Page 229 - 2023 SMOG Digital

VASCULAR ACCESS

(INTRAVENOUS)

CLINICAL INDICATIONS:
• Need for intravascular access to provide resuscitative fluids and/or medications.
• Anticipated need for intravenous access in emergency patients.
CONTRAINDICATIONS:
• Injuries proximal to IV site/ipsilateral to IV site (relative).
PROCEDURE:
• Prepare all necessary equipment: PPE, tourniquet, IV catheters, alcohol/betadine wipe,
saline lock or IV tubing, IVFs if administering, and tape/securing device.
• Ensure all IV tubing/saline locks flushed prior to attempting IV.
• Place venous tourniquet proximal to anticipated IV puncture site.
• Identify vein to be cannulated and cleanse overlying area with alcohol/betadine.
• While holding traction on skin/vessel, cannulate the vessel (use a shallow angle of attack
with the needle). Once flash returned, advance slightly to ensure catheter in vessel,
then advance catheter only fully into vessel (should pass without resistance).
• While holding pressure proximally on vein and maintaining catheter position, remove
tourniquet and needle. Attach NS flush and flush IV – this fluid should flow easily into
the vein – any resistance suggests missed attempt or “blown” vein. (Note: If blood
samples being drawn – they should be taken prior to removing tourniquet and always
prior to flush (after flushing – may obtain dilute sample which will alter results.)
• Secure catheter using transparent dressing or tape.
• Repeat until 2 IV sites have been established and are functional.
Document procedure, results, and vital signs.

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