Most complaints that are received from patients and their significant others even before the start of a shift are swelling and infiltrated intravenous sites.
Intravenous therapy (or simply IV therapy) is one of the most basic treatments given to almost every patient admitted to every hospital, and the skill of intravenous catheter insertion must be remembered by heart by every nurse therapist. To avoid these complaints and giving undue pain to your patients, take a look at these tips on how to become a sharpshooter in every intravenous insertion that you make.
- I. Introduction & Overview
- II. Vein Selection
- III. Making it More Visible
- IV. Insertion of Catheter
- V. Securing the Line
- VI. Special Considerations
I. Introduction & Overview
Preliminary tips and tricks in intravenous insertion.
1. Stay calm and be prepared. Hitting the bullseye on one try will depend on the nurse’s preparation and skill. You and your patient should be composed as a nervous, and rushed procedure will likely result in failure. Allay anxiety by explaining the procedure to the patient and determine the patient’s history with IV therapy. Ensure the patient is comfortable and sufficiently warm to prevent vasoconstriction.
2. Exude confidence. Believe in yourself and reassure the patient you know what you’re doing. The patient will be encouraged by your confidence and you too, of course.
3. Assess for needle phobia. Needle phobia is a response as a result of previous IV insertions. Symptoms include tachycardia and hypertension before insertion. On insertion bradycardia and a drop in blood pressure occurs with signs and symptoms of pallor, diaphoresis, and syncope. Reassure the patient with a comforting tone, educating the patient, keeping needles out of sight until the last minute before use, and use of topical anesthetics can help manage needle phobia.
4. Observe Infection control measures. Use gloves in inserting a cannula into the patient. Intravenous insertion is an invasive procedure and requires aseptic technique and proper infection control measures. Wipe a cotton swab or alcohol pad on the insertion site to minimize microorganisms in the area and also to visualize the chosen vein more clearly.
5. Assess the vein. Before inserting a needle into a patient’s vein, you have to assess its condition first. A well-hydrated person has firm, supple, and easy-to-reach veins. Well-hydrated veins are bouncy, making them the right fit for insertion. Some patients need intravenous therapy but are dehydrated, so it is a challenge to hit the vein in one go. To avoid injuring the vein, always assess first that you are aiming for a vein that is not frail enough to blow up during the insertion. The following tips can help you with that.
6. Feel rather than look. If you can’t see a suitable vein, trust your fingers even more than your eyes. It’s also an excellent opportunity to familiarize yourself with a suitable vein. A tendon may feel like a vein but palpating it through a range of motion may prove that it is not.
7. Ask your patient. The patient may know more which veins are suitable basing on his previous IV history.
8. Use appropriate cannula size. Match the needle and the gauge of the cannula to the size of the patient. You can hit a vein that is smaller than your needle, but it would be injured and would blow up because the needle is bigger than it is.
9. Consider the use. Put into consideration the type of infusion that is needed when you choose your cannula. Needles with smaller gauges could not accommodate blood transfusion and parenteral feeding. Needleless equipment is now widely used to minimize injury to the vein during and after insertion.
10. Insert at the non-dominant hand first. Consider inserting on non-dominant hand first so the patient can still perform simple functions using the dominant hand. However, if you cannot locate an appropriate site or vein for insertion in the non-dominant hand, proceed with the dominant hand.
Next page: II: Vein Selection