Procedures
Disclaimer: the clinical information on this site is only meant to serve as a reference. Please consult with your team for individual diagnostic and treatment decisions.
- Supplies (in order of use): Chuck/pad, tourniquet, alcohol/chlorhexidine swabs, gauze, IVs (long ones), connectors, saline syringes, Tegaderms, tape
- Position the bed to your height, place pads on bed so you don’t get blood on the bed/gown
- Adjust depth of ultrasound view so your intended vessel is in the middle
- Assess artery (non-collapsible, pulsating) versus vein (collapsible)
- Places to go: forearm (antecubital, brachioradialis area, ulnar vein), upper arm (brachial vein, cephalic vein), neck (external jugular), foot (dorsal foot, posterior tibial)
- Start as distally as possible in case you damage the vein
- Assemble IV connectors with saline syringe and flush through prior to starting
- Determine angle (often more aggressive than you think) to reach vein and still have catheter length to thread in) and if you need a longer IV. Start ½ cm from the probe (screen shows vessel directly under probe and you need travel distance to reach it)
- If you have to change the angle, come out to near the skin then adjust angle
- Target sign with catheter tip in middle of vein
- Keep track of time with tourniquet on
- Flush through with syringe after taping down to confirm placement
- Supplies (in order of use): alcohol/chlorhexidine swabs, ABG kit (with assembled needle disposal kit), gauze, tape, patient label
- Position the bed to your height, place pads on bed so you don’t get blood on the bed/gown
- Move syringe so to the 1.5cc mark (cannot aspirate once in vessel)
- Start distally close to wrist bones, palpating with two fingers to determine angle/course
- Go in with about a 45-60 degree angle with your body near the distal hand and the needle moving more proximally, bevel up (so arterial blood flowing distally naturally flows upward into the bevel and syringe)
- If you miss, come up near the skin, then change angle (don’t go back and forth with needle deeply in)
- Cover with gauze and hold pressure (it’s an artery)
- Place needle into disposal kit, detach syringe, remove excess air, and cap
- MUST have patient label on syringe before bringing to the lab