Peripheral IV Administration

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.