Gather Supplies: 💉🧴🩹🧤🗑️

• IV catheter (appropriate gauge)
• Tourniquet
• Antiseptic solution (chlorhexidine, alcohol)
• Gauze pads (sterile)
• Transparent dressing
• Gloves (sterile)
• Sharps container

Prepare Yourself and the Patient: 🧼🗣️

• Perform hand hygiene (wash hands thoroughly or use hand sanitizer). 🧼
• Introduce yourself to the patient, explain the procedure, and obtain consent. 🗣️
• Position the patient comfortably.

Select the Vein: 👀

• Choose a suitable vein in the patient’s arm or hand. Look for a vein that is:
  • Straight
  • Large enough for the catheter
  • Easily visible or palpable
• Avoid areas that are:
  • Near a joint
  • Damaged or inflamed
  • Previously used for IV insertion

Apply the Tourniquet: tourniquet

Apply the tourniquet around the patient’s upper arm, proximal to the selected vein. Ensure the tourniquet is tight enough to distend the vein but not so tight that it cuts off arterial blood flow (you should still be able to feel a pulse).

Clean the Insertion Site: 🧴

Clean the skin over the selected vein with the antiseptic solution. Start at the intended insertion site and move outward in a circular motion. Allow the antiseptic solution to dry completely.

Prepare the Catheter: 💉

Remove the IV catheter from its packaging, maintaining sterility. Inspect the catheter for any damage.

Perform Venipuncture: 🧤💉

• Put on sterile gloves. 🧤
• Anchor the vein by gently pulling the skin taut distal to the insertion site with your non-dominant hand.
• Hold the catheter in your dominant hand, with the bevel (opening) of the needle facing up.
• Insert the needle through the skin at a shallow angle (10-30 degrees) just proximal to where you plan to enter the vein.
• Advance the needle slowly until you see a “flashback” of blood in the catheter’s flashback chamber.

Advance the Catheter: ➡️

Once you see the flashback, lower the angle of the catheter slightly and advance it a few millimeters further. Hold the needle steady and gently slide the plastic catheter off the needle and into the vein until the hub is at the insertion site.

Remove the Needle and Secure the Catheter: 💉🩹

• Release the tourniquet.
• Apply pressure to the vein just proximal to the catheter tip with your non-dominant hand to prevent bleeding.
• With your dominant hand, carefully remove the needle from the catheter and activate the needle’s safety mechanism (if applicable) to prevent needlestick injuries.
• Immediately connect IV extension tubing or a compatible connector to stabilize the catheter.
• Secure the catheter to the patient’s skin with a transparent dressing. Ensure the dressing does not cover the insertion site.

Confirm Patency and Dispose of Sharps: 💧🗑️

• Gently flush the catheter with a small amount of sterile saline solution to check for patency (free flow) and to ensure there is no infiltration or swelling.
• Dispose of the needle in an approved sharps container. 🗑️

Document the Procedure: 📝

Document the date, time, location of insertion, catheter gauge, number of attempts, and patient’s response to the procedure.

Gather Supplies: 💉🧴🩹🧤

• IV catheter (appropriate gauge)
• Tourniquet
• Antiseptic solution (chlorhexidine, alcohol)
• Gauze pads (sterile)
• Transparent dressing
• Gloves (sterile)
• Sharps container
• Ultrasound machine with a linear probe
• Sterile ultrasound probe cover
• Sterile ultrasound gel

Prepare the Ultrasound Equipment: अल्ट्रासाउंड

• Position the ultrasound machine for easy visualization during the procedure.
• Apply a small amount of sterile gel to the ultrasound probe.
• Cover the probe with a sterile probe cover, ensuring no air bubbles are trapped.

Prepare Yourself and the Patient: 🧼🗣️🛌

• Perform hand hygiene. 🧼
• Introduce yourself to the patient, explain the procedure (including the use of ultrasound), and obtain consent. 🗣️
• Position the patient comfortably, with the arm supported and extended. 🛌

Identify a Suitable Vein with Ultrasound: 👀 अल्ट्रासाउंड

• Turn on the ultrasound machine and select the appropriate settings (usually a vascular or small parts setting).
• Place the ultrasound probe on the patient’s skin, using a small amount of gel to ensure good contact.
• Identify a suitable vein. Look for a vein that is:
  • Large enough for the catheter
  • Located away from arteries and nerves
  • Straight, with minimal valves
• Assess the depth and course of the vein.

Apply the Tourniquet: tourniquet

Apply the tourniquet proximal to the selected vein, as in the standard procedure.

Clean the Insertion Site: 🧴

Clean the skin over the selected vein and the surrounding area with the antiseptic solution. Allow the solution to dry completely.

Prepare the Catheter: 💉

Remove the IV catheter from its packaging, maintaining sterility. Inspect the catheter for any damage

Perform Ultrasound-Guided Venipuncture: 🧤💉

• Put on sterile gloves. 🧤
• Hold the ultrasound probe in your non-dominant hand.
• Hold the catheter in your dominant hand, with the bevel of the needle facing up.
• Visualize the vein with ultrasound as you insert the needle into the skin at a shallow angle (usually 15-30 degrees).
• Advance the needle under direct ultrasound visualization, keeping the vein centered on the screen. Use either a short-axis or long-axis approach, depending on your preference and the vein’s location.
• Watch for the needle tip to enter the lumen of the vein.

Advance the Catheter: ➡️

Once the needle tip is confirmed to be in the vein, advance the catheter over the needle, as in the standard procedure.

Remove the Needle and Secure the Catheter: 💉🩹

• Release the tourniquet.
• Apply pressure to the vein just proximal to the catheter tip with your non-dominant hand.
• Carefully remove the needle and activate the safety mechanism.
• Immediately connect IV extension tubing or a connector.
• Secure the catheter to the patient’s skin with a transparent dressing.

Confirm Patency and Dispose of Sharps: 💧🗑️

• Gently flush the catheter with sterile saline solution to check for patency.
• Dispose of the needle in an approved sharps container. 🗑️

Document the Procedure: 📝

Document the date, time, location of insertion, catheter gauge, number of attempts, patient’s response, and the use of ultrasound guidance.