Assisting with Catheter Insertion Procedure

Equipment
- Intra cath (20 cm, 16-gauge, radio opaque, polyvinyl chloride) or peripheral line catheter
- Iodine solution
- Betadine ointment and swabs
- Alcohol sponges
- Aceptone solution (optional)
- Sterile 4x4 gauze pads
- Sterile gloves
- Sterile towels or drapes
- Sterile gown
- Masks (2)
- 3-mL syringe with 25-gauge needle
- Lidocaine or local anesthetic agent
- Sterile black silk suture with needle, IV filter and tubing
- IV extension tubing
- 500 ml normal saline IV bag or DW
- Hyper alimentation solution
- IV infusion pump and cassette
- Bath blanket to provide roll under shoulders

Preparation
1. Explain procedure to client to allay anxiety
2. Obtain consent from client or family
3. Teach Valsalva’s Maneuver for use during catheter insertion procedure if client does not have a cardiac disorder.
4. Review the orders for correct hyper alimentation solution additives. Check the content of solution with order.
5. Inspect TPN bottle for cracks, turbidity, or precipitates.
6. Assemble IV insertion tray or kit, normal saline solution bottle or DW, IV tubing, extension tubing, and filter.
7. Wash hands
8. Flush IV tubing with IV solution
9. Place IV tubing through infusion pump
10. Place catheter insertion equipment on bedside stared

Procedure
1. Position client in head-down position with head turned to opposite direction of catheter insertion size. Place a small roll between client’s shoulders to expose insertion site.
2. Cleanse insertion area with Betadine solution (if allergic to Betadine solution, use 70% isopropyl alcohol).
3. Assist the physician to gown, put on mask and gloves prior to beginning procedure.
4. Done mask and sterile gloves.
5. Assist physician as needed during catheter insertion
6. Instruct client in Valsalva’s Maneuver when stylet is removed from catheter and when IV tubing is connected to catheter
a) Instruct client to exhale against a closed glottis.
b) If client is unable to do this compress client’s abdomen. Both these procedures help decrease possibility of air embolism.

7. After tubing is connected, instruct client to breath normally.
8. Tape area between tubing and catheter hub.
9. Turn on IV infusion pump, using normal saline solution, at slow rate, 10 gtt/mincle, until X-ray ensures accurate catheter placement.
10. Place Betadine over catheter insertion site. Apply transparent dressing.
11. Order portable chest X-ray to verify correct catheter placement.
12. Following confirmation of Catheter placement. Change IV solution to hyper alimentation solution and adjust flow rate as ordered.
13. Time tape the bottle after adjusting flow rate. Be prepared to document on IV hourly infusion recorded.
14. Observe for signs of complication.
15. Take vital signs every 4 hours. If signs change or temperature rises significantly, the client may be developing complications.