Initiating Peripheral IV Access

Equipment and Supplies:

• exam gloves

• IV insertion kit

• IV extension tubing

• 2m: 0.9% normal saline (NS) syringe flush

• IV catheter (select appropriate size)

• gauzes

Procedure:

• verify health care provider order

• verify purpose for IV access

• assess for allergies (including latex)

• gather supplies

• perform hand hygiene

Patient Bedside:

• verify patient ID (name and DOB)

• assess for allergies

• introduce self and explain procedure to patient

• perform hand hygiene

• proper mechanical (adjust bed to comfortable working position)

• place patient in comfortable position

• position patient’s arm for IV insertion (may use pillow or towel)

• open IV kit using sterile technique

• prime IV extension tubing with NS, leave syringe attached

Assess for IV Access:

• apply a tourniquet

• select appropriate IV site (hand, forearm)

• select appropriate vein (based on purpose, catheter size, bouncy vein)

Cleanse IV Site:

• clean site with antiseptic or chlorhexidine gluconate (CHG) wipes

• clean inner to outer 2 inches or for CHG wipes uses based weave, back and forth and up and down scrubbing motion

• allow to dry

IV Insertion:

• don gloves

• use non-dominant hand to hold the skin taut about 1-2 inches from IV insertion site to anchor vein in place

• carefully remove protective cap from the IV catheter device

• align IV catheter with the vein, bevel up on the needle

• at a 10-30 degree angle to the vein gently puncture the skin (instruct patient before puncturing the vein)

• observe for blood in the flashback chamber

• continue to slowly advance the needle ¼ inch into the vein

• advance the IV catheter, not the needle into the vein using the non-dominant hand

• apply pressure above the IV insertion (about 1-1.5 inches) before activating the safety device to remove the needle

• release tourniquet

• attach extension tubing to catheter hub

• apply transparent dressing over the IV insertion site

• pull back on the NS flush syringe

• observe for blood return

• flush the site with the NS; observe for leakage or infiltration

• remove syringe and close extension tubing clamp

• secure IV extension tubing to patient’s arm with tape

• label IV site: date, time, needle gauge, length and your initials

• dispose of the needle in a sharps container

• dispose of IV supplies in trash receptacle

• remove gloves, perform hand hygiene

• document