6. Central Venous Access
ï‚¥ Veins located deep in the body
ï‚¥ Internal jugular, subclavian,
femoral
ï‚¥ Peripherally inserted central
catheter (PICC lines)
ï‚¥ Larger veins that will not
collapse in shock
8. Do not use any IV fluids after
their expiration date; any fluids
that appear cloudy, discolored, or
laced with particulate; or any fluid
whose sealed packaging has been
opened or tampered with.
9. IV Administration Sets
 Macrodrip—10 gtts = 1 ml, for
giving large amounts of fluid.
 Microdrip—60 gtts = 1 ml, for
restricting amounts of fluid.
 Blood tubing—has a filter to
prevent clots from blood products
from entering the body.
 Measured volume—delivers
specific volumes of fluids.
10.  IV extension tubing—extends
original tubing.
ï‚¥ Electromechanical pump
tubing—specific for each pump.
 Miscellaneous—some sets have
a dial that can set the flow rates.
IV Administration Sets (continued)
36. Insert the flanged spike into the spike port
of the blood and/or normal saline solution.
37. Squeeze the drip chamber until it is one
third full and blood covers the filter.
38. Attach blood tubing to the intravenous cannula
or into a previously established IV line.
39. Open the clamp(s) and/or flow
regulator(s) and adjust the flow rate.
40. Factors Affecting IV Flow Rates
ï‚¥ Constricting band
ï‚¥ Edema at puncture site
ï‚¥ Cannula abutting the vein wall or
valve
ï‚¥ Administration set control valves
ï‚¥ IV bag height
ï‚¥ Completely filled drip chamber
ï‚¥ Catheter patency
42. Changing an IV Bag or Bottle
ï‚¥ Prepare the new bag or bottle.
ï‚¥ Occlude the flow from depleted bag
or bottle.
ï‚¥ Remove spike from depleted bag or
bottle.
ï‚¥ Insert spike into the new IV bag or
bottle.
ï‚¥ Open the clamp to appropriate flow
rate.
60. ï‚¥ A rigid needle is inserted into
the cavity of a long bone.
ï‚¥ Used for critical situations when
a peripheral IV is unable to be
obtained.
ï‚¥ Initiate after 90 seconds or three
unsuccessful IV attempts.
Intraosseous Infusion
73. Contraindications to Intraosseous Placement
ï‚¥ Fracture to tibia or femur on side of
access
 Osteogenesis imperfecta—
congenital bone disease resulting in
fragile bones
ï‚¥ Osteoporosis
ï‚¥ Establishment of a peripheral IV line
74. Summary
ï‚¥ Types of intravenous access
ï‚¥ Equipment for intravenous
access
ï‚¥ IV drug administration
ï‚¥ Intraosseous infusion