IV Tips & Tricks
IV
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to look, they automatically retract their arm, and this can cause you to
lose the insertion site," she says.
Ask the patient to slide over to the railing on the far side from you,
which will allow more room for the arm on which you're working.
Laying the arm flat on the bed will stabilize it and works better than
having the arm hanging off the edge of the bed.
"The goal is to position yourself distally to the vein and keep the
catheter aligned with the vein," says Ms. Gallagher.
Because no 2 arms are shaped alike, you can use a rolled blanket or
pillow to straighten the arm. The hand should hang off the end of the
blanket or pillow, which gets the knuckles out of the way if you're
using a hand vein. Having to hold the catheter over the knuckles can
change the entry angle of the needle, which can cause you to go too
deep and miss the vein. For bigger patients who fill the stretcher, you
can also use the bedside table to straighten out the arm and create
more workspace for yourself to insert the IV. Adjust the table to lift or
lower the arm to a more workable and comfortable angle, says Ms.
Gallagher.
Tourniquet etiquette
When applying the tourniquet, be aware of the hair on the
patient's arm. Instead of putting the tourniquet directly on a hairy
arm, put something between the arm and the tourniquet so you don't
pull on the hair. You can use a sleeve, wrap a piece of gauze around
the arm before applying the tourniquet, or even use a blood pressure
sleeve and set it on IV start, says Nikolaus Gravenstein, MD, profes-
sor of anesthesia at the University of Florida College of Medicine in
Gainesville.
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