Lecture Notes: How to Start a Peripheral IV

Introduction

• Presenter: Sarah from RegisteredNurseRN.com
• Topic: Demonstration on starting a peripheral IV.
• Initial Step: Follow hospital protocols to ensure adherence to the latest guidelines.

Preparation

• Gather Supplies: Ensure all necessary items are on hand.
• Hand Hygiene: Perform before beginning any procedure.
• Vein Selection: Choose an appropriate vein for IV insertion.

Pre-Insertion Steps

1. Hand Hygiene and Don Gloves: Reaffirm cleanliness before proceeding.
2. Trim Patient's Hair:
   • Necessary for secure tape application.
   • Use trimmers, not razors, to prevent pain and improve adhesion.

Insertion Process

• Apply Tourniquet: Identify the vein.
• Disinfect Site:
  • Use chloraprep kit.
  • Press and release chloraprep to activate.
  • Clean site starting from the center and move outward for 30 seconds.
  • Allow site to dry completely.

IV Insertion

• Stabilize Vein: Prevent vein from rolling by pulling on the skin below the cleaned area.
• Insert IV:
  • Hold at a 20-degree angle, bevel up.
  • Insert following the natural vein direction.
• Confirm Blood Return: Ensure successful insertion.
• Thread Cannula: Finalize placement.

Post-Insertion Steps

1. Release Tourniquet: Prevent further blood flow restriction.
2. Apply Firm Pressure: Minimize leakage.
3. Needle Safety: Use safety button for needle removal.
4. Connect Access Device: Ensure secure attachment.
5. Check Blood Return and Flush IV:
   • Use a push-pause technique with 3-5 cc flush.
   • Monitor site for signs of infiltration.

Cap Types and Procedure

• Neutral Displacement Cap:
  • No sequence required for clamping.
• Positive Pressure Cap:
  • Flush, disconnect, then clamp.
• Negative Pressure Cap:
  • Flush, clamp, then disconnect.

Securing the IV

• Apply Dressing: Familiarize with kit components and secure dressing firmly.
• Secure Tubing:
  • Follow 'J' shape to prevent tension.
  • Use additional tape to secure.

Final Steps

• Dispose of Waste: Follow facility protocols for disposal.
• Remove Gloves and Hand Hygiene: Maintain hygiene post-procedure.
• Documentation: Record insertion date and other required information.

Conclusion

• Access More Resources: Additional videos on nursing skills available via a link in the description.

Note: These notes capture the essential steps and tips for starting a peripheral IV as demonstrated in the video by Sarah.