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  • 1. 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
  • 2. 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
  • 3. IV Therapy (continued)Lidocaine use for IV starts:Lidocaine is not routinely used when starting IV’sIt is used however if a patient requests it or if the nurse feelsit will relieve the patient’s anxiety related to the IV startThe 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 physicianLidocaine 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
  • 4. 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 buttonNeedle should be retracted prior to disposal in a puncture-resistant, leak-proof containerNever reinsert needle into the catheter as this could shear thecatheterDo not use scissors at or near the insertion site
  • 5. 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
  • 6. 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