Most hospitals now have IV machines, which include the pole and hanger.
If there is no water source, rub your hands with an alcohol-based hand sanitizer.
Note and Locate bag size you need. Usual bag size in hospital setting is 1,000 ccs which is run over a specific period of time. (See order. ) However, an IV comes in ccs of 1,000 ; 500 ; 250 ; 100 ; and for administration of IV-medications, cc bags of 50 or 100 which is referred to as a “IV piggyback” (IVPB), while a continuous larger bag IV is referred to as the primary IV. If placed in a peripheral vein, it is a peripheral IV, while an IV attached to a central port is a central IV. Note and Locate the type of fluid needed. The most common orders can include one of these: water W (this indicates sterile water) ; dextrose (Dex); saline (S) (e. g. normal saline); normal saline (NS) ; Ringers Lactate/ Lactated Ringers (RL or LR) ; potassium chloride. Note any percentage given in the order for the type of fluid. Some percents are standard in the industry, but you must still always make sure you pick the correct percent listed on the bag that matches the order. Make sure to get any labels that you need to fill out and adhere to the IV bag. Double check that you are giving the medication to the right patient, that you are doing it at the right date and time, that you are giving the correct medication in the correct order, and that the bag is the right volume. Redo these steps at bedside. You must redo these steps even though you checked these facts already. Always re-verify at bedside. If you have any questions at all, it is important that you ask your supervisor before continuing so that you are 100% sure you understand what you are supposed to do. Consult the physician or on-call doctor if you question the order itself.
A microset is used when you want to give the patient 60 drops of IV fluid per minute. Infants, toddlers, and younger children generally need a microset. The size of the tubing (and the size of needle) that you use will also depend on the purpose for the IV. If it is an emergency situation where the patient needs fluids as quickly as possible, you will more likely choose a larger needle and tube in order to deliver the fluids and/or blood products or other medications as quickly as possible. In less urgent situations, you may choose a smaller needle and tubing.
If you ever get confused while assembling the IV bag, there should be instructions written on the bag that you can follow. However, if you have any questions, stop what you’re doing and find someone who knows what to do. Make sure the valve flow is set to “off” (you learn which way to move the slide on the tubing by experience). You want it set to stop the fluid from freely flowing until you’ve got the tubing inserted into the bag and the bag hung.
IV pumps, or infusion pumps, are often used to help deliver a precise dose for the proper amount of time.
This is also termed as priming the IV tubing. This is an essential step, because inserting any air or air bubble into the patient could be fatal.
If the IV line does touch the floor, you will have to prepare a new IV, as the contaminated IV could potentially harm your patient. Keep the IV line close so that it does not touch the floor again.
Lying or sitting calms the patient and can reduce the amount of pain he will feel. It also ensures that she is in a stable position where she won’t pass out if he has a psychological fear of needles. Wash your hands again to ensure extra cleanliness. Put on your gloves — this can also help reassure the patient that you care about her health and protecting her against unnecessary exposure to bacteria.
Start by looking for veins lower down on the arm, or even on the back of the hand. Starting lower down will give you more “chances” if you are not successful at inserting the IV on your first try. If you need to try a second time, you will need to move higher up the arm, so there are benefits to trying lower down on the hand/wrist first if you can find a reasonably visible vein. Most hand or wrist veins look plump, but can roll. On heavier patients, it may be difficult to see or feel (palpate) hand or wrist veins. You can also look for veins that are located in the crease where the forearm meets the upper arm. This is called the antecubital space. These are often the easiest to insert an IV into; however, if the patient tries to bend his arm, this can block the IV tubing and the IV solution.
Do not wave your hand over the area as if to dry it, as this can causes bacteria to be waved over the “cleaned area”. Instead, allow the alcohol to air dry on its own. Note: Never, ever, blow air on the site using your mouth.
Push the cannula forward another 2mm. Then, fix the needle and push the rest of the cannula in a little bit further. [10] X Trustworthy Source PubMed Central Journal archive from the U. S. National Institutes of Health Go to source Remove the needle fully. Apply pressure above insertion site while maintaining site and connect the IV tubing. If you do not apply pressure, the patient may bleed from the cannula. Once the tubing is connected, you still MUST hold the cannula in place until you get the site cleaned and taped. Dispose of the needle in a designated sharps container. Finally, untie the tourniquet and clean the insertion site where the cannula is sticking out of the skin with a hypoallergenic dressing or alcohol swab.
Start by administering normal saline from a single needle/syringe in order to ensure the IV is open and unobstructed. If you notice swelling in the surrounding tissue (infiltration), or other problems with the fluid administration, stop the saline flush immediately. Immediately remove the cannula. You will need to start the process over again, but using a different insertion site. Assuming that the saline flows normally through the IV access point you have set up, you can proceed to administer any other medication(s) the doctor has specifically ordered to be delivered through the IV (e. g. IV piggyback).
In a field setting, you will need to regulate the IV rate manually. The IV may have roller clamps and you need to count the drops per minute as the drops fall into the chamber. Count the drips for a full minute, and adjust until you get the proper rate. Other IV sets already have a roller knob that you can turn and set the drops per minute so that you don’t have to count. IV machines in hospitals are easiest of course, because you set the drip rate using buttons, like setting a digital clock.
