Intravenous (IV) therapy is the giving of liquid substances into the veins. Intravenous means “within a vein”, but is commonly referred to IV therapy.

In this article, we will show you several tips and tricks, or hacks if you insist, in administering IV Therapy effectively.

Picking the correct cannula size.

The size of the cannula to be used depends on the type of care the patient needs.

It is ideal to use a large bore 18g needle for patients with the slimmest chance of being a surgical patient. Same goes with patients who might need blood transfusion or emergency medication in the near future. Smaller gauge cannulas are ideal for patients in non-emergent settings.

Patients set to undergo CT scan with intravenous contrast need a larger cannula size (20g or 18g).

Use a smaller cannula in a large bore vein when administering irritating/hyper-tonic drugs. Doing so minimizes pain and tissue damage.

Looking for the right vein. Don’t look. Feel.

Even though a vein looks good on the outside, it could be too frail for an IV insertion. Always use the same fingers when feeling or palpating the vein so they become familiarized with it. Deeper veins provide better insertion sites compared to superficial veins which are mostly thin. However, try to avoid thick veins just below a bifurcation as they are more likely to blow within an hour.

When dealing with older patients, with fragile veins that blow easily, try to visualize the veins by using blood pressure cuff instead of a tourniquet. After ensuring the absence of any leaks, inflate the cuffs a few points higher than their diastolic.

IV needle insertion.

Protect yourself by wearing gloves, every patient must be deemed infective at all times.

Start the IV’s from the lowest veins, then upwards. If you start at the most proximal point, you can potentially lose several sites you could have below it.

After spotting the right vein, start asking the patient random questions to serve as a distraction. Insert the IV as the patient verbalizes the answer.

Lastly, remember that the needle is a bit longer than the cannula. Once the needle enters the vein, insert it a little bit further. Do this before retracting the needle to ensure the cannula is in the vein.

Educate Simplify is a Los Angeles based continuing healthcare education company. Its offerings include IV Therapy and Bloodwithdrawal Certification by the BVNPT.