
Verify the provider’s order.

Review the patient’s medical record for allergies to antiseptic solutions, adhesives, latex, and anesthetic
agents. Also, review the medical record for factors that may affect peripheral vasculature.

Gather the necessary supplies:
o
Clean/nonsterile gloves
o
Single-use tourniquet
o
Appropriate type and size of peripheral IV catheter based on patient status
o
Needless cap/extension tubing set
o
Appropriate antiseptic agent/pad based on client’s allergy status (chlorhexidine-based, povidoneiodine, or 70% alcohol)
o
Sterile 10-mL prefilled syringe (or a syringe specifically designed to generate lower injection
pressure) containing preservative-free normal saline solution
o
IV pole
o
Securement device (integrated securement device, subcutaneous anchor securement system,
tissue adhesive, or adhesive securement device)
o
Transparent semipermeable dressing
o
Label
NOTE: Commercial IV insertion kits come with or without an IV access device. Many facilities keep venipuncture
equipment on a tray or cart, enabling increased choice of access devices and easy replacement of contaminated
items.

Perform hand hygiene.

Confirm the patient’s identity using at least two patient identifiers and ask if they have any allergies.

Provide privacy.

Explain the procedure.

If the patient is in bed in an inpatient setting, raise the patient’s bed to waist level. Place the patient in a
comfortable sitting or reclining position, leaving the arm in a dependent position.

Apply a tourniquet on an upper extremity to dilate the veins and assess for an appropriate insertion site.
Verify the radial pulse. If the intended site is visibly soiled, clean it with soap and water. Clip the hair around
the insertion site if needed. Administer a local anesthetic, if indicated and prescribed.

Assess the veins in the upper extremity and identify potential sites that are easily seen or palpated. Choose
an insertion site based on the assessment findings.

Lightly palpate the site of the selected vein without visible valves or bifurcations with the index and middle
fingers of the nondominant hand. Stretch the skin to anchor the vein. If it feels hard or ropelike, select
another vein. If the vein is easily palpable but not sufficiently dilated, place the extremity in a dependent
position for several seconds or lightly stroke the vessel. Apply dry heat, if necessary.

Release the tourniquet for site preparation.

Perform hand hygiene and put on gloves.

Open and prepare the supplies. Flush the needleless cap/extension set with normal saline and keep the
syringe attached. Maintain the sterility of the end of the connector.

Clean the intended insertion site and surrounding skin with a facility-approved antimicrobial, and then
allow it to dry completely.

Reapply the tourniquet. Verify the radial pulse.

Using the thumb of the nondominant hand, stretch the skin taut below the puncture site to stabilize the
vein.

Tell the patient that the device will be inserted.

Place the short peripheral catheter on top of the vein at a 10- to 15-degree angle from the skin. Puncture
the skin and anterior vein wall, watching for blood to appear in the catheter, flashback chamber, or both.
Lower the catheter until almost flush with the skin. Advance the needle slightly into the vein after flashback
is observed to ensure the needle tip and cannula are inserted into the vein.

After inserting the IV catheter into a patient’s vein, do not let go until it has been properly secured to
prevent accidental dislodgment.

While continuing to hold the skin taut, use the device’s push-off tab to separate the catheter from the
needle stylet. Advance the catheter into the vein.

Release the tourniquet.

Activate the device’s safety mechanism, as applicable, to cover the needle following the manufacturer’s
instructions for use.

Stabilize the catheter hub while attaching the extension set to the catheter hub and tighten the Luer lock,
making sure the Luer lock does not come in contact with the patient’s skin and maintaining sterility of the
insertion site and Luer lock.

Slowly aspirate to assess for blood return that is the color and consistency of whole blood. If no blood
return occurs, take steps to locate an external cause of obstruction. It may be necessary to slightly
withdraw the catheter if the tip is against a valve in the vein.

If blood return occurs, slowly inject preservative-free normal saline solution into the catheter according to
facility policy while ensuring there is no swelling of surrounding tissue.

Clamp the catheter.

Remove and discard the syringe.

Stabilize and secure the catheter using an engineered stabilization device, if available. If an engineered
stabilization device is unavailable, secure the catheter with sterile tape.

Using sterile technique, apply a transparent semipermeable dressing over the insertion site, following the
manufacturer’s instructions.

Curl the extension set to the side and tape it to the inside of the patient’s arm if needed for extra
securement.

Label the dressing with the current date or the date the dressing is due to be changed, as directed by
agency policy.

Discard needle(s) into a sharps container.

Dispose of used equipment in appropriate receptacles.

Remove and discard gloves and other personal protective equipment, if worn.

Perform hand hygiene.

In an inpatient setting, help the patient into a comfortable position and place personal items, the tray
table, and the call light within easy reach. Make sure the patient knows how to use the call light to summon
assistance. To ensure the patient’s safety, raise the appropriate number of side rails and lower the bed to
the lowest position. Ensure the bed is locked.

Perform hand hygiene.

Document the procedure and assessments.