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Hit me with your best shot: IV Insertion

Its a typical day in the hospital: busy people roaming around the halls and going about with their own
businesses, patients complaining here, nurses walking fast to and fro stations, doctors conducting their rounds.
This is going to be my life someday, Cher* thinks to herself as she observes the scenario around her. A few
more years and shell be one of these super people who save lives every day, hopefully. Shes just trying to
relieve her first day at nursing school when their Clinical Instructor calls them.

Student nurses, your staff nurse will be inserting an IV today. Try to observe how she does it and picture
yourself doing it, their CI instructs them

Yes maam, they say in chorus and followed the CI to the ward area.

Cher, together with her classmates, stands there observing as the staff nurse expertly assesses the patients arm
and look for an accessible sit. Once she finds one, her eyes lit and carry on with all the disinfecting and stuff
and then inserting the cannula itself. Blood draws out from the inserted cannula and the staff nurses eyes
brighten more. Cher doesnt actually get it, but it seems like hitting a vein has brought a sense of happiness to
the staff nurse.

Maybe, its something special, and maybe Ill be able to experience it someday, Cher thinks as she envisions
herself being the one inserting the IV in front of students and her eyes lighting up at the first sign of blood.

Someday, she says.


It may seem weird to some, but inserting an IV has got to be one of those few factors that could easily affect a
nurses mood for the entire day. Who would ever deny the ultimate high one feels after successfully hitting a
vein at the first attempt? Nor the depression failing to insert an IV line brings?

But whats most known amongst all is the notion that a nurse inserting an IV really looks cool, especially on the
part of student nurses. When a student nurse envisions herself in the future, she will always find herself
picturing someone in white with a cap on the head and inserting IVs or administering IV meds. But for someone
who has seen others insert IVs for numerous times and pictures herself doing the same, but hasnt actually
experienced doing one yet, how do you do it?

IV insertion: An Overview

IV insertion or cannulation in other terms is the procedure in which an IV catheter is inserted into a peripheral
vein to create intravenous access. An IV may be inserted for the purpose of administering fluids to correct
electrolyte imbalances and for fluid replacement; blood products and medicine. When you compare IV
administration with other routes, it can be considered as the fastest way to deliver medications and fluids
throughout the body.

When a physician orders to start an IV line, below are some steps you need to follow:

1. Select an appropriate cannula

Large cannulas may be used for adults, those receiving blood products and/or are due for surgery; while smaller
cannulas are used for pediatric patients. Usually, a G-18 cannula is used for patients who are about to undergo
blood transfusions and surgeries.

2. Select the site

After selecting the appropriate cannula, the site must then be located. Non-dominant hands are usually chosen
as suitable sites for insertion. You may choose a long and straight vein at the non-dominant arm for adult
patients, while you may prefer a site that is on the hand, foot or scalp for pediatric patients.

3. Prime the IV Line

Once you have chosen your site, it is now time to prepare your IV set. Get the solution ordered, open the IV set
and hold the bag upside down and attach to a pole. Insert the cannula to what is now the bottom of the bag.
Prime your chamber and tubings and clamp it shut. Make sure that there are no bubbles present in the tubings.

4. Get ready

Ready yourself, your area and the materials. Do hand washing first and put on latex gloves. Check your IV
cannula for damage, and once you are sure that the cannula is in good condition, wheel the IV pole near the
patients bed.

5. Prepare the skin

Find the vein with your fingers and apply a tourniquet on a proximal area. Disinfect the site with a betadine
solution and cotton swab. Allow the area to dry.

6. Time for Insertion

Pull the skin tight near the injection site. This is to make the vein even more distinguishable. Insert the IV with
through an upward angle and decrease the severity of the angle as you advance the needle. Wait for blood
backflow and insert the needle for about one centimeter more. Advance catheter forward until it is completely
inserted and then remove needle. Then remove tourniquet and apply occlusive dressing.

7. Finish the connection

Attach the IV tubing to the catheter port and lock the tube in place. Regulate the IV flow rate according to the
orders in the chart. Note the date of the insertion as the site and IV tubings are due to be changed after 3 days.

Though it looks easy to do, IV insertion might be one tricky job. In fact, it takes someone some time before they
master the art of inserting an IV. Also, for one to legally perform intravenous therapy (i.e., inserting and IV, and
administering IV meds), one must undergo an IV therapy training and seminar, comply with all the
requirements needed and own an IV therapy license.