How to Place an Intravenous Catheter

Prepare necessary materials. Fully intravenous catheterization is not as difficult as other complex procedures, but still requires the same basic level of preparation and care as any minor procedure. Before you begin, you should have all tools and equipment at hand, and make sure all supplies used on the patient’s body — especially needles — are new and sterile. To place an intravenous catheter, you will need: ^[1]

• Disposable sterile gloves
• Catheters with an “inside guide needle” of the appropriate size (usually 14 – 25)
• Intravenous fluid bag
• Garage is not made from natural rubber
• Sterile bandages
• gauze
• Alcohol soaked cotton
• Medical tape
• Medical waste bin
• Sterile paper (put small tools on it for easy access)

Introduce yourself to the patient. An important part of the intravenous catheterization process is introducing yourself to the patient and explaining the procedure to be performed. Communicate with patients and share this basic information to give them peace of mind, making sure nothing takes them by surprise. In addition, you need their absolute approval to proceed. Once completed, have the patient lie down or lie on the side of the ear where the IV catheter was placed.

• If the patient is worried, their veins may experience some constriction, also known as vasoconstriction. ^[2] This interferes with the placement of an intravenous catheter, so you need to make the patient as relaxed and comfortable as possible before proceeding.
• You should ask if the patient has had any problems with intravenous catheterization in the past. If so, they can tell you where the tube is easiest to place.

Prepare the infusion tube. Next, prime the infusion tube by hanging the bag on a high post, allow saline solution to flow into the tube, and check for bubbles. If necessary, clamp the tube so that the solution does not drip onto the floor. All bubbles must be removed from the pipe by flicking, squeezing or running the solution through the tube. You then put a signed and dated label on both the infusion tube and the bag. ^[3]

• Injecting air bubbles into the patient’s bloodstream can cause a very dangerous embolism.
• An easy way to remove air bubbles from the infusion tube is to completely straighten the coil and open the valve all the way toward the infusion chamber. Then use the tip of the infusion tube to pierce the fluid bag, and squeeze the infusion chamber. Open the valve so that the solution flows down the length of the pipe without creating air bubbles.

Select an intravenous catheter of the appropriate size. Often an intravenous catheter is attached to a needle used to puncture a vein. After penetrating the vein wall, the catheter is left in place for easy access to the vein. Intravenous catheters come in different sizes. The smaller the size, the thicker the catheter, the faster the medicine can get in, and the faster the blood can be drawn out. However, thick catheters also cause more pain when inserted, so you should choose a larger intravenous catheter than necessary.

• In general, you usually use an intravenous catheter in a size 14-25. Choose a larger (thinner) IV catheter for children and the elderly, but choose a smaller size when you want to infuse fluids faster.

Wear sterile gloves. Intravenous catheterization means piercing the skin and inserting the device directly into a blood vessel. To avoid dangerous infection, you must wash and dry your hands with a clean tissue before proceeding, and then put on sterile gloves before handling the device and touching the patient. If at some point your gloves are no longer sterile, you need to change them — better safety than regret later. Here are situations where most medical standards require a glove change: ^[4]

• Before touching the patient
• Before sterile procedures (such as intravenous injections)
• After procedures where there is a risk of touching bodily secretions
• After touching the patient
• After touching objects around the patient
• Before coming into contact with another patient

Find prominent veins. You need to find a place on the patient’s body to place the intravenous catheter. For adults, the most accessible veins are the long, straight veins located in the arms, not near the joints, and furthest from the body. For children, the head, hands or feet are preferred positions over the legs, arms or elbows. Although you can insert a catheter in any easy-to-find vein, it’s best to avoid veins in your dominant hand. ^[5] If the patient has a history of difficult to find veins, ask where the previous doctor injected them. Often people who have had difficulty with intravenous injections know the easiest places to find veins. Keep in mind, even though you can find a vein, there are some places where you should n’t have a catheter. They are: ^[6]

• Places where intravenous catheters interfere with surgery
• The same location as the place where the venous catheter was recently inserted
• At the site showing signs of infection (redness, swelling, irritation and etc.)
• On the arm or leg on the same side as a mastectomy or open-heart surgery (this can lead to complications)

Wrap the tourniquet. To make the vein swell for easy puncture, wrap the tourniquet behind (in the direction of the upper body) the site where the venous catheter is intended. For example, if you are going to insert an intravenous catheter into the inside of the forearm (typical location), wrap the tourniquet at the biceps.

• Do not wrap the tourniquet too tightly as the hands can be bruised, especially for the elderly. The tourniquet should wrap tightly but not so tightly that you cannot slip a finger underneath.
• Keeping your arm hanging on the floor during a tourniquet will help the veins stand out more as the blood rushes to that arm.

Tap a vein if needed. If you can’t see a suitable vein, try patting the skin where the catheter is to be inserted. Place your finger along the vein and press down. You should feel the vein “push back”. Continue pressing up and down for about 20-30 seconds. The veins will become larger. ^[7]