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Uncovering Difficult IV's
Report on obtaining IV access in difficult settings. Discusses the basics of ...
From sarge299
INTRAVENOUS THERAPYDefinition:Intravenous therapy
or
IV therapy
is the giving of liquidsubstances directly into avein.It
can be intermittent or continuous; continuous administration is called an
intravenous drip
. Theword
intravenous
simply means "within avein", but is most commonly used to refer to IVtherapy.Compared with other routes of administration, the intravenous route is one of the fastestways to deliver fluids and medications throughout the body
Purpose:
•
To supply fluid when clients are unable to take in an adequate volume fluids by mouth
•
To provide salts needed to maintain electrolyte balance
•
To provide glucose (dextrose), the main fuel for metabolism
•
To provide water-soluble vitamins and medications
•
To establish a lifeline for rapidly needed medication
Materials:
•
Infusion set
•
Container of sterile parenteral solution
•
IV pole
•
Adhesive and non allergenic tape
•
Clean gloves
•
Tourniquet
•
Antiseptic swabs
•
Antiseptic ointment, such as povidine-iodine (optional)
•
Splint
ProcedurePrepare the IV fluid administration set
•
Inspect the fluid bag to be certain it containsthe desired fluid, the fluid is clear, the bag isnot leaking, and the bag is not expired.
•
Select either a mini or macro dripadministration set and uncoils the tubing. Donot let the ends of the tubing becomecontaminated.
•
Close the flow regulator (roll the wheel awayfrom the end you will attach to the fluid bag).
Rationale
This will maintain thesterility of the ends of
ResponsiblePerson
Registered Nurse
•
Remove the protective covering from the portof the fluid bag and the protective coveringfrom the spike of the administration set.
•
Insert the spike of the administration set intothe port of the fluid bag with a quick twist. Dothis carefully. Be especially careful to not puncture yourself!
•
Hold the fluid bag higher than the dripchamber of the administration set. Squeezethe drip chamber once or twice to start theflow. Fill the drip chamber to the marker line(approximately one-third full). If you overfillthe chamber, lower the bag below the level of the drip chamber and squeeze some fluid back into the fluid bag.
•
Open the flow regulator and allow the fluid toflush
all
the air from the tubing. Let it run intoa trash can or even the (now empty) wrapper the fluid bag came in. You may need toloosen or remove the cap at the end of thetubing to get the fluid to flow although mostsets now allow flow without removal. Takecare not to let the tip of the administration set become contaminated.
•
Turn off the flow and place the sterile cap back on the end of the administration set (if you've had to remove it). Place this endnearby so you can reach it when you are readyto connect it to the IV catheter in the patient'svein.
Perform the venipuncture
•
Be sure you have introduced yourself to your patient and explained the procedure.
•
Apply a tourniquet firmly 15 to 20 cm (6 to 8in.) above the venipuncture site. It should betight enough to visibly indent the skin, but notcause the patient discomfort. Have the patientthe tubingHeight is needed toenable the gravity toovercome venous pressure and facilitateflow of the solutioninto the vein
make a fist several times in order to maximizevenous engorgement. Lower the arm toincrease vein engorgement.
•
Select the appropriate vein. If you cannoteasily see a suitable vein, you can sometimesfeel them by palpating the arm using your fingers (not your thumb) the vein will feellike an elastic tube that "gives" under pressure. Tapping on the veins, by gently"slapping" them with the pads of two or threefingers may help dilate them. If you stillcannot find any veins, then it might be helpfulto cover the arm in a warm, moist compress tohelp with peripheral vasodilatation. If after ameticulous search no veins are found, thenrelease the tourniquet from above the elbowand place it around the forearm and search inthe distal forearm, wrist and hand. If still nosuitable veins are found, then you will have tomove to the other arm. Be careful to stayaway from arteries, which are pulsatile.
•
Don disposable gloves. Clean the entry sitecarefully with the alcohol prep pad. Allow itto dry. Then use a betadine swab. Allow it todry. Use both in a circular motion startingwith the entry site and extending outwardabout 2 inches. (Using alcohol after betadinewill negate the effect of the betadine) Notethat some facilities may require alcohol prepwithout betadine.
•
To puncture the vein, hold the catheter in your dominant hand. With the bevel up, enter theskin at about a 30 to 45 degree angle and inthe direction of the vein. Use a quick,short, jabbing motion. After entering the skin,reduce the angle of the catheter until it isnearly parallel to the skin. If the vein appearsHeat dilates superficial blood vessels, causingthem to fill.Gloves protect thenurse fromcontamination by theclient’s blood.This motion carriesmicroorganisms awayfrom the site of entry.
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Intravenous Therapy
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| Upload Date: | 10/27/2009 |
| Copyright: | Attribution Non-commercial |
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