The document provides a comprehensive overview of peripheral intravenous catheter (IV) insertion, including definitions, indications, contraindications, complications, and safe practices for insertion. It emphasizes the importance of proper technique, vein selection, and the use of technology to improve insertion success while adhering to ethical and legal considerations. Additionally, it outlines equipment needed, steps for insertion, and strategies for enhancing patient safety and comfort.

1. Peripheral Intravenous Catheter
Insertion
Prepared/
Assist.Prof.Dr. Zeinab Gamal Mohamed
Assistant Professor of Medical Surgical Nursing
College of Nursing - MUST

2. Outlines:
 Introduction
 Definition of peripheral intravenous catheter insertion.
 Indications of peripheral intravenous catheter.
 Contraindications of peripheral intravenous catheter.
 Complications of peripheral intravenous catheter.
 Most common sites of peripheral venous catheter insertion
 Factors to Consider in Vein Selection
 Equipment for peripheral venous catheter insertion .
 Steps for Safe PVC Insertion
 Strategies to Improve Success Insertion
 Role of Technology in Improving PIV Insertion
 Ethical and Legal Considerations of PIV catheter Insertion.

3. - Peripheral intravenous (IV) insertion is the most commonly used invasive
medical device in health care in which a catheter is inserted into a
peripheral vein, typically in the hand or arm, to deliver medications,
fluids, or draw blood.
Introduction

4. Definition
Peripheral intravenous (IV) lines, catheters or cannulas are
indwelling single-lumen plastic conduits that introduced directly
into a peripheral vein.

5. Healthcare providers use peripheral IV lines to draw blood
and give treatments, including:
A. IV fluids.
B. Medications, such as antibiotics.
C. Blood transfusions.
D. Liquid nutrition (total parental nutrition).
Indications of peripheral intravenous
catheter

6.  Local skin infection, inflammation, trauma or burns.
 Need for long-term IV access; consider central venous
access in this situation
 Lymphedema or DVT in the extremity of the IV (choose
another extremity)
 Coagulopathy (relative contraindication)
 AV graft or fistula in the same extremity
Contraindications of peripheral
intravenous catheter

7. - Local complications:
 Hematoma or bleeding at the insertion site.
 Infiltration of the IV therapy into surrounding tissues.
 Phlebitis, or inflammation of the vein.
 The catheter or vein may become occluded due to
mechanical trauma,
Complications of peripheral intravenous
catheter

8. - Systemic complications:
 Allergic reactions may be more commonly attributable to
medications or fluids administered through the line.
 Vasovagal syncope is more likely in patients who have a
history of fainting; or in those who have significant
anxiety over the sight of blood or needles

11. Most common sites of peripheral
venous catheter insertion

12. Factors to Consider in Vein
Selection
- Size and Condition of the Vein: Larger, straight veins are
preferred, but fragile veins (common in elderly) should be
avoided.
- Non-dominant hand: Use the patient’s non-dominant
hand or arm, when possible, to prevent discomfort or
interference with daily activities.
- Arm precautions: Avoid veins in an arm affected by a
stroke, mastectomy, or arteriovenous (AV) fistula for
dialysis.

13. Sterile Equipment:
- Sterile gloves.
- A new sterile catheter (correct gauge based on patient’s
age, condition, and intended use).
- Sterile dressings and antiseptic wipes.
Disinfection Supplies:-
Chlorhexidine-alcohol solution for skin antisepsis or 70%
isopropyl alcohol.
Equipment Preparation

14. Injection Supplies: -
- Sterile syringes and needles.
- Normal saline for catheter flushing.
Personal Protective Equipment (PPE):
- Gloves, masks, and possibly a gown if there's a high risk of
contamination.

16. 1. Hand Hygiene:-
Use alcohol-based hand rub or soap and water to clean hands thoroughly before
touching the patient or equipment.
2. Prepare the Insertion Site:-
- Select an appropriate vein, typically on the forearm or hand.
- Use a tourniquet to dilate the vein and assess the best insertion point.
3. Skin Antisepsis:-
Clean the site with chlorhexidine or 70% alcohol, making sure to allow it to
dry before proceeding to reduce contamination risks.
Steps for Safe PVC Insertion

17. 4- Insertion of the Catheter:-
- Use the bevel-up technique, angling the catheter at 15-30 degrees.
- Once blood return is observed in the catheter chamber, carefully advance the
catheter into the vein.
- Withdraw the needle while holding the catheter in place.
5- Securing the Catheter:-
- Secure the catheter using a sterile transparent dressing, avoiding excessive
pressure that could restrict blood flow.
6- Flushing the Catheter:-
- Flush the catheter with normal saline to check for patency, ensuring the
catheter is functioning properly without resistance.

18. Aim of the study
:
The current study aimed to assess the perception of the
uses of innovative healthcare
-
related-applications on smartphone among undergraduate
nursing students
.
7. Safe Injection Practices Post-Insertion:
Accessing Injection Ports:
- Always disinfect the port with an alcohol wipe before use to avoid
contamination.
- Aseptic Medication Administration:
- Use new sterile syringes for each injection.
- Avoid reusing needles or syringes, even with the same patient, as this
increases infection risks.
Catheter Flushing:-
- Flush with normal saline before and after medication administration
to maintain catheter patency.
Minimal Handling:-
Avoid unnecessary manipulation of the catheter or injection ports,
which could introduce pathogens.

20. Strategies to improve success insertion
1- Enhancing Vein Visualization:
Hydration
Gravity: Have the patient lower their arm below heart level for a few minutes to increase
venous filling.
Vein Distention Techniques:
- Tourniquet
- Fist Pumping
- Tapping or Gentle Massage
- Warm Compress

21. Strategies to improve success insertion
2- Depth and Angle of Insertion:
Begin at a 10-30° angle depending on the depth of the vein. Shallow
veins require a smaller angle of entry. Once you see the flashback,
flatten the needle angle to nearly parallel with the skin, and advance
the catheter smoothly.
3- Knowing When to Withdraw:
If you feel resistance or the patient experiences sharp pain, or if no
blood return is seen, withdraw the needle slightly, reposition, and
attempt again.

22. Role of technology in improving PIV
insertion
A. Ultrasound-Guided PIV Insertion:
Ultrasound guidance involves the use of real-time imaging to visualize veins and guide
needle insertion.

23. Role of technology in improving PIV
insertion
B. Vein Visualization Devices:
Devices such as AccuVein use infrared technology to project a visual map of veins
onto the skin, allowing clinicians to locate viable veins quickly, reducing the risk of
multiple punctures.

24. Ethical and legal considerations of PIV
catheter insertion
A. Informed Consent.
B. Patient Rights and Dignity.
C. Documentation:
Including the number of attempts, location, and any complications, is critical in
protecting both the patient and the healthcare provider in the event of legal
inquiries.
Ethical Practice: If multiple attempts are unsuccessful, it is essential to seek
assistance from a more experienced colleague to prevent unnecessary patient
discomfort and vein damage.

25. References
- Centers for Disease Control and Prevention (CDC): Guidelines for
the Prevention of Intravascular Catheter-Related Infections.
- World Health Organization (WHO): Injection Safety Guidelines.
- https://www.health.qld.gov.au/__
data/assets/pdf_file/0025/444490/icare-pivc-guideline.pdf.
- https://www.ivcannula.com/cannula-with-wings-with-port.html

27. Thank you