Lecture Notes: Peripheral IV Insertion and Discontinuation

Introduction

• Presenter: Kimberly Trion
• Topic: Procedures for inserting and discontinuing a peripheral IV

Preparation for IV Insertion

• Hand Hygiene: Perform hand hygiene and wear gloves.
• Gather Supplies:
  • Catheter
  • IV start kit
  • Extension tubing
  • Non-expired normal saline flush
• Patient Information:
  • 75-year-old male
  • Here for fluid rehydration
  • No anticipated surgery or blood products

Insertion Procedure

1. Prepare Equipment: Flush the extension tubing to ensure no air is in the line.
2. Select Catheter Size: Using a 22-gauge catheter.
3. Tourniquet Application:
   • Place 4 to 6 inches above anticipated IV site.
   • Ensure it’s not too tight and check for a distal peripheral pulse.
4. Site Cleansing:
   • Use alcohol in circular motions from inside working outwards.
   • Allow to dry.
5. Anchor and Insert Catheter:
   • Anchor vein by pulling skin taut.
   • Insert catheter bevel up, advance until flash seen in the chamber.
   • Lower angle slightly and advance another quarter inch.
6. Catheter Placement:
   • Feed catheter off, tamper and release needle into sharps container.
   • Pop tourniquet.
7. Attach Extension Tubing:
   • Aspirate for blood then flush.
   • Check for any signs of infiltration (e.g., swelling, pain, discomfort).
8. Finish Setup:
   • Place Tegaderm to keep IV site visible.
   • Label dressing with date, time, gauge, length, and initials.
9. Post-Procedure:
   • Remove supplies, discard sharps, perform hand hygiene, document procedure.

Discontinuation Procedure

1. Verification and Preparation:
   • Verify orders are in place.
   • Perform hand hygiene and wear clean gloves.
2. Remove Dressing:
   • Remove Tegaderm while holding catheter steady.
   • Discard tape on extension tubing.
3. Withdraw Catheter:
   • Use sterile gauze, apply pressure and slowly withdraw catheter.
   • Hold pressure for at least 30 seconds until bleeding is controlled.
   • Inspect catheter for integrity and length.
   • Discard catheter in sharps container.
4. Post-Discontinuation:
   • Place new sterile gauze over site and tape it down.
   • Discard all supplies in the trash, perform hand hygiene, and document procedure.

Conclusion

• Ensuring sterility and proper documentation is crucial throughout the procedure.
• Proper disposal of sharps and maintaining cleanliness are essential for patient safety.