Lecture Notes: How to Start an IV

Introduction

• Speaker: Sam from PrepMedic
• Topic: Demonstration and explanation on starting an IV (intravenous)
• Overview: Discussion of IV supplies, procedure, and tips for effective IV insertion.

IV (Intravenous)

• Definition: A route of medication administration directly into the vein
• Advantage: Fast absorption of medication
• Common Use: Widely used in various medical scenarios

Required Supplies

• PPE (Personal Protective Equipment): Non-sterile gloves for aseptic technique
• IV Catheters:
  • Various sizes, color-coded universally in healthcare (US)
  • Sizes include 24 gauge (yellow), 22 gauge, 20 gauge (standard), 18 gauge, 16 gauge, 14 gauge
• Alcohol Prep/Chlorhexidine: For site cleaning
• IV Start Kit: Contains essentials for securing and prepping the IV
• Pigtail and Flush: Connects to IV catheter hub
• Sharps Container: For proper disposal of needles

IV Catheter Anatomy

• Consists of:
  • Needle cover
  • Flash chamber (holds blood flashback)
  • Needle and hub
  • Plastic catheter (stays in vein)
• Safety Features: Spring-loaded retractable needle to prevent needle sticks

Preparing for IV Insertion

1. Wear PPE: Protects both the caregiver and patient
2. Prepare Supplies:
   • Flush the J-loop
   • Ready the saline flush
   • Set up tape, gauze, and venous tourniquet
3. Site Selection:
   • Preferably start lower, move higher
   • AC sites for EMS, lower sites for med-surg units
   • Choose veins that are palpable and have a bounce

Procedure

1. Clean the Site:
   • Use chlorhexidine, scrub for 15 seconds from center outward
2. Catheter Preparation:
   • Hold with middle finger and thumb, guide with pointer finger
   • Insert at approximately 45 degrees (or slightly shallower)
3. Insertion and Securing:
   • Watch for flash in the flash chamber
   • Thread catheter into vein
   • Pop the tourniquet, hold tamponade
   • Connect flush, check for infiltration or patient discomfort
   • Apply Tegaderm and tape to secure

Tips and Considerations

• Direction: Always insert IV towards the heart
• Positionality: Be aware the IV might be positional (especially in joints)
• Clean Techniques: Avoid contaminating the sterile parts
• Removal: Use gauze over the site, secure with tape

Conclusion

• IV Starting Tips:
  • Proper preparation is key to success
  • Use tactile feedback to choose veins
  • Ensure all tools and supplies are prepped and ready
• Why Important: IVs are crucial for effective medication administration in emergency and clinical settings.