Starting an IV

■ Prepare the Pt: Explain procedure, answer any questions, and give reassurance.
■ Gather equipment: IV bag with primed tubing, sharps container, catheter, tape, dressing, tourniquet, antiseptic swabs, gloves, IV catheter of appropriate size.
■ Organize supplies:Tear tape, hang IV solution with primed tubing close by, sharps container within easy reach, 2x2 or other dressing.
■ Apply tourniquet: Proximal to intended insertion site, either mid-forearm or above the elbow; don gloves.
■ Locate vein: Palpate with fingertips. To further enhance dilation, gently tap, apply heat/warm soak, have patient make a fist, or dangle arm below heart.
■ Cleanse site: Using moderate friction, cleanse in a circular motion, moving outward from intended site.
■ Put on gloves: While waiting for cleansed area to dry, avoid touching site once it has been prepared.
■ Apply traction: Opposite the direction of the catheter.
■ Position needle: Bevel side up, 15 –30 . Note: Hold the needle with the thumb and pointer finger in a way that allows for visualization of the flash chamber.
■ Insert needle: Perform venipuncture and observe for “flash back” in flash chamber. Lower catheter almost parallel to the skin, and insert the needle 1–2 additional mm. This is done to ensure that the catheter has also entered the vein.
■ Advance the catheter: Thread catheter into vein while maintaining skin traction and pulling back on needle.
■ Release the tourniquet: After releasing tourniquet, apply digital pressure just above the end of the catheter tip while gently stabilizing the hub of the catheter.
■ Remove needle: Remove and discard into approved sharps container.
■ Connect IV tubing: Open clamp, and observe for free flow of IV fluid.
■ Secure catheter: Apply tape and sterile dressing per policy.
■ Clean up: Discard soiled equipment per hospital policy.
■ Document: Per hospital policy and guidelines.