The first step in this skill is to clearly explain the procedure to the patient.
After we have done that. We need to establish and set up our equipment.
Our equipment that we need for this skill
includes our IV solution
Our administration set, IV catheters,
Our sharps container and our universal start kit.
The first item that we are going to set up is our IV solution
First we need to make sure that we have the correct solution.
We need to make sure that it is clear and there's no particulate matter in it.
We need to make sure that it has a good expiration date
and we need to make sure that tail ports have the correct cover on them
Next is our administration set
For this we will be using a 10 drop set
After we've chosen the correct administration set
We'll go ahead and remove it from the packaging
and we will go ahead and untangle the tubing
From here we want to make sure that the protective caps are on both ends.
and we want to move the flow clamp close to the drip chamber
From there we will remove our saline solution from the packaging
remove the tail port cover
we'll remove the cover from the drip chamber
and we are going to spike the bag by pushing and twisting them together.
Once we've broken the seal
We'll go ahead and turn the bag upright.
we'll squeeze the chamber until it's about halfway full
From there we are going to purge the air out of the administration set
Once the air has been purge from the line we will close the flow clamp
We'll take the bottom of the administration set
and attach it to the flow clamp
and from there we'll hang the saline solution where it needs to go.
After we've set up our saline solution and administrative set
we are going to get ready to perform a venipuncture.
At this time we set up our equipment.
First we are going to set up our tape.
After that we are going to set up our alcohol swab.
Our gauze 2 by 2.
and our occlusive dressing which in this case happens to be a tegaderm.
after that is completed it's time to put our PPE on
We are going to let the patient know that at this time
we are inspecting for a possible site for cannulation.
Once we find a site that we think will be to be ok
we are going ahead and apply our tourniquet.
Once the tourniquet has been applied we can go ahead a palpate the area.
Once we are satisfied with it we will go ahead
and pour our alcohol swab out and we will clean
using the aseptic technique starting inside and working out.
Once the area has been cleaned we are going to go ahead
and choose the appropriate IV catheter
In this case it will be a 20 gauge IV catheter.
we are going to try and maintain sterility as much as possible
as we pull it out of the packaging.
Once we have it we'll go ahead and pull the cap off
We are going to inspect for burrs and we are going to loosen the hub.
From here we are going to let the patient know
that we are getting ready to perform the puncture
We are going to grasp the arm from underneath
pulling the skin tight so that the vein is stable.
We are going to come in with the stylet bevel up.
at a 45 degree angle and what we are looking here for is
as we insert a pop and as well our flash chamber filling.
Once we have the flash chamber filled and we felt the pop
we are going to go ahead and lower an eighth to a quarter of an inch
advance the catheter
until the hub meets the skin and lock out our needle.
From there we will go ahead and pinch the hub into place
remove the needle
and sharps it immediately.
at this time if we need to perform a venous blood draw
we could by attaching a syringe and drawing back
since we don't need to we are going to go ahead and attach our administration set.
Release our tourniqet
and we are going to go ahead and open up the flow
looking for a patent line. At this time we have a patent line.
We can go ahead and secure it using the tegaderm.
Once the line has been secured
we are going to be inspecting for infiltration and any kind of irritation.
We are also going to be inspecting for the therapeutic effect
of our normal saline solution.