Starting a Peripheral IV Catheter

Introduction

This tutorial provides a step-by-step guide on how to start a peripheral IV catheter, a crucial skill in emergency medicine. Successfully performing this procedure can ensure timely access to a patient's vascular system for medication and fluid administration.

Step 1: Gather Your Supplies

Before starting the procedure, make sure you have all necessary equipment ready:

• Peripheral IV catheter (appropriate size for the patient)
• Tourniquet
• Alcohol swabs
• Gauze pads
• Tape or securement device
• Gloves
• A sharps disposal container

Step 2: Prepare the Patient

• Explain the procedure to the patient to obtain consent and alleviate anxiety.
• Position the patient comfortably, ideally with their arm extended and relaxed.
• Ensure adequate lighting to visualize the veins better.

Step 3: Apply the Tourniquet

• Place the tourniquet approximately 6-8 inches above the intended insertion site.
• Ensure the tourniquet is tight enough to engorge the veins but not so tight that it causes discomfort.

Step 4: Select the Insertion Site

• Look for visible and palpable veins, typically in the forearm or hand.
• Prefer larger veins, such as the median cubital vein, for easier access.
• Palpate the vein to assess its size and direction.

Step 5: Clean the Insertion Site

• Use an alcohol swab to clean the chosen site.
• Allow the area to dry completely to minimize discomfort and reduce the risk of infection.

Step 6: Insert the Catheter

• With your dominant hand, hold the catheter at a 15-30 degree angle, bevel up.
• Insert the needle into the vein, watching for a "flashback" of blood, indicating successful venous access.
• Once you see the flashback, lower the angle and advance the catheter into the vein.

Step 7: Secure the Catheter

• Once the catheter is in place, release the tourniquet.
• Use gauze to apply pressure near the insertion site.
• Remove the needle while holding the catheter in place and then secure the catheter with tape or a securement device.

Step 8: Confirm Placement

• Flush the catheter with saline to confirm patency and ensure there are no signs of infiltration or resistance.
• Monitor the site for swelling or discomfort, indicating possible complications.

Conclusion

Starting a peripheral IV catheter requires careful preparation, technique, and monitoring. Always remember to follow hygiene protocols and patient comfort guidelines to ensure a successful procedure. For further learning, consider practicing on simulation models or under supervision in a clinical setting.