How to Start an IV | Starting an IV Clinical Nursing Skills

Registered nurses (RNs) learn in nursing school the nursing skill on how to start an IV. A nurse must learn the skill of starting an IV. This particular skill can help patients maintain their health so that they can get on with their lives after receiving medical treatment. Learning how to start an IV properly can extend the lives of patients.

Introduction on How to Start Intravenous Lines (IV)

Nurses must learn how to deliver IV therapy or Intravenous Therapy correctly because if they do not, they are putting the lives of their patients in danger. The process of using intravenous lines involves injecting liquids into the veins. Many nurses use a drip chamber so that air does not enter the patient’s blood stream. IV lines are used for medication delivery, blood transfusions, electrolyte imbalance correction, and fluid replacement. It is so important that nurse know how to use IVs because in some cases the use of IVs is the only way to administer certain medications and to perform procedures such as lethal injections and blood transfusions.

Steps on How to Start an IV

Nurses should use the following steps to start an IV (*always check the latest protocols for your area):

1. The first step in the process is to find a good vein to insert the IV. The large vein located in the bend of the elbow is most often used, but nurses can also find good vein sites on the forearm, feet, scalp, hand, and wrist if necessary.
2. Have a fellow nurse prepare the tubing and the fluid bag while the nurse that will insert the IV prepares the sight.
3. The nurse should now apply a tourniquet just a few inches above the site, securing it for easy removal after inserting the catheter.
4. Make sure that the vein is secure and wipe the area with an alcohol pad.
5. Now is the time to choose a catheter size. Children and the elderly generally use a smaller catheter, but an 18 gauge should work for most patients. Nurses should use larger gauges in emergency situations.
6. Carefully remove the cap on the catheter with one hand, and tightly pull the skin around the IV site with the free hand. Keep the catheter as parallel to the skin as possible and insert the needle. A hint of blood in the catheter’s applicator will indicate that the nurse hit the vein directly, and he or she should continue to advance the catheter.
7. While still advancing the catheter, the nurse should now remove the catheter according to the manufacturer’s instructions. Do not forget to secure the needle for the safety of everyone involved.
8. Remove the tourniquet to prevent discomfort and tissue death.
9. Using the fingers, apply pressure to the vein just above the catheter so that back bleeding does not occur.
10. The nurse should now apply tape to the area around the catheter while attaching the IV tubing.
11. Open the IV line and fluid should be dripping into the chamber if the process was successful. Look for leaking and swelling at the IV site. If this occurs, the process was unsuccessful.
12. Additional secure the IV line with additional tape. Nurses should adjust the drip rate accordingly for the patient.

Video on How to Start an IV

Tips on Starting an IV

• Choose a catheter that is a 14 or 18 gauge when quick fluid replacement is needed.
• It may not be necessary to use a tourniquet when the patient has large veins.
• Applying pressure to a vein can help straighten veins that do not look straight enough to inject.
• Always become familiar with the IV catheter brands used before administering IVs.
• Immediately stop advancing a catheter that hangs up on a valve.
• Immediately place the needle used into a sharps container in order to prevent needle sticks.

Different Types of IV Gauge Needles

How to Find a Vein

Complications with Starting an IV

Nurses will know immediately after they try to start an IV if they have done so correctly. The biggest problems come when starting the IV is a success but the nurse conducting the procedure makes mistakes during the process. The complications that can arise from an IV include air embolism, infiltration, extravascular drug administration, phlebitis, hematoma, and intraarterial injections. These complications occur when nurses make mistakes when inserting the needle and starting the IV. Although intraarterial injection is the rarest complication that can occur, it is the most life threatening of all complications.

It is so important that nurses are properly trained on the manner in which to start an IV. There are so many things that can go wrong during the procedure that can cause health issues for the IV patients. Nurses must have the skills to know where to place IVs so that the patients are comfortable and the IV process is a success.