1. IV Therapy
Maintenance Therapy for Peripheral IV’s
 Verify that the correct solution is hanging
 Verify that the rate is correct
 Assess amount left, availability of solution
 Change the IV bag at least every 24 hours (label)
 Change primary & secondary IV tubing along with caps
every 96 hours (label)
 Mark IV tubing for change using appropriate label
 Change peripheral IV sites every 96 hours
 Mark all peripheral IV sites with start date

2. IV Therapy (continued)
When choosing an IV site:
 Start with the distal veins of the hand and work up
 Avoid the antecubital site because it interferes with blood sampling
 Choose site free of abrasions, inflammation, and lesions
 Be considerate of patient's comfort/mobility (use nondominant arm)
 Longer and larger veins will better dilute infusions
 Start an 18 gauge if possibility of patient going to surgery or
receiving blood

3. IV Therapy (continued)
Lidocaine use for IV starts:
Lidocaine is not routinely used when starting IV’s
It is used however if a patient requests it or if the nurse feels
it will relieve the patient’s anxiety related to the IV start
The registered nurse uses topical EMLA or injects 0.2 ml of
plain 1% Lidocaine (not to exceed 1 ml intradermally) at a
peripheral intravenous site prior to insertion of the
intravenous catheter as directed by the ordering physician
Lidocaine is administered with a doctor’s order when the IV
insertion is expected to be difficult, when the patient is
anxious, and/or when the patient requests anesthesia prior to
IV insertion

4. IV Therapy (Reminders)
Documentation
 Document location, number of attempts, size of cathlon and
confirmation of patency (positive blood return, successful saline
flush)
Do not withdraw needle from catheter hub before pressing the
white button
Needle should be retracted prior to disposal in a puncture-
resistant, leak-proof container
Never reinsert needle into the catheter as this could shear the
catheter
Do not use scissors at or near the insertion site

5. IV Therapy (Tips for Success)
Site Prep – always prep site using the chlorascrub inside the
start kit. If first attempt unsuccessful obtain another single
chlorascrub to prep new site.
 Insertion Success
• slow down the speed of insertion - use less force to penetrate
the skin
• lower the initial insertion angle keeping the elbow low
 Feeling the “pop” (pop causes damage to the vein - flash is a
better indicator)
• slowing the approach allows the flash to catch up
 Seeing the flash
• Trust your instinct and take a pause - look for the flash
behind the spring
• The initial flash may be seen along the cathlon

6. IV Therapy (Tips for Success)
Threading with ease
 After flash, lower the angle and advance 1/8 inch
 Retract the Needle
 Rotating the barrel 360 ensuring cathlon seal is broken
 Release tourniquet before pressing the button
 Do not activation before it’s time (be aware of where your
fingers are)
 Remove needle cover in a straight, outward motion