Equipment
- IV tubing(s), solution(s)
- Appropriate safety engineered IV catheter
- T-connector extension set as required if not present on catheter
- 10 mL syringe with normal saline (NS) without preservative
- One-piece needleless connector injection cap (MicroCLAVE Clear Connector)
- Sterile transparent dressing
- Disposable latex free tourniquet
- 2 dry wipe
- 2x2 gauze
- Chlorhexidine 2% in 70% alcohol swabs x3
- Clean disposable gloves (non-sterile)
- Clear tape (paper tape for sensitive skin)
- Arm board, cotton balls and protective cover as needed
- Clippers or scissors if needed
- Securement device if needed
INITIATING PERIPHERAL VASCULAR ACCESS [Internet]. 2022. Available from: https://shop.healthcarebc.ca/phsa/BCWH_2/BC%20Children%27s%20Hospital/C-05-12-60010.pdf
PIV Insertion
- POSITION patient in comfortable position and hold as necessary. OBTAIN help of second HCP as needed
- SELECT appropriate peripheral site for venipuncture. Avoid areas of flexion, such as wrist or antecubital fossa. Avoid feet after walking age and in children older than 10 years
- CLEANSE venipuncture site and area to be covered by dressing with chlorhexidine/alcohol pad using friction for 30 seconds and
- ALLOW to air dry for 60 seconds
- APPLY tourniquet 10 – 15 cm, dependent on child’s size, above insertion site
- PERFORM venipuncture
- STABILIZE selected vein using the non-dominant hand
- PENETRATE skin at a 10-30 degree angle with the bevel end up
- LOWER CATHETER almost parallel to skin
- ADVANCE catheter into the vein; DO NOT reinsert needle/stylet once it has been partially or completely withdrawn from the catheter
- PULL BACK THE STYLET, advance the catheter forward into the vein
- OBSERVE for positive blood return in catheter or flashback chamber
- REMOVE stylet activating the safety feature as per manufacturer’s guidelines
- RELEASE the tourniquet
- ATTACH needleless cap with syringe with pre-filled normal saline
- UNCLAMP tubing, FLUSH tubing gently while observing site and CLAMP
- LEAVE syringe attached until ready for IV tubing connection and IV securement is completed
PIV Insertion Video
Ultrasound-guided PIV Insertion
Peripheral Intravenous Line Placement [Internet]. 2017. Available from: https://youtu.be/W4_9louZ4OU?si=ImcaOzEOv1enkS6f
Shared with permission of the American Thoracic Society. https://youtu.be/4s0V-NMaUdg?si=hZ7b-q8-kBJ2fKCT
PIV Troubleshooting
PIV Troubleshooting
BCCH Child & Youth Health Policy and Procedure Manual. PERIPHERAL INTRAVENOUS (PIV) TROUBLESHOOTING GUIDELINES [Internet]. 2012. Available from: https://shop.healthcarebc.ca/phsa/BCWH_2/BC%20Children%27s%20Hospital/C-05-07-62482.pdf