EQUIPMENT
Needle, scalp vein or angiocathAntiseptic solution (povidone-iodine and/or alcohol)TourniquetGloves, nonsterile
GENERAL GUIDELINES
1.Check physician’s order.
Ensures appropriate adminis- tration of prescribed intravenous therapy.
2.Prepare child and family.
Enhances cooperation and participation and reduces anxiety and fear.
3.Check child for allergies, especially allergies to tape,latex, and povidone-iodine.4.Gather equipment.
Promotes organization and effi-ciency.
5.Wash hands.
Reduces transmission of microorganisms.
6.Choose site and type of device.a.Use most distal portion of vein found.
Proximal site is still usable if needed.
b.Avoid using dominant hand if possible.
Interferes less with the child’s usual activities.
c.Avoid bony prominences.
Difficult to access and maintain.
d.Avoid inserting IV through an infection or rash.
Reduces risk for IV-associated bacteremia.
7.Apply a warm compress over the area if needed.
Helps distend the vein.
8.Put on gloves.
Protects from contact with body fluids.
9.Position child.a.For scalp vein insertion, use a mummy restraint.b.For infants and children who are unable to fully cooperate, have a second nurse restrain as necessary.10.Cleanse the insertion site by using povidone-iodine oralcohol; use a circular motion moving outward from thepuncture site.
Reduces the transmission of microorgan- isms and carries microorganisms away from site of entry.
a.If using povidone-iodine allow to dry for 1–2 min-utes.
Povidone-iodine must dry to be effective.
b.If povidone-iodine makes it difficult to visualize the vein, it can be wiped off with alcohol.c.If using alcohol alone, scrub site until last applicatoris visually clean.
INSERTION OF SCALP VEINNEEDLE
PROCEDURE
1.Steps 1–10 of General Guidelines.2.Apply a rubber band tourniquet if using a scalp vein, ora tourniquet if using an extremity.
Distends vein and makes it easier to enter.
3.Prepare needle by attaching a syringe with normal salineto the needle and forcing out a few drops of saline.
Determines patency of needle and removes air from nee- dle.
4.Select a fairly straight segment of vein; place the needlein the direction of the blood flow.5.Grasp the needle by the winged tabs bevel up and at a23°–30°angle.
Produces less trauma to the skin and vein.
6.Anchor the vein with a finger of the free hand by stretching the skin.
Applying traction to the skin helps to stabilize the vein.
7.Hold the needle parallel to the long axis of the vein.
Decreases the risk of thrusting the needle through the wall of the vein as the skin is entered.
8.Gently advance the needle into the vein until bloodappears in the tubing. Do not advance the needle onceblood is seen.
Reduces risk of piercing the distal wall of the vein. Increased venous pressure from the tourniquet increases backflow of blood.
9.Release the tourniquet.
Permits venous flow of blood.Reduces backflow of blood.
10.Infuse 2–3 ml of saline from the syringe into the vein.
Checks patency of the system.
11.Secure IV by taping.
Reduces risk of needle becoming dislodged from the vein.
(Figure17A)12.Attach hub of needle to adapter of the infusion tubing.13.Set appropriate rate on infusion pump and begin infu-sion.14.Place medicine cup or drinking cup cut in half andpadded over IV site. Commercial devices are also avail-able.
Protects site from child’s touch.
(Figure17B)15.Dispose of used equipment in appropriate container.
Consistent with body fluid precautions.
16.Remove gloves. Wash hands.
Reduces transmission of microorganisms.
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Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.
SKILL 18SKILL 18
Insertion ofa Peripheral IV Line
continued
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