply

the tourniquet six to eight inches above

the anticipated venipuncture site clean

at the site of the venipuncture

insertion with topical antiseptic using

circular motions moving from the center

outward for several inches allow the

solution to dry on the skin insert the

lidocaine anesthetic intradermally with

the needle angle parallel to the skin

inject 0.2 to 0.5 ccs to lessen pain

during IV insertion use the non-dominant

hand to pull the skin taut below the

entry site hold the angio catheter at a

10 to 15 degree angle with the needle

bevel facing up insert the needle stylet

and catheter through the skin and into

the vein once blood flow is seen lower

the assembly angle advance it slightly

to ensure that both the needle stylet

and catheter are in the vein and then

stop advance only the over the needle

catheter with the index finger until the

hub is at the venipuncture site and in

contact with the patient's skin release

the tourniquet carefully remove the

needle stylet and engage the needle

safety device while holding pressure on

the vein with your non-dominant thumb

two to three inches proximal to the

insertion site to prevent blood backflow

secure intravenous equipment attach the

saline lock to the hub of the catheter

and release thumb pressure flush the

catheter with normal saline to ensure

position patency and flow remove the

normal saline flush syringe

take the catheter with tape strips which

forms a loop that travels underneath the

hub and over the wingtip flanges on

either side of the hub also place a

strip of tape across the hub apply a

Tegaderm over the top of the insertion

site loop the saline lock tubing and

secure it with tape remember to label

the date time of insertion type and

gauge of catheter and nurses initials

clamp the saline lock tubing discard the

tourniquet and any sharps remove and

discard the gloves perform hand hygiene

and you're done hello