Peripheral IV Administration

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Section 9 - Procedure Guidelines

9.25 PERIPHERAL IV ADMINISTRATION

Preparing the IV:

The E.M.S. personnel correctly assemble the components:

  • IV solution.
  • Micro drip, macro drip, blood set tubing, buretrol or dial-a-flow
  • # 14 - #24 catheter over the needle, or butterfly needle.
  • Venous tourniquet.
  • Antiseptic swab.
  • Gauze pad or adhesive bandage.
  • Antibiotic ointment.
  • Veniguard.


Preparation:

  • Open IV bag for clarity, expiration date, etc.
  • Examine the IV bag envelope at the edge where it is notched.
  • Read the name of the solution.
  • Open IV tubing.
  • Close control valve below the drip chamber.
  • Insert IV tubing in the IV solution bag port.
  • Squeeze the drip chamber until the drip chamber is half full of solution.
  • Uncap distal end of tubing and hold the cap so it does not become contaminated.
  • Open the IV tubing valve to allow the solution to flow through until all bubbles are out of the tubing.
  • Close the tubing valve and recap the distal end of the tube.


Insertion:

  • Explain to the patient that an IV is going to be started.
  • Place the tourniquet around the patient's arm proximal to the IV site.
  • Palpate veins for resilience.
  • Clean the skin with the antiseptic swab in an increasing sized concentric circle and follow it with an alcohol swab.
  • Stabilize the vein distally with the paramedic's thumb/fingers.
  • Enter the skin with the bevel of the needle facing upward.
  • Enter the vein, obtain a flashback, and advance the catheter off of the catheter over the needle and remove the needle while compressing the proximal tip of the catheter to minimize blood loss.
  • Remove the tourniquet.
  • Connect IV tubing to the catheter.
  • Open the IV clamp to assure free flow.
  • Set IV infusion rate.


Secure:

  • Tape gauze or adhesive bandage with antibiotic ointment over the insertion site of the skin.
  • Secure the IV catheter and tubing with prepared tape.
  • Recheck IV drip rate to make sure it is flowing at appropriate rate.


Troubleshooting the IV, (if the IV is not working well):

  • Make sure the tourniquet is off.
  • Check the IV insertion site for swelling.
  • Check the IV tubing clamp to make sure it is open.
  • Check the drip chamber to make sure it is half full.
  • Lower the IV bag below IV site and watch for blood to return into the tubing.