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Essential Guide to IV Insertion Techniques
Aug 16, 2024
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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.
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