September 29, 2024
:IV cannula (size appropriate for the patient, typically 18-24 gauge)
Tourniquet
Alcohol swab or antiseptic solution (chlorhexidine or iodine).
Sterile gloves
Adhesive dressing or IV securing device
Saline flush (optional, to check for patency)
Tape
Sharps disposal container
IV extension set or tubing (if connecting to an infusion)
2. Explain the Procedure to the Patient
Reassure the patient, explaining the need for the IV and the steps involved.Position the patient comfortably and ensure good lighting at the site.
3. Select the Insertion Site Choose a vein:
Preferred sites include the dorsal veins of the hand or the cephalic, basilic, or median cubital veins in the forearm.
Avoid areas of flexion (such as the wrist) and any veins that feel hard, scarred, or inflamed.
4. Apply a Tourniquet Apply the tourniquet above the chosen site to distend the veins.
* Ensure the tourniquet is not too tight, which may cause discomfort or restrict arterial flow.
* Instruct the patient to clench their fist to help distend the vein further.
5. Clean the Site Using an alcohol swab or antiseptic solution, clean the insertion site in a circular motion from the center outwards.
Allow the site to dry for at least 30 seconds to ensure the skin is disinfected.
6. Insert the Cannula Don sterile gloves.
Stabilize the vein by applying gentle traction on the skin below the puncture site.
Hold the cannula bevel side up at a 15-30 degree angle to the skin.Insert the needle into the vein.
Once you see a flashback of blood in the cannula hub, lower the angle and advance the cannula a few millimeters further into the vein.
7. Advance the Cannula While holding the needle steady, advance the plastic catheter off the needle and into the vein.
Once the catheter is fully inserted, remove the needle and engage the needle safety device if present.
8. Release the Tourniquet Immediately release the tourniquet to restore blood flow.
9. Secure the Cannula Attach the extension set or IV tubing to the cannula hub.
* Secure the cannula in place using adhesive dressing or a specialized securing device.
* Tape the IV tubing to the patient’s arm to reduce the risk of accidental dislodgement.
10. Flush the Cannula If required, flush the cannula with a saline syringe to confirm patency (flow) and ensure there is no resistance or swelling.
11. Dispose of Equipment Safely dispose of the used needle in a sharps container.
* Ensure that all used materials, including swabs and gloves, are discarded appropriately.
12. Monitor the Site Regularly inspect the IV site for signs of infection (redness, swelling, or heat), infiltration, or phlebitis (vein inflammation).
* Common Tips for Success:
Stay calm:
Practice good communication with the patient to reduce their anxiety, which may help prevent vasoconstriction.
Warm the site:
If veins are difficult to locate, a warm compress can help dilate the veins.
Choose the right size:
The gauge of the cannula should be appropriate for the treatment.
Smaller gauges (22-24) are ideal for elderly patients or children, while larger gauges (18-20) are used for rapid infusions.
Complications to Watch For:
Infiltration:
Fluid entering the surrounding tissue instead of the vein.
Phlebitis:
Inflammation of the vein, causing pain and swelling.
Air embolism:
Rare, but can occur if air enters the vein during insertion or flushing.
Infection:
Ensure proper aseptic technique to avoid introducing bacteria.
