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Occasional ramblings by an anesthesiologist/mother (and sometimes her husband).

Monday, March 16, 2009

BufBloPoFo09 Day 3 - How to start an IV

So today I'm supposed to teach something. So how about something I do every day and can do pretty much half asleep.

Talk to the patient, see if they tell you that there's one spot where they always take blood from or if there's a spot where everyone tries and misses.

Put the tourniquet up and look for a promising vein.

Take the tourniquet down.

Prep your equipment - tape and dressing are open and in reach; you have angiocaths availble (at least 2 in the size you want to try, plus a smaller and a bigger one); the saline trap/iv bag with line are ready.

Wipe of the spot with an alcohol swab.

Put the tourniquet back up.

Use your non-dominant hand to hold the pt's hand/arm and pull the skin taut.

Grab the angio in your dominant hand with your thumb and middle finger (kinda like a pencil).

Insert the angio into the skin at about a 30 degree angle.

Look for the flash of blood.

Push the angio with the needle still inside another few milimeters.

Advance the angio off the needle, keeping the needle perfectly still, until the hub is at the skin.

Leave the needle in and put first piece of tape/occlusive dressing to secure.

Attach the saline trap/iv line.

Secure the trap/iv line to the skin.

Leave a loop to keep tension off the line and keep it from kinking.

See you tomorrow.

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