When to start an iv
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
