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Peripheral Intravenous Catheter Insertion

Overview

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT

The purpose of peripheral intravenous catheter (PIV) insertion is to infuse medications, perform intravenous (IV) fluid therapy, or inject radioactive tracers for special examination procedures. Placing a PIV is an invasive procedure and requires the use of an aseptic, no-touch technique.

Common IV venipuncture sites are the arms and hands in adults and the feet in children. According to the Intravenous Nurses Society (INS), the feet should be avoided in the adult population because of the risk of thrombophlebitis. Venipuncture sites should be carefully assessed for contraindications, such as pain, wounds, decreased circulation, a previous cerebral vascular accident (CVA), dialysis fistulas, or a mastectomy on the same side. The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. The cephalic vein has been associated with nerve damage when used for IV placements. The most distal site available on the hand or arm is preferred so that future venipuncture sites may be used if infiltration or extravasation occurs.

This video will demonstrate the insertion of a PIV, including the preparation and attachment of an IV extension set. Although a PIV securement device is used here to stabilize the IV catheter, according to INS recommendations, some facilities may not elect to purchase these devices, and the alternate chevron or U-shaped taping method may also be used.

Procedure

1. General PIV placement considerations (review in the room, with the patient).

  1. Upon first entering the patient's room, wash hands with soap and warm water, applying vigorous friction for at least 20 s. Hand sanitizers may be used if the hands are not visibly soiled, but vigorous friction should also be applied.
  2. At the bedside computer, log into the patient's electronic health record and review the patient's orders for PIV insertion. Review the patient history for potential bleeding comp

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Application and Summary

Placement of a PIV using venipuncture with an over-the-needle catheter for infusion therapy is an aseptic, no-touch procedure. Always educate the patient about the procedure and possible complications prior to venipuncture. Inform the patient about the process and the pain associated with insertion. In addition, many patients mistakenly think the needle remains in the vein after venipuncture. It is important to emphasize that only the soft, flexible catheter portion remains and that they will be able to move the limb fre

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References
  1. Policies and procedures for infusion nursing, Fourth Edition. Chapter 5: Vascular access device site selection and placement. Infusion Nurses Society. (2011).
  2. Potter, P. A., Perry, A. G. Fundamentals of Nursing, Seventh Edition. Elsevier. St. Louis, MO. (2009).
Tags
Peripheral Intravenous CatheterNursing ProcedureAseptic TechniqueIV Extension SetCommon SitesArmsHandsFeetThrombophlebitisMedian Cubital VeinCephalic VeinDistal SiteInfiltrationExtravasationPainWoundsDecreased CirculationCerebrovascular AccidentDialysis FistulasMastectomyHand HygieneElectronic Health RecordBleeding Complications

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0:00

Overview

0:40

Patient Preparation

2:46

Supply Preparation

6:29

PIV Insertion Technique

11:19

Summary

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