Ultrasound-Guided Peripheral IV Tips
The Bottom Line
- Supplies: Collect all of your supplies before starting the procedure, specifically:
- An underpad (e.g., a chux) to catch any stray blood
- Sterile ultrasound gel
- Extra gauze to clean up the gel
- IV catheter: Choose a catheter long enough to reach the deep veins and large-bore enough for fluids or IV contrast as needed.
- Ultrasound transducer: Use the high-frequency linear probe with the smallest footprint available.
- Vein selection: Before starting the procedure, identify the best-candidate vein. Check both arms if needed. Remember the basilic, cephalic, and saphenous veins as possibilities.
- Ultrasound mapping: Map the course of the vein by sliding the probe up and down the arm. Try to select a straightened segment of the vein.
- During the IV cannulation procedure:
- If you cannot find the needle tip, look for it by moving either the probe or the needle. Do not move both at the same time.
- Once you see the flash of blood, advance the needle and catheter into the vein. Confirm your needle tip in the vein before advancing the catheter.
- After securing the catheter but before withdrawing the needle, wipe off the ultrasound gel to help with securing the tubing.
- Practice makes perfect: Practice on adults with large veins. Don’t get frustrated from early difficulties.
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