INSERTION OF PERIPHERAL IV LINE

Aims

To gain peripheral venous access in order to:

• administer fluids

• administer blood products, medications and nutritional components.

To minimise the risk of complications when initiating IV therapy through:

• judicious choice of equipment

• careful choice of IV site

• good insertion technique

• aseptic preparation of infusions

Key points
In the case of two unsuccessful attempts at insertion, the operator will seek the assistance of another experienced nurse for one additional attempt. After a total three unsuccessful attempts the assistance of a medical practitioner will be sought.
PROCEDURE & ADDITIONAL INFORMATION

1. Explain procedure to patient/parent


2. Wash hands with antiseptic soap.


3. Don gloves
   (Strict adherence to hand washing and
   aseptic technique remains the
   cornerstone of prevention of cannula
   related infections)


4. Apply the tourniquet above insertion site(For paediatric patient, an assistant's hand used both as a tourniquet and restraint is
   often more acceptable to a child than a
   tourniquet)


5. Disinfect the selected site with skin prep
   and allow to dry.
   (Do not touch the skin with the fingers after
   preparation solution has been applied)


6. If infiltration of local analgesia is
   required, inject lignocaine 1% at the
   proposed site of entry of cannula.
   (Lignocaine may only be injected by a
   Medical Officer)


7. Inspect the cannula before insertion to
   ensure that the needle is fully inserted
   into the plastic cannula and that the
   cannula tip is not damaged.
   (Do not touch the shaft or tip of the
   cannula)


8. Ensure the bevel of the cannula is
   facing upwards.
   (Facilitates the piercing of the skin by the
   bevel)


9. Insert the needle and the cannula into
   the vein.
   (Gentle traction on skin may stabilise the
   vein under the skin)


10. Partially withdraw the needle and
    advance the cannula.


11. Release the tourniquet


12. Secure the hub of the cannula with
    clean adhesive tape.
    (Do not cover the puncture site. Cut tape
    immediately prior to use only)


13. Flush the cannula with normal saline (Ensures the line is patent and accessible )


14. Cover the intravenous and surrounding
    area with a sterile transparent dressing.
    (Ensure that the insertion site and the area
    proximal to the site are visible for
    inspection purposes)


15. If infusion ordered, prime the line and
    connect the intravenous giving set to the
    cannula


16. Note the date and time of insertion in
    the patient's medical record.
    Record date of line change and secure
    to IV line
    (Intravenous lines used for intermittent
    infusions must be labelled with the
    patient’s name, and the date and time of
    commencement)


17. If the site needs to be immobilised, use
    a well padded splint and strapping if
    necessary.
    (For infants <12>)


18. Dispose of equipment safely