Intravenous Catheter Placement (Emergency Medicine)

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  • Administration of fluids, blood products, medications, or contrast dyes for radiologic diagnostic studies

Absolute Contraindications

  • Cellulitis in the skin overlying the venipuncture site
  • Severe trauma to the extremity
  • Phlebitis, thrombosis of the vessel

Relative Contraindications

  • A burn in the skin overlying the venipuncture site
  • Poorly perfused extremity
  • Extremity edema
  • Bleeding diathesis
  • A tourniquet, preferably latex
  • 70% alcohol wipes
  • If obtaining blood cultures, 10% povidone-iodine, chlorhexidine gluconate, or other antiseptic, depending on local practice
  • An 18-, 20-, 22-, or 24-gauge angiocatheter
  • Angiocatheter connection tubing
  • Normal saline in a 5- or 10-mL syringe
  • Sterile injection cap for needleless administration of solutions
  • Transparent sterile occlusive dressing
  • An immobilization board
  • Tape (cloth, plastic, or paper)
  • Gauze pads (2 × 2 or 4 × 4) and a bandage
  • Nonsterile gloves, preferably latex-free
  • Eyewear and mask should be considered. **UNIVERSAL PRECAUTIONS**
  • Local anesthetic
  • IV fluid administration supplies
  • Equipment required for blood collection includes the following:
    • 3-, 5-, or 10-mL syringes
    • Specimen tubes and blood culture bottle(s) and labels
  • Veins are thick-walled, distensible, and compressible vessels. Tendons are firmer than veins or arteries and are not distensible or compressible.
  • Venous valves are located most commonly where larger veins split into smaller tributaries, such as on the hand.
  • Vein selection:
    • The most commonly used veins for venipuncture are the cephalic and basilic veins of the antecubital region and forearm and the branches of these veins on the dorsum of the hand.
    • In neonates and infants, lower extremity veins can be used.

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The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

  • After removing the angiocatheter, apply pressure, then apply a bandage.
  • Pain
  • Hematoma at the site
  • Arterial puncture
  • Infiltration of soft tissue
  • Phlebitis, thrombophlebitis, cellulitis
  • Tendon injury, nerve injury (rare)
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