At a glance…IV tips for January 2010

In case you missed it, here’s a summary of the IV tips I posted on Twitter in January.

Lucky Tourniquet: Do you know some nurses won’t get rid of their “lucky tourniquet” for fear they can’t start an IV without it? Single use only please..
• Unless cleaned in between patient use, IV tourniquet should be used only once and discarded.

Peripheral IV catheter: Use short length & small gauge IV catheter. This will allow good blood flow inside the vein. Find veins that can sustain good blood flow to avoid vein wall irritation.
• Many clinicians think that using a large gauge catheter when infusing an irritating drug is better. Keep in mind, that good blood flow through the vein will prevent vein wall irritation.
• In certain situations, large gauge catheters may be required for rapid infusions.

Twice is enough: Only 2 unsuccessful attempts when starting a peripheral IV. Multiple unsuccessful attempts cause unnecessary trauma to the patient & limit vascular access.
• Key is good assessment of veins prior to venipuncture.
• Always check for blood return before advancing the catheter inside the vein.

No shaving: During venipuncture, shaving hair not recommended because of potential for microabrasion allowing microorganisms to enter vascular system.
• If patients asked to have hair removed prior to sticking, clip hair using safety scissors instead.

Just say no: Avoid the antecubital fossa when starting a peripheral IV. Start distally and work your way up the arm during assessment.
Read blog on this topic.

Proper tip: CVC’s distal tip placement is in lower 1/3 of SVC to the junction of SVC /RA. If not, it’s not a central venous access.
• CVC tip should not be in contact with the vein wall to avoid irritation leading to other complications.