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
  1. POSITION patient in comfortable position and hold as necessary. OBTAIN help of second HCP as needed
  2. 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
  3. CLEANSE venipuncture site and area to be covered by dressing with chlorhexidine/alcohol pad using friction for 30 seconds and
  4. ALLOW to air dry for 60 seconds
  5. APPLY tourniquet 10 – 15 cm, dependent on child’s size, above insertion site
  6. 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    • ADVANCE catheter into the vein; DO NOT reinsert needle/stylet once it has been partially or completely withdrawn from the catheter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
  7. OBSERVE for positive blood return in catheter or flashback chamber
  8. REMOVE stylet activating the safety feature as per manufacturer’s guidelines
  9. RELEASE the tourniquet
  10. ATTACH needleless cap with syringe with pre-filled normal saline
  11. UNCLAMP tubing, FLUSH tubing gently while observing site and CLAMP
  12. LEAVE syringe attached until ready for IV tubing connection and IV securement is completed
PIV Insertion Video
Remote video URL

Ultrasound-guided PIV Insertion

Remote video URL

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

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