NEVER place an IV line in an arm with a fistula or the same side as a mastectomy.
- This is one of the most common procedures required of you during your intern year and is a vital skill to become good and efficient at.
- On call you will undoubtedly be asked on numerous occasions to either insert or re-site an IV line.
- Currently the hospital is testing pre-made IV kits (not available on every ward) which contain all the supplies needed apart from gloves and the cannula.
- Always use an aseptic/no touch technique – hand hygiene!
- Document the insertion date and site – hospital policy is that all lines should be reviewed by a doctor after 72 hours.
- Scrub the bung with an alco-wipe before and after each use.
Tips
- You should generally start off with pink and slowly graduate down to blue lines in all routine cases. Some situations require wider-bore lines (CCU and unstable patients). Try using green lines in these situations.
- If the line has been difficult or the patient looks like they may pull the line out, connect the bung directly to the cannula and wrap it in a crepe bandage.
- Remember – smaller lumen tissue quicker.
- If you are having difficulty with a line – try hanging the arm over the bed and let gravity do its work.
- If inserting a new IV line, you can on this instance take bloods from the line but remember not to flush the line until samples are taken.
Equipment
- Iv Cannula (See table below)
- Gauze x3
- Syringe (10mls)
- Saline flush
- Tegaderm
- Tape
- Alcohol/Chlorhexidine wipes x2
- T-connector and blue bung
- Tournastrips should now be in all clinical rooms (do not use gloves)
Cannula | Colour | Guage |
---|---|---|
Smallest | Yellow | 24G |
Small | Blue | 22G |
Standard | Pink | 20G |
Big | Green | 18G |
Large (Resus) | Grey | 16G |
Huge (Anaes) | Orange | 14G |