The Process of Starting an IV (intravenous)
Several skills are beneficial to the nurse and paramedic, but perhaps one of the most important skills is the ability to place an intravenous catheter into a vein. This procedure is most commonly referred to as “starting an IV”. In today’s medical community, intravenous cannulation is necessary for the administration of many antibiotics and other therapeutic drugs. Listed below are the procedures and guidelines for starting a successful IV. Following these instructions will provide a positive experience for the patient and clinician.
First, you must obtain all of the necessary supplies: gloves, alcohol or Betadine preps, a tourniquet, tape, an appropriately sized IV catheter, a bag of IV solution, the IV tubing, and gauze pads. While obtaining the supplies, you should inform the patient that IV catheter placement is necessary, and why. Do not lie to the patient and tell him or her that it is a painless procedure. Instead, be honest with them and explain that the initial puncture feels like a sharp pinch on the skin and that the pain and discomfort associated with the IV placement is only temporary. You may find it helpful to demonstrate to the patient the amount of pain to expect by pinching the skin on the back of their hand. This is especially helpful for younger patients or patients who are more concrete in their thinking.
Now, assemble and arrange all of the needed supplies so that they are easily accessible. Connect the IV tubing to the solution bag and allow the fluid in the bag to run through the entire length of the tubing, also known as priming the tubing. When this is done, clamp the tubing closed. You will then need to tear several pieces of tape, six to eight inche...
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...f the clamps on the tubing to allow the IV solution to run freely. Slowly, decrease the flow of the solution to the appropriate rate as ordered by the physician. Using a small gauze pad, wipe away any excess blood or fluid on the surface of the skin. Then, using the pre-torn pieces of tape, secure the catheter hub and the IV tubing to the patient’s skin. Take extra caution not to kink the tubing. Once everything is secured, recheck the IV solution’s flow and then attend to the rest of your patients needs.
Starting a successful IV takes practice, time, and patience. Once you have perfected this procedure, you will see that the above steps are simply guidelines to help beginners. As your experience grows, you will develop your own techniques and preferences. Remember these steps, and both you and your patient will have a successful IV catheter placement experience.
An interesting combination of recalled events and editorial commentary, the story is not set up like a traditional short story. One of the most interesting, and perhaps troubling, aspects of the construction of “How to Tell a True War Story” is O’Brien’s choice to create a fictional, first-person narrator who might just as well be the author himself. Because “How to Tell a True War Story” is told from a first-person perspective and O’Brien is an actual Vietnam veteran, a certain authenticity to this story is added. He, as the “expert” of war leads the reader through the story. Since O’Brien has experienced the actual war from a soldier’s point of view, he should be able to present the truth about war...
The truth to any war does not lie in the depths of storytelling but rather it’s embedded in every person involved. According to O’Brien, “A true war story does not depend on that kind of truth. Absolute occurrence is irrelevant. A thing may happen and be a total lie; another thing may not happen and be truer than the truth” (pg. 80). Truths of any war story in my own opinion cannot be fully conveyed or explained through the use of words. Any and all war stories provide specific or certain facts about war but each of them do not and cannot allow the audience to fully grasp the tru...
Then after threading a catheter through the needle, the anesthesiologist will withdraw the needle and leave the catheter i...
IV sedation is reserved for our most complicated procedures and patients with very high levels of fear and anxiety. IV sedation creates a sleep-like state that allows you to wake up from a procedure with no memory of the sights, smells, sounds, or sensations that occurred during the treatment. This form of sedation is administered through an intravenous line and only by a licensed
In the chapter “How to Tell a True War Story”O’Brien elaborates on how the differences between the “story-truth” and “happening-truth,”
will require intravenous cannulation” (Ogston-Tuck, 2014). The key to prevention is knowing the cause of the problem. Some key nursing interventions as noted in the [Manual of IV Therapeutics] include using aseptic technique
A true war story is not always true. Some would say a true war story is an experience from war. Others, who came from war, would say they make up stories to make war seem crazier than it really is. Tim O’Brian states that the story is fiction, but the moral is true. Tracy Kidder had written war stories based on his time in Vietnam, and his book is rated as nonfiction, even though he admits that some war stories are made up.
The needle is usually inserted into in a vein close to the elbow, the wrist, or placed on the back of the hand. IV infusion works effectively because gravity pushes the fluid down through the IV tubing into the patient's vein. The higher the bag is hung, the greater the gravitational pressure on the IV fluid to flow downward through the tubing. To get enough pressure for gravity to force the fluid into the vein at a constant rate, the IV bag needs to be hung high. So, all IV bags must be hung above the ...
Distance from the flashing light: a distance of 2 feet or more is safe and can cause minimal effect to the people with epilepsy. However, very close distance (less than two feet away) can trigger the seizures. Therefore, there is need for the disable individuals to stay at least two feet away from the flashing light and in a well-light environment.
Additionally, the LPN cannot push medications into a peripheral intravenous line if the patient “weighs less than 80 lbs, is prenatal, pediatric, or antepartum”, although given that the situation is on a general med-surg floor it is unlikely these patients would be under Sarah’s care at this time. (Rules and Regulations of Practical Nurses. 2015) Sarah can delegate the postoperative patients who need dressing changes and ambulating them to the LPN, but Sarah should assess the wounds for complications initially and serve as resource to the LPN if she has questions about the wounds. Additionally, she could help the nursing assistant with answering calls and serve as a reference for the nursing assistant to ask questions or help with tasks if Sarah is not available. With regards to supervision, the LPN would need continuous supervision given that the working relationship is new. (Cherry and Jacob, 2014) Sarah should be available and willing to answer any questions or address any concerns the LPN
Several stories into the novel, in the section, “How to tell a true war story”, O’Brien begins to warn readers of the lies and exaggerations that may occur when veterans tell war stories.
In his assessment of storytelling, O’Brien highlights the challenges of telling stories by including many tales that take place after the Vietnam War. For example, back in America, the soldier’s of Vietnam found
On 25 June 1950, the Republic of South Korea was invaded by the North Korean Democratic people. Then, many things started to happen and these showed that they became the main significance of the Cold War that had been going on between the Allies power and the communists, since World War II was over. The invasion by the North Korean communists made President Harry Truman got furious. He looked at the attack as a direct dispute to America's decision to fight against international communism and to his 1947 Truman Doctrine. As a result, the Korean War broke out, which lasted for about three years. Just like in the Battle of Stalingrad, the Korean War left behind huge impacts and consequences. The Korean War and the Battle of Stalingrad each placed huge strain upon civilian populations, including mass executions, destruction of property and tolls of prisoners or wars.
After almost one hour of “tube procedure connections”, I got up to go to the restroom with an IV pole following my s...
Keep the patient NPO, and establish two IV access sites with a large bore catheters running one IV with NS at KVO and morphine sulfate for pain. Initial laboratory testing including a complete blood cell count (CBC), basic metabolic panel (BMP), cardiac enzymes (creatine kinase, creatine kinase-MB, and cardiac Troponin) and repeat in 90 min. Administer antiplatelet ASA 324mg PO (Sen, B., McNab, A., & Burdess, C., 2009, p. 18). Before administering nitroglycerin 0.4 mg SL (every 5 minutes up to three doses) reassess blood pressure if systolic <90 mmHg, patient has used cocaine in the last 24 hours, or taking PDE-5 inhibitors do not administer. Thrombolytic therapy should be implemented within 30 minutes from the patient’s arrival to the emergency department, and if they are a candidate for cardiac catheterization it should be done within 90 minutes from the patient being admitted to the hospital. Delay on either therapy option increases the risk of mortality (Kosowsky, Yiadom, Hermann, & Jagoda, 2009, p. 10).