1) The first step in the process is to find a good vein to insert the IV. The large vein located in the bend of the elbow is most often used, but nurses can also find good vein sites on the forearm, feet, scalp, hand, and wrist if necessary.
2) Have a fellow nurse prepare the tubing and the fluid bag while the nurse that will insert the IV prepares the sight.
3) The nurse should now apply a tourniquet just a few inches above the site, securing it for easy removal after inserting the catheter.
4) Make sure that the vein is secure and wipe the area with an alcohol pad.
5) Now is the time to choose a catheter size. Children and the elderly generally use a smaller catheter, but an 18 gauge should work for most patients. Nurses should use larger gauges in emergency situations.
6) Carefully remove the cap on the catheter with one hand, and tightly pull the skin around the IV site with the free hand. Keep the catheter as parallel to the skin as possible and insert the needle. A hint of blood in the catheter’s applicator will indicate that the nurse hit the vein directly, and he or she should continue to advance the catheter.
7) While still advancing the catheter, the nurse should now remove the catheter according to the manufacturer’s instructions. Do not forget to secure the needle for the safety of everyone involved.
8) Remove the tourniquet to prevent discomfort and tissue death.
9) Using the fingers, apply pressure to the vein just above the catheter so that back bleeding does not occur.
10) The nurse should now apply tape to the area around the catheter while attaching the IV tubing.
11) Open the IV line and fluid should be dripping into the chamber if the process was successful. Look for leaking and swelling at the IV site. If this occurs, the process was unsuccessful.
12) Additional secure the IV line with additional tape. Nurses should adjust the drip rate accordingly for the patient.
Tips on Starting an IV- Choose a catheter that is a 14 or 18 gauge when quick fluid replacement is needed. It may not be necessary to use a tourniquet when the patient has large veins.
- Applying pressure to a vein can help straighten veins that do not look straight enough to inject.
- Always become familiar with the IV catheter brands used before administering IVs.
- Immediately stop advancing a catheter that hangs up on a valve.
- Immediately place the needle used into a sharps container in order to prevent needle sticks
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