Intravenous therapy or IV is an important skill for healthcare workers. In this blog, we will discuss the important aspects of an IV. Here, we have a step-by-step guide on how to start an IV. But first, it is important to know what IV or intravenous therapy is, its types, and its importance.
What is an IV?
IV, also known as intravenous therapy, is the process in which fluids, medications, or nutrients are given to patients directly into the bloodstream through a vein.
Types of IV catheters
- Common types of IV catheters are as follows:
- Peripheral IV: Placed in arm or hand.
- Central Venous Catheter (CVC): Used in long treatments.
- PICC line: Used for prolonged IV access.
- Port-a-Cath: Used in long-term treatments such as chemotherapy.
Step-by-step guide on how to start an IV
The first step is to gather the supplies needed to start an IV. It is important to have all the supplies nearby so they are easy to reach. The list of supplies you need to start an IV is as follows:
Gather Supplies
- Gloves
- IV catheter
- Alcohol swabs to disinfect the area
- Tourniquet
- IV tubing
- Saline flush
- Adhesive tape
- Sharp container
Label the IV:
The most important thing when starting an IV is to label it. So, it is clear who placed an IV, when it was placed, and whether it should be administered.
Choosing the IV Guage
Choosing the right size of gauge is an important part of IV therapy. There are five types of IV gauge sizes, each with its benefits and drawbacks.
- 14g-16g IV: The largest size is 14g-16g IV. It is rarely used typically during critical situations.
- 18g IV: This size is also used in emergencies and is not advised for people with fragile veins.
- 20g IV: This size is used for adults.
- 22g IV: This size is smaller and perfect for adults with fragile veins or pediatric patients.
- 24g IV: This is an extremely small size designed for infants.
Preparing the patient
- Explain the procedure: Before starting an IV, prepare the patient. Explain the procedure to the patient. It is important to explain the procedure to the patient before starting an IV to help them reduce their anxiety.
- Good visibility: Position the patient in such a way that they are comfortable and you have good visibility of the arm of the hand for inserting an IV.
- Wash your hands and wear gloves before starting the procedure.
Apply Tourniquet
- Place the tourniquet about 4-6 inches above the insertion site.
- Make sure it is tight enough to restrict the venous flow but not the arterial flow.
- Select straight and large veins. Sometimes, you cannot see the vein, but you can feel it by tapping it.
- Once you find the vein, clean the area with an alcohol swab. This is to make sure the area is disinfected before inserting an IV needle.
How to set up an IV bag
- Hang the IV bag with something elevated.
- Fill the tubing with saline solution.
- If you see bubbles in the IV line, remove it by tapping or squeezing the line.
- Open the IV by twisting the catheter hub.
- Make sure that the IV does not touch anything except the patient’s skin at the insertion site.
Step-by-step guide on IV insertion procedure
Now, we will explain how to insert an IV. This process requires a lot of diligence and precision.
- Hold the catheter in your dominant hand.
- Taut the skin with your non-dominant hand; this will help stabilize the vein. Stabilizing the vein will make the insertion of the IV easier.
- Insert the needle in the vein at a 10 to 30-degree angle. It is the most key step in inserting an IV. If the angle is shallow, you will not be able to penetrate the vein and if it is too steep you might puncture the vein.
- You will see a flash of blood in the flash chamber if the needle is inserted correctly.
- Once you see the flash of blood then lower the angle of the needle. Advancing it 2-3 milliliters will make sure that the catheter is fully seated.
- Once the needle is inside the vein the next step is to advance the catheter. The catheter is flexible and will stay inside the vein to deliver the fluid or medication.
- Remove the tourniquet to ensure proper blood flow.
- Put your index finger and apply a small pressure beyond the catheter tip to prevent bleeding when the needle is removed.
- Press the activation button.
Securing IV line
Use adhesive tape or transparent dressing to secure the IV line. Make sure everything is done correctly and there is no pain or swelling at the insertion site.
Flushing the IV line
After placing the catheter, flush the line with sterile saline to ensure that the catheter is positioned correctly.
Monitor and Documenting
The last step of how to insert an IV is monitoring and documenting.
- Make sure there is no swelling or pain.
- Document the whole procedure, insertion site, patient response, and catheter size.
Removing the IV
We have discussed the steps on how to start an IV and how to insert an IV, now we will discuss how to remove an IV carefully.
- Wash your hands and put on gloves.
- Loosen the dressing around the area of insertion.
- Put gauze on the site of insertion and pull out the IV with one quick smooth move.
- Apply firm pressure with gauze on the insertion site to prevent blood seepage.
- Apply the pressure for 2 minutes and after that see if the blood has stopped.
- Secure the insertion site with tape.
- Dispose of everything properly. Sharp objects go into the sharp container.
Benefits of IV therapy
- Faster delivery of medications and fluids.
- Especially useful in emergencies to give direct and quick medication to the patient.
- The dosages are precise and controlled.
Risks of IV therapy or complications
- Infection
- Inflammation of the vein
- Infiltrations mean a leak of fluid in surrounding tissues.
- Air embolism, which means air enters the vein.
Conclusion
In this blog, we have discussed how to start an IV which is an important skill requirement for nurses and other healthcare workers. It is a modern tool that helps the healthcare worker to allow the efficient delivery of medications, fluids, or nutrients to patients, especially during emergencies. Nurses should know how to effectively insert an IV into the patients and this blog has provided all the essential steps to do so. From the types of catheters to how to set up an IV bag and insert the catheter.
