This document provides guidelines for peripheral intravenous catheter insertion and maintenance. It outlines best practices for site selection, skin cleaning, catheter insertion, securement, dressing application, and documentation. Proper hand hygiene, aseptic technique, and catheter stabilization are emphasized to maintain sterility of the fluid pathway and prevent complications. Peripheral IV catheters should be inserted into veins of the arms and hands, avoiding areas at risk for infiltration or compromised circulation, and secured with a transparent or gauze dressing changed according to guidelines.

1. PERIPHERAL IV STARTS
SRT

2. REFERENCE
INFUSION NURSES SOCIETY
2011 INFUSION NURSING STANDARDS OF PRACTICE

3. MEMORY AID
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Wash your hands first.
Use body fluid precautions.
All cleaning solutions must be allowed to dry.
Aseptic care of all vascular access devices.
The fluid pathway must remain sterile.
Use arm and hand veins – avoid areas of
flexion.
• Catheters must be secured.

4. What Is A Peripheral Catheter

5. VEINS

7. MEMORY AID
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Wash your hands first.
Use body fluid precautions.
All cleaning solutions must be allowed to dry.
Aseptic care of all vascular access devices.
The fluid pathway must remain sterile.
Use arm and hand veins – avoid areas of
flexion.
• Catheters must be secured.

8. Peripheral IV Catheters

9. Peripheral Intravenous Sites
• Use veins of the arms and hands.
• Avoid the lateral surface of the wrist, areas of
flexion, compromised areas
(bruised, corded, infiltrated, phlebotic, scleros
ed), veins on the side of breast surgery with
axillary node dissection/lymphedema, veins
on the side of hemodialysis grafts and fistulas.

10. Tourniquets
• A tourniquet shall be properly applied to
promote vascular distension in preparation for
peripheral venipuncture.
• Practice Criteria
A. The tourniquet should be single-patient use.
B. The nurse should assess the patient for latex
allergy when considering tourniquet material.

11. Tourniquets
C. The tourniquet should be applied at an appropriate
location above the selected venipuncture site
D. An arterial pulse should be easily palpable distal to the
tourniquet location.
E. The tourniquet should be applied in such a manner as
to prevent circulatory impairment. Release the
tourniquet as soon as possible.
F. The nurse should assess for factors indicating that a
tourniquet should be loosely applied or its use avoided
in patients who bruise easily, are at riskfor
bleeding, have compromised circulation, and/or have
fragile skin or veins.

12. Skin Cleaning Solutions
• >.5% Chlorhexidine
• Povidone-Iodine
• 70% Alcohol
• Cleaning solutions work while they are drying.
• Allow all skin cleaning solutions to completely
dry before putting a sharp through or a
dressing over the area.

13. Skin Cleaning Solutions
• Clean the insertion site outwards, “clean to
dirty”.
• Clean the entire area that will be under the
dressing.

14. Dressings
• Transparent dressings get changed when nonadherent, soiled, wet, and when the catheter
is changed.
• Gauze and tape dressings get changed every
48 hours, when non-aderent, soiled, wet, and
when the catheter gets changed.
• If gauze is applied under a transparent
dressing it is considered a gauze dressing.

15. Peripheral IV Catheters
• The type of catheter is based on prescribed
therapy, duration of therapy (usually less than
1 week), availability of peripheral IV
sites, diagnosis, inserter’s experience.

16. Peripheral IV Catheters
• Venipuncture
•Prior to venipuncture,rotate catheter hub 360
degrees, and seat it in its original position.
•Approach vein slowly at a low angle. Maintain skin
traction.
•Observe flashback.

17. Peripheral IV Catheters
• Advancement
• Upon flashback visualization, lower the
catheter almost parallel to the skin and
slightly advance the entire unit to ensure the
catheter tip is in the vein.
• Thread the catheter into the vein.
• Release the tourniquet.

18. Peripheral IV Catheters
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Securement
Apply the transparent dressing.
Apply digital pressure beyond the cather tip.
Stabilize the hub and remove the sharp.
Attach the pre-flushed PRN adaptor.
Check for blood return and flush the catheter.
Ensure there is no swelling, bruising or pain
with flushing.

19. Peripheral IV Catheters
• Peripheral IV cather insertion sites get
changed every 72 hrs and as needed.

20. Document
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What you did.
How you did it.
What device you used.
Any changes from the standard and why. There
must be documentation and order that the MRP
is aware and agrees.
• Any complications, problems, and your
intervention.
• How the procedure was tolerated by the patient.

21. BD Insyte Autoguard BC IV Catheters
http://www.youtube.com/watch?v=GMQUbsPHF2c
BD Insyte Autoguard BC IV Catheters