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.