Introduction

• Video tutorial: Comprehensive guide on starting an IV (intravenous catheter).

• Patient in the video: Name: Zach. Demonstrates the procedure in a clinical setting.

• Purpose of the IV: To provide medications, conduct blood work, or administer fluids, ensuring patient hydration and treatment.

Initial Steps

• Introduce yourself to the patient: Engage with Zach to build rapport, ensuring he feels comfortable and knows who will be conducting the procedure.

• Explain the procedure and its purpose: Clearly articulate the importance of starting an IV, what medications or fluids will be delivered, and the expected benefits.

• Gather essential materials necessary for starting an IV:

  • Gloves: Ensure hand hygiene and protection.

  • Gauze: To maintain sterility and apply pressure post-insertion.

  • Sterile saline: For flushing the IV line and maintaining patency.

  • IV catheter: Choose an appropriate size (e.g., 18G, 20G, 22G) based on patient’s veins and type of infusion.

  • IV start kit: Contains tape, tourniquet, alcohol prep pads, and Tegaderm for securing the IV line.

Preparing for the IV

• Ensure patient is in a comfortable position: Adjust the examination table/lit and support Zach's arm to promote vein prominence.

• Apply the tourniquet:

  • Position 3-4 inches above the intended insertion site.

  • Ensure it's snug but not excessively tight to prevent discomfort or pain.

  • Highlight quick-release capability for removal after accessing the vein.

Setting Up

• Put on gloves: Ensure proper fit and hygienic practices.

• Prepare tape and large 4x4 gauze for easy access during the procedure.

Finding the Vein

• Look at the antecubital area for a suitable vein:

  • This is often the ideal location due to visibility and size.

  • Evaluate for any varicosities or damage prior to insertion.

• Clean the area with an alcohol swab:

  • Use circular motions and scrub for at least 30 seconds.

  • Vigorous cleaning can enhance visibility of the veins by causing temporary vasodilation.

• Avoid having the patient make a fist:

  • Instead, encourage relaxation to minimize excess pressure on the vein and prevent complications.

Inserting the IV

• Uncap the IV catheter with the bevel up:

  • This angle helps facilitate smoother insertion into the vein.

• Position hands:

  • Two fingers on the catheter, the other hand will anchor the vein to stabilize it during insertion.

• Insert the IV:

  • Watch for blood return in the fill canister to confirm proper placement.

  • Continue to push the cannula in further once blood is observed to ensure proper venous access.

• Remove the needle while applying pressure with gauze:

  • Maintain pressure to prevent bleeding.

Securing the IV

• Once IV placed, ensure it's secure with Tegaderm:

  • This helps stabilize the IV and maintain sterility.

• Perform a final check for pain or any signs of complications:

  • Ask the patient if they feel any discomfort or notice any abnormalities.

• Make the IV setup visually neat with tape:

  • This not only presents a professional appearance but also prevents accidental dislodgement.

Removing the IV

• Glove up before removal:

  • Maintain aseptic technique.

• Materials needed: Gauze and tape at the ready for immediate application post-removal.

• Carefully remove the IV:

  • Gently peel away Tegaderm to reduce discomfort.

  • Apply gauze over the site as the IV is pulled out to absorb any residual blood.

• Apply pressure to prevent bleeding and secure with tape:

  • Educate the patient on the importance of maintaining pressure on the site for several minutes.

Conclusion

• Patient Zach feels better after receiving medication through the IV: Acknowledgement of improved condition post-treatment.

• Final message: Video wraps up with encouragement for viewers to practice and refine their skills.