hey everyone it's sarah with registerednessrn.com and in this video i'm going to demonstrate how to start a peripheral iv before performing any nursing skills you want to make sure that you're following your hospital's protocols to ensure you're following the latest guidelines before inserting the iv first what you want to do is you want to gather your supplies and perform hand hygiene then after that you want to prepare your supplies and find a vein that you want to use on your patient to actually insert the iv in once you have done that you'll perform hand hygiene don gloves and then prepare for insertion so here we have actually trimmed the patient's hair and sometimes you have to do this because what will happen is whenever you go to secure it the tape will not stick to the patient it'll roll off over time and then plus whenever you go to remove the ivy it'll be very painful to that person who has a lot of hair so we have used trimmers that have just trimmed it you don't ever want to use like a straight razor so use whatever trimming supplies that your facility has so now i'm ready to insert the iv and i've applied the tourniquet so the vein that we're going to go in is in the hand we're going to go right there so before we even stick the vein we first have to disinfect the site and we're going to use the kits chloraprep that it comes with and depending on what type of kit you have will depend on what it looks like so with this particular one we're going to take this and just push it together and you'll hear that cracking noise that's just releasing all the core prep what i'm going to do is i'm going to start in the center and i'm going to work my way outward we're going to clean the site for about 30 seconds and then we're going to let it completely dry so in the center and i'm cleaning we're going to clean for 30 seconds now the site has completely dried so i'm ready to stick the vein so what i'm going to do first is i want to stabilize this vein i don't want it to roll away on me so i'm going to go below the area where i cleaned and i'm just going to pull on the skin which will help stabilize the vein then i'm going to hold my iv i'm holding it with my thumb and index finger at that area and i'm going to hold it bevel up and i'm going to go in at give or take about a 20 degree angle and i'm going in the way that the vein is naturally made because we just want this plastic cannula to slide in there okay so here we go you're going to feel a sharp stick okay okay i have blood return and you can see that in the chamber right there now remember i want to go just a hair bit more okay i'm there so now what i'm going to do is i'm going to thread this off it's in there so now after that i want to pop the tourniquet and i'm going to take my finger and i want to apply firm pressure because i don't want to leak out then i'm going to hit the safety button and it's going to remove the needle and then i'm going to connect the access device so i'm going to connect this and then twist this on make sure that is nice and secure when you do this because you don't want it to get loose so first i'm going to check for blood return and we have it then i'm going to flush the ivy i'm going to flush using a push pause flush i'm going to flush in about three to five cc so i'm gonna do one to two cc's pause flush again one to two and i'm looking at the site it's not bubbling up which would mean infiltration and how does the site feel to you feels fine it doesn't hurt okay and it looks great and because we're using a neutral displacement cap there's no sequence required so i'm just going to clamp it off and then i'm just going to undo this but let's say that this is a positive pressure cap well with this it would change my sequence with how i would clamp like for instance i would flush and then i would disconnect from this cap with my flush and then i would clamp you can also have negative pressure and with those what you would do is flush then you would clamp and then disconnect so just be familiar with the type of device you're using and we're going to secure with our dressing i'm just going to lay that there and i'm going to go ahead and apply my keuros cap just to protect the site there we go so now we're going to secure it i'm going to with this particular dressing you want to get familiar with your kits what's in your kits because everything's different i'm going to take this part off like so and i'm going to hold it at this end and has a notched area so i want this part to lay on the top of the cap where before it goes in to the access the extension set so i'm just going to lay it there i'm going to apply some firm pressure just to get it down on the skin okay so i'm securing that down by touching it then what i want to do is i want to slightly compress these sides and i'm going to just lift this tubing up just a little bit because i want those notch parts to get underneath that part of the ivy so i'm pressing everything down making sure it's nice and secure then what i'm going to do is i'm going to tear off these edges around the abbey this part right here little edges and then as you're doing that just push it down make sure it sticks to the skin because you don't want to lose your ivy after you have started it then what i'm going to do is i'm going to take this part of the tape this big piece and i'm going to lay it across this part so it just provides extra securement so we have that there i'm applying pressure like that i'm just sealing it down nice and sealed then with this particular extension tubing remember the letter j okay because that's how you want to secure it down we don't want this flopping everywhere that's going to put tension on the ivy line causing possibly the iv to slip out and we want to protect it and then there's this other piece of tape that you will use to secure the tail of the iv so i've already went ahead and filled it out i've put the insertion date here put whatever date your facility requires you to put so i'm going to peel that off and i'm going to put this up again in the j shape and i'm going to lay that there and i'm going to just take this piece of tape and just slide it on this part and then be sure you smooth the edges down so that it sticks and that will just help protect that site from falling out and just keep it more secure then dispose of this in the receptacle area that your facility requires you to dispose these types of things in remove our gloves perform hand hygiene and document okay so that wraps up this video and if you would like to watch more videos on nursing skills you can access the link in the youtube description below