IV Starts for the RN and EMT

Intravenous (IV) therapy is a crucial aspect of patient care, allowing the administration of fluids, medications, and nutrients directly into the bloodstream. For registered nurses (RNs) and emergency medical technicians (EMTs),mastering the art of IV starts is essential for effective patient management. This comprehensive article will delve into the fundamental principles, techniques, and best practices of IV starts, empowering you to provide safe and efficient care.

Understanding the anatomy and physiology of peripheral veins is paramount for successful IV starts. Veins are blood vessels that carry blood back to the heart. They have thinner walls and lower pressure than arteries, making them ideal for IV access. The most commonly accessed veins for IV starts are:

• Median cubital vein (located in the crease of the elbow)
• Cephalic vein (runs along the outside of the forearm)
• Basilic vein (runs along the inside of the forearm)

IV therapy is indicated for a wide range of conditions, including:

IV Starts for the RN and EMT: RAPID and EASY Guide to Mastering Intravenous Catheterization, Cannulation and Venipuncture Sticks for Nurses and Paramedics

by Mike Lanza

4.5 out of 5

Language	:	English
File size	:	3751 KB
Text-to-Speech	:	Enabled
Screen Reader	:	Supported
Enhanced typesetting	:	Enabled
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• Dehydration
• Blood loss
• Electrolyte imbalances
• Administration of medications
• Nutrition support

Contraindications for IV therapy include:

• Local infection at the intended IV site
• Severe burns or trauma to the site
• Known allergies to IV fluids or medications
• Suspected blood clots or vascular disFree Downloads

Assembling the necessary equipment and materials prior to an IV start ensures a smooth and efficient procedure. You will need:

• IV catheter (appropriate size and type)
• IV tubing
• IV bag (containing the prescribed fluid or medication)
• Tourniquet
• Alcohol wipes
• Sterile gloves
• Tape and dressing

Follow these steps carefully to initiate an IV:

1. Preparation:

   • Gather your equipment and materials.
   • Wash your hands thoroughly and don sterile gloves.
   • Clean the intended IV site with an alcohol wipe.
   • Apply a tourniquet 3-4 inches above the site to distend the vein.

2. Vein Selection:

   • Visually inspect and palpate the area for a suitable vein.
   • Choose a vein that is straight, visible, and easily accessible.

3. Catheter Insertion:

   • Hold the catheter bevel-side up and at a 15-degree angle to the skin.
   • Insert the catheter into the vein with a smooth, fluid motion.
   • Advance the catheter over the stylet until blood return is observed in the IV tubing.

4. Securing the Catheter:

   • Remove the stylet and connect the IV tubing to the catheter.
   • Adjust the flow rate as prescribed.
   • Tape the catheter securely in place to prevent dislodgement.

5. Confirming Catheter Placement:

   • Flush the IV line with saline or a prescribed fluid to ensure patency.
   • Observe for signs of extravasation (fluid leakage into the surrounding tissue).
   • If any concerns arise, discontinue the IV and consult a more experienced clinician.

Once an IV has been established, it is essential to manage and monitor it properly:

• Regular flushing: Flush the IV line every 8-12 hours to prevent clotting.
• Site observation: Inspect the IV site daily for signs of infection, swelling, or leakage.
• Flow rate adjustment: Adjust the flow rate as prescribed or as needed to maintain proper hydration and electrolyte balance.
• Medication administration: Administer medications through the IV line according to the prescribed dosages and intervals.
• Patient education: Educate the patient about IV care, including the importance of keeping the site clean and reporting any concerns.

IV therapy can occasionally lead to complications. Some common complications include:

• Infiltration: Fluid leakage into the surrounding tissue, which can cause pain, swelling, and tissue damage.
• Extravasation: Fluid leakage into the surrounding tissue during catheter insertion.
• Phlebitis: Inflammation of the vein, causing redness, pain, and swelling at the IV site.
• Air embolism: Air entering the bloodstream through the IV line, which can be life-threatening.

If any complications arise, remove the IV catheter immediately and consult a more experienced clinician.

To ensure safe and effective IV starts, adhere to these best practices:

• Use ultrasound guidance: If difficulty is encountered in locating a vein, ultrasound guidance can provide real-time imaging to assist in catheter insertion.
• Choose the appropriate catheter size: The catheter size should be appropriate for the patient's vein size and the intended duration of IV therapy.
• Anchor the IV tubing: Secure the IV tubing to prevent kinking or disconnection.
• Maintain aseptic technique: Sterile technique is crucial throughout the IV start procedure to prevent infection.
• Document the procedure: Accurately document all aspects of the IV start, including the site, catheter size, and any complications or interventions.

Mastering IV starts is essential for RNs and EMTs to provide effective patient care. By understanding the anatomy and physiology of peripheral veins, adhering to proper technique, managing IV therapy appropriately, and troubleshooting complications, you can confidently initiate and maintain IVs, ensuring optimal patient outcomes. Remember, continuing education and adherence to best practices are key to enhancing your skills and providing the highest quality of care.

IV Starts for the RN and EMT: RAPID and EASY Guide to Mastering Intravenous Catheterization, Cannulation and Venipuncture Sticks for Nurses and Paramedics

by Mike Lanza

4.5 out of 5

Language	:	English
File size	:	3751 KB
Text-to-Speech	:	Enabled
Screen Reader	:	Supported
Enhanced typesetting	:	Enabled
Print length	:	89 pages
Lending	:	Enabled

FREE