IV Insertion Technique Block 2

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Starting IV ã ã ã ã ã ã ã ã ã Collect supplies--- Insertion Device (Administration Set), Extension Set, Gloves, Fluid, Tubing, Alcohol Swab Verify order against bag, check expiration on bag Hand hygiene, ask about allergies, identify client’s name and DOB, explain procedure, determine which arm IV will be put in Open plastic on bag, examine integrity of bag, clarity of fluid, hang bag Open tubing (as if sterile) *Important to keep spike sterile Move roller clamp closer to drip chamber, make sur
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  Starting IV ã Collect supplies --- Insertion Device (Administration Set), Extension Set, Gloves, Fluid, Tubing, Al-cohol Swab ã Verify order against bag, check expiration on bag ã Hand hygiene , ask about allergies , identify client’s name and DOB , explain procedure, deter-mine which arm IV will be put in ã Open plastic on bag , examine integrity of bag, clarity of fluid, hang bag ã Open tubing (as if sterile) *Important to keep spike sterile ã Move roller clamp closer to drip chamber, make sure roller works, close clamp ã Pull plug on bottom of hanging bag, take cap off of spike, spike port ã Check drip chamber ---needs to be 1/3-1/2 full (squeeze drip chamber if needed) ã Prep Tubing: (optional---open lever lock--alligator--and attach to end of tubing) Prime tubing ---run fluid into basin or trash until bubbles out, recapHang tubing over pole to keep it out of the way ã Place chux under arm ã Open IV KIT Check expiration , open package and keep sterile ã Apply tourniquet (only should be on up to 2 minutes) ã Search for juicy vein ã Release tourniquet ã Prep area with chloraprep in back and forth motion and let dry ã Tell client to remain still ã Set up two pieces of tape ---on back of open IV Kit package; have tegaderm ready ã Open IV Catheter Extension Kit : ã Open saline flush syringe, remove cap, attach to buffalo cap on end of extension set ã Prime extension tubing into basin ã Recap end of extension tubing but keep loosened , syringe stays attached to other end, setdown on right side of patient’s arm NOTE: (IV Site Now Dry---Do not touch area that was disinfected) ã Apply gloves ã Put tourniquet back on, make sure radial pulse present ã  To insert catheter : ã Pull skin taunt below insertion site to side of vein ã Pierce skin at 20-30˚ angle ã Look for flashback ã Release tourniquet  ã Release catheter with pointer finger and slide up to touch arm ã Pull barrel back until it clicks ã Cover site with tegaderm , partially over hub  To Attach Extension Tubing: ã Stabilize hub (blue part) with thumb and pointer of non-dominant hand, meanwhile hold middle andring finger above point of entry to keep from bleeding ã Detach needle with dominant hand ã Pull cap off of extension tubing (keep sterile), attach to catheter ã Pull back on syringe to check for blood ã Inject saline , clamp  just before saline runs out ã  Tape clear part of extension tubing  just under hub. Make u-turn on arm with extension tubing and tape tubing to arm ã Clean buffalo cap on end of tubing coming from bag with alcohol swab ã Either:--- Attach end of tubing to buffalo cap on extension tubing ****this one for check-offOR---Attach alligator clip to buffalo cap on extension tubing(IV is now complete) ã Remove gloves ã Unclamp all clamps ã Calculate drops/minute (divide by 4 and count for 15 seconds), set tubing to that rate by adjust-ing roller clamp ã Label site with date, time, gauge of needle, your initials ã Label bag with date, time, initials ã Document in chart, include gauge Discontinue IV  ã Hand Hygiene ã Supplies: gauze and tape ã Check order ã Identify client ’s name and DOB ã Clamp everything and disconnect IV tubing from extension tubing ã Remove tape on IV ã Rub edges of tegaderm with alcohol ã Hold catheter and pull tegaderm up toward catheter (top to bottom) ã Fold 2X2 in half and then in half again, hold over site lightly (don’t press) ã Pull cannula out ã Press on 2X2 for 1-2 minutes , 5-10 if on blood thinners ã Look at catheter to make sure it is intact ã  Tape gauze onto arm ã Remove gloves ã Document D/C of IV in chart Phlebotomy ã Hand Hygiene ã Supplies: gloves, vacutainer, tubes to collect blood in, gauze, tape, alcohol swab ã Check order ã Verify client’s name and DOB , ask about allergies ã Explain procedure ã Apply tourniquet to find vein, release tourniquet ã Clean site (usually antecubital) with alcohol or betadyne in circular motion ã Apply gloves ã Assemble vacutainer ã Have 2 blood tubes nearby ã  Tie tourniquet on ã Insert needle ---feel for pop and then stop ã Put tube on vacutainer, fill it, remove tube ã Put other tube on, fill, remove ã Release tourniquet ã Fold 2X2 and hold over puncture site and withdraw needle ; then apply pressure ã Activate needle safety device if present ã  Tape gauze in place. ã Rotate blood (don’t shake) 3-5 times ã Affix label (may already have on them) ã Add date, time, initials to label ã Put vials in biohazard bag , get to lab
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