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Real life Nurse tips to successful IV insertions.

While explaining to the patient what you are going to do, and the need for the I V, listen to them. Many times they will assist you with which arm is best to us e, and which sites others have had difficulty. Place a towel under the patients arm, to catch the blood if they drip after insertion, prior to heplock. Saves a lot of clean up for you and your CNA's. 1. a) the b) you Assess your patient and see if veins are showing prior to tourniquet. IF they are already bulging and easy to see, then place your tourniquet at top of their bicep with slight tightening. If they have small fragile veins, then rub the arm, small pats to the place wish to place the IV, then place the tourniquet tight right above the elbow.

2. After you have placed the Tourniquet, let their arm fall on the side of the bed and allow gravity to assist. 3. Raise the bed up as high as what makes you level with the arm while it is da ngled off the side of the bed. Once you are ready for prep, you can place the a rm back on the bed. I many times sit in a chair and keep it dangled depending o n how hard the stick will be. 4. Clean the area of insertion, and LET IT DRY! Which they did not do in this video. Their patient will have more risk of infection, with inadequate prep tim e for drying of the betadine, or most of the time we use chloraprep now. 5. Hold with your left hand under the patients hand, arm pulling the skin taunt underneath the place you are going to insert. Opposite depending on if you are left or right handed. Pulling the skin depending on the vein could be light or tight. Insertion is a one hand stick. 6. Hold the Catheter with your thumb and middle finger on the sides with index finger on top to easily thread the catheter once you have punctured the vein. T his will assist with you Not puncturing through the vein or blowing the vein. 7. Have a thin piece of tape ready, and after the catheter is all in, then plac e the tape to temporary secure the catheter. 8. Release the tourniquet and then use your index finger to pop the safety but ton to safely remove the needle. 9. Hold slight pressure to where the tip of the catheter should be in the vein. Place the IV prn adapter or luer lock which should be primed prior to startin g the first step. Do not hook straight up to an IV drip. Use the luer locks, th en hook up your iv line once secure. 10. Then secure with the facility's choice of cover. Remember if a patient will be getting many days of IV fluids, and antibiotics th en start with the hands, rotating arms and move up the arm. Rotating iv sites every 3 days is a good practice to decrease risk for infection . If they are just getting one treatment, then use the ac. Especially if they are going to receive a Potassium drip. They burn like hell, when given lower on the arm, and if they have small veins. This will make their treatment more pleasan t, and yours too. Numbing the site with lidocaine can interfere with your ability to see the vein.

Plus it is a double stick, burns, and can make for more pain for a patient the n not using. When a patient insists, then make sure not to get too close to the vein, so you can visually see the vein once the bubble is achieved.

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