Peripheral IV Insertion




Indications



Listen






  • • Vascular access in nonemergent situations or temporary access in emergent situations.


    • Administration of fluids and electrolytes.


    • Administration of intravenous medications.


    • Administration of blood and blood products.


    • Blood sampling.





Contraindications



Listen




Absolute





  • • Do not insert through an infected site.


    • Do not insert through a burn.


    • Do not insert in an injured site.





Relative





  • • Avoid a paralyzed extremity.


    • Do not insert in a massively edematous extremity.


    • Do not insert an IV distal to injured organs (eg, do not use lower extremities when treating abdominal injuries).


    • Avoid joint area.





Equipment



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• Caution: All equipment must be latex free.






  • • Gloves.


    • Tourniquet or rubber band.


    • Tape and occlusive transparent dressing.


    • Alcohol wipes.


    • Povidone or chlorhexidine.


    • Syringe filled with injectable saline.


    • Gauze pads.


    • IV device: catheter or butterfly of appropriate size to fit the patient and the task.


    • Topical anesthetic cream.







  • • Ultrasound guiding equipment (if available and if trained in its use).





Risks



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  • • Infection.


    • Hematoma.


    • Extravasation.


    • Compartment syndrome.


    • Severe vasoconstriction if vasoactive medications are infused through a peripheral IV and extravasate.


    • Venous thrombosis.


    • Embolization of air or catheter fragment.





Pearls and Tips



Listen






  • • Plan the procedure.


    • Limit the procedure time.


    • Have a backup plan.


    • Examine all possible sites carefully before choosing one.


    • Apply gentle circumferential pressure with 1 hand on the extremity to fill up the veins, which helps identify the most appropriate site.


    • In choosing the equipment and the site for the line, consider the patient’s needs.




    • • A trauma patient will require a large bore line, preferably a short one in order to avoid high resistance with high flows.





Patient Preparation



Listen






  • • Introduce yourself to the parents and to the patient.


    • Explain to the parents and the child, if appropriate, the procedure and its purpose.


    • Choose 1 or more possible sites, and apply topical anesthetic cream.


    • Answer all of the parents’ and patient’s questions.



Jan 4, 2019 | Posted by in PEDIATRICS | Comments Off on Peripheral IV Insertion

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