Essential Guide to IV Insertion Techniques

Aug 16, 2024

Notes on IV Insertion Techniques

Overview

  • Aim to become proficient in IVs.
  • Focus on five common mistakes that lead to missed IVs and how to correct them.

1. Targeting the Vein

  • Importance of making the vein visible:
    • Increase the size of the vein for better chances of success.
  • Steps to enhance vein visibility:
    • Use gravity by letting the hand hang down.
    • Apply a tourniquet to engorge the vein.
    • Shake the hand and perform gentle flicks with the finger.
    • Ask the patient to squeeze their hand several times.
    • Relax and rub the hand to enhance visibility.

2. Needle Insertion Angle

  • Maintain parallelism:
    • Avoid inserting at an angle to prevent blowing the vein.
    • Keep the needle parallel throughout the insertion process.

3. Skin Traction

  • Significance of skin traction:
    • Prevents vein rolling, which can lead to a blown vein.
  • How to hold skin traction:
    • Traction should be strong enough that the skin does not move.
    • Use your thumb behind the knuckle for good traction.
    • Counter traction may be required in different directions for stability.

4. Correct Catheter Hold

  • Proper grip on the catheter:
    • Hold using your thumb and middle finger to maintain visibility of the flash chamber.
    • This facilitates easy advancement of the catheter over the needle.

5. Advancing the Needle

  • Advancement after flash:
    • Recognize that seeing a flash of blood indicates the needle is in the vein, but the catheter is not.
    • Advance the needle further to ensure the catheter is also in the vein.
    • The distance to advance depends on the gauge of the needle used.

Practical Demonstration

  • Step-by-step demonstration of IV insertions:
    • Use lidocaine for numbing before insertion.
    • Ensure good skin traction and maintain a parallel needle angle.
    • Watch the flash chamber during insertion for blood return.
    • Advance both the needle and catheter as needed, ensuring no rolling of the vein occurs.

Final Tips

  • Troubleshooting stuck catheters:
    • If the catheter gets stuck during advancement, pull the needle back slightly to ease the catheter's movement.

Conclusion

  • By following these five steps, one can significantly improve their skills in IV insertion and become proficient in this essential medical procedure.