The Process of Starting an IV (intravenous)
Several skills are beneficial to the nurse and paramedic, but perhaps one of the most important skills is the ability to place an intravenous catheter into a vein. This procedure is most commonly referred to as “starting an IV”. In today’s medical community, intravenous cannulation is necessary for the administration of many antibiotics and other therapeutic drugs. Listed below are the procedures and guidelines for starting a successful IV. Following these instructions will provide a positive experience for the patient and clinician.
First, you must obtain all of the necessary supplies: gloves, alcohol or Betadine preps, a tourniquet, tape, an appropriately sized IV catheter, a bag of IV solution, the IV tubing, and gauze pads. While obtaining the supplies, you should inform the patient that IV catheter placement is necessary, and why. Do not lie to the patient and tell him or her that it is a painless procedure. Instead, be honest with them and explain that the initial puncture feels like a sharp pinch on the skin and that the pain and discomfort associated with the IV placement is only temporary. You may find it helpful to demonstrate to the patient the amount of pain to expect by pinching the skin on the back of their hand. This is especially helpful for younger patients or patients who are more concrete in their thinking.
Now, assemble and arrange all of the needed supplies so that they are easily accessible. Connect the IV tubing to the solution bag and allow the fluid in the bag to run through the entire length of the tubing, also known as priming the tubing. When this is done, clamp the tubing closed. You will then need to tear several pieces of tape, six to eight inches in length, to later secure the IV catheter and tubing to the patient’s skin. Keeping these items within close reach will help with the success of the IV catheter placement.
Before continuing any further, place protective gloves on your hands, as there will be direct contact with bodily fluids. Then, you will need to locate a suitable venipuncture site. Some common placement sites for IVs include the back of the hand, the forearm, the antecubital fossa (inside of the elbow), foot, or ankle. After choosing an appropriate site, place a tourniquet above the desired puncture area. Tie the tourniquet using a slip-knot, leaving one end of the knot exposed for rapid removal. The tourniquet slows the venous blood return and increases the vein’s size, thus increasing the ability to see and feel the vein. Now, choose a vein that is well fixed (not rolling) by palpating it with your fingers. The vein will feel spongy and spring back to the surface when you remove your finger. Be...