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IV TherapyMaintenance Therapy for Peripheral IV’s Verify that the correct solution is hanging Verify that the rate is correct Assess amount left, availability of solution Change the IV bag at least every 24 hours (label) Change primary & secondary IV tubing along with caps every 96 hours (label) Mark IV tubing for change using appropriate label Change peripheral IV sites every 96 hours Mark all peripheral IV sites with start date
IV Therapy (continued)When choosing an IV site: Start with the distal veins of the hand and work up Avoid the antecubital site because it interferes with blood sampling Choose site free of abrasions, inflammation, and lesions Be considerate of patients comfort/mobility (use nondominant arm) Longer and larger veins will better dilute infusions Start an 18 gauge if possibility of patient going to surgery or receiving blood
IV Therapy (continued)Lidocaine use for IV starts:Lidocaine is not routinely used when starting IV’sIt is used however if a patient requests it or if the nurse feelsit will relieve the patient’s anxiety related to the IV startThe registered nurse uses topical EMLA or injects 0.2 ml ofplain 1% Lidocaine (not to exceed 1 ml intradermally) at aperipheral intravenous site prior to insertion of theintravenous catheter as directed by the ordering physicianLidocaine is administered with a doctor’s order when the IVinsertion is expected to be difficult, when the patient isanxious, and/or when the patient requests anesthesia prior toIV insertion
IV Therapy (Reminders)Documentation Document location, number of attempts, size of cathlon and confirmation of patency (positive blood return, successful saline flush)Do not withdraw needle from catheter hub before pressing thewhite buttonNeedle should be retracted prior to disposal in a puncture-resistant, leak-proof containerNever reinsert needle into the catheter as this could shear thecatheterDo not use scissors at or near the insertion site
IV Therapy (Tips for Success)Site Prep – always prep site using the chlorascrub inside thestart kit. If first attempt unsuccessful obtain another singlechlorascrub to prep new site. Insertion Success • slow down the speed of insertion - use less force to penetrate the skin • lower the initial insertion angle keeping the elbow low Feeling the “pop” (pop causes damage to the vein - flash is a better indicator) • slowing the approach allows the flash to catch up Seeing the flash • Trust your instinct and take a pause - look for the flash behind the spring • The initial flash may be seen along the cathlon
IV Therapy (Tips for Success)Threading with ease After flash, lower the angle and advance 1/8 inch Retract the Needle Rotating the barrel 360 ensuring cathlon seal is broken Release tourniquet before pressing the button Do not activation before it’s time (be aware of where your fingers are) Remove needle cover in a straight, outward motion