Procedure for Starting IVs
To help distend the vein:
Palpate the vein:
Release the tourniquet, gather and prepare equipment.
Prepare equipment, including IV bag, tubing, and pump as needed.
Check agency policy for use of a topical anesthetic for cannula insertion.
Select insertion device depending on the patient situation.
Over-the-needle cannulas (Angiocaths is one brand) are flexible plastic cannulas with a metal stylet for insertion.
Straight steel needles (Butterflies) are used for short term infusions and with pediatric patients (small veins)
An 18-19 gauge is recommended for infusing blood in adults.
Cleanse according to agency policy (often povidone iodine and/or 70% alcohol) - use a circular motion from the site outward.
Anchor the vein, being careful not to touch the cleansed insertion site.
When using an over-the-needle catheter, insert with bevel up at a 450 angle until through the skin, then immediately lower the angle to 20-300 (You may use a 20-300 insertion angle throughout).