PERIPHERAL IV STARTS

SRT

REFERENCE

INFUSION NURSES SOCIETY

2011 INFUSION NURSING STANDARDS OF PRACTICE

MEMORY AID

• Wash your hands first.• Use body fluid precautions.• All cleaning solutions must be allowed to dry.• Aseptic care of all vascular access devices.• The fluid pathway must remain sterile.• Use arm and hand veins – avoid areas of

flexion.• Catheters must be secured.

What Is A Peripheral Catheter

VEINS

MEMORY AID

• Wash your hands first.• Use body fluid precautions.• All cleaning solutions must be allowed to dry.• Aseptic care of all vascular access devices.• The fluid pathway must remain sterile.• Use arm and hand veins – avoid areas of

flexion.• Catheters must be secured.

Peripheral IV Catheters

Peripheral Intravenous Sites

• Use veins of the arms and hands.• Avoid the lateral surface of the wrist, areas of

flexion, compromised areas (bruised, corded, infiltrated, phlebotic, sclerosed), veins on the side of breast surgery with axillary node dissection/lymphedema, veins on the side of hemodialysis grafts and fistulas.

Tourniquets

• A tourniquet shall be properly applied to promote vascular distension in preparation for peripheral venipuncture.

• Practice CriteriaA. The tourniquet should be single-patient use.B. The nurse should assess the patient for latex

allergy when considering tourniquet material.

Tourniquets

C. The tourniquet should be applied at an appropriate location above the selected venipuncture site

D. An arterial pulse should be easily palpable distal to the tourniquet location.

E. The tourniquet should be applied in such a manner as to prevent circulatory impairment. Release the tourniquet as soon as possible.

F. The nurse should assess for factors indicating that a tourniquet should be loosely applied or its use avoided in patients who bruise easily, are at riskfor bleeding, have compromised circulation, and/or have fragile skin or veins.

Skin Cleaning Solutions

• >.5% Chlorhexidine• Povidone-Iodine• 70% Alcohol

• Cleaning solutions work while they are drying. • Allow all skin cleaning solutions to completely

dry before putting a sharp through or a dressing over the area.

Skin Cleaning Solutions

• Clean the insertion site outwards, “clean to dirty”.

• Clean the entire area that will be under the dressing.

Dressings

• Transparent dressings get changed when non-adherent, soiled, wet, and when the catheter is changed.

• Gauze and tape dressings get changed every 48 hours, when non-aderent, soiled, wet, and when the catheter gets changed.

• If gauze is applied under a transparent dressing it is considered a gauze dressing.

Peripheral IV Catheters

• The type of catheter is based on prescribed therapy, duration of therapy (usually less than 1 week), availability of peripheral IV sites, diagnosis, inserter’s experience.

Peripheral IV Catheters

• Venipuncture

•Prior to venipuncture,rotate catheter hub 360 degrees, and seat it in its original position.

•Approach vein slowly at a low angle. Maintain skin traction.

•Observe flashback.

Peripheral IV Catheters

• Advancement• Upon flashback visualization, lower the

catheter almost parallel to the skin and slightly advance the entire unit to ensure the catheter tip is in the vein.

• Thread the catheter into the vein.• Release the tourniquet.

Peripheral IV Catheters

• Securement• Apply the transparent dressing.• Apply digital pressure beyond the cather tip.• Stabilize the hub and remove the sharp.• Attach the pre-flushed PRN adaptor.• Check for blood return and flush the catheter.• Ensure there is no swelling, bruising or pain

with flushing.

Peripheral IV Catheters

• Peripheral IV cather insertion sites get changed every 72 hrs and as needed.

Document

• What you did.• How you did it.• What device you used.• Any changes from the standard and why. There

must be documentation and order that the MRP is aware and agrees.

• Any complications, problems, and your intervention.

• How the procedure was tolerated by the patient.

http://www.youtube.com/watch?v=GMQUbsPHF2c

BD Insyte Autoguard BC IV Catheters

BD Insyte Autoguard BC IV Catheters