After blood return,then what?

  1. After venipuncture blood return,using an over the needle catheter,how do you then procede?
    Do you insert the needle half way then withdraw it and insert the catheter all the way?
    Do you "float" the catheter in with NS,then secure it?
    Once the catheter is fully inserted do you then secure it or do you flush it then secure it?
    Is it better to secure the catheter first or flush it first?
    When flushing the vein do you flush with NS in a syringe or do you attach it to the IV line and flush via IV pump?
    Ive seen nurses procedure a number of different ways,whats best for you?
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  2. 21 Comments

  3. by   fergus51
    I prefer to float it in with NS, then securing it. I usually don't need to flush it (as long as the NS is infusing just fine).
  4. by   cactus wren
    I think you just have to practice, practice until you find what
    feels right" to you...Many different ways, and all work...I tend to stop just after i see flash and slide just the catheter the rest of the way in, not the needle...but have done this for many years, so had to actually stop and think about it.....automatic now
  5. by   WalMart_ADN
    i stop and slide the catherter in....then attatch extension set and flush with NS via syringe...then secure....with lots and lots and lots of tape!! kids are active little buggers and like to pull on tubes...but i agree..you will find what works for you!
  6. by   JedsMom
    Originally posted by cactus wren
    I think you just have to practice, practice until you find what
    feels right" to you...Many different ways, and all work...I tend to stop just after i see flash and slide just the catheter the rest of the way in, not the needle...but have done this for many years, so had to actually stop and think about it.....automatic now
    Ditto
  7. by   l.rae
    much depends on the condition of the pt's veins...l have done it all of those ways. if pt seems to have valves obstructing or veins that curve and are fradgile, l will float in with NS. lf l question if the IV is in the vein, l might flush before l secure it. Where l work in the ER, we obtain our lab draw...draw a rainbow...from the IV stick whenever possible. l found this very challanging at first...for me every pt is different, and some require a different technique in order to not blow the vein....generally with healthy non challanging veins, l slide the cath in after the flash.

    we also use angiocaths...butterfly type IV's where the needle is pulled out via a small plastic tube attatched to the IV...it's hard to describe...it uses less steps and is mechanically less difficult to do, but they are duller than the insites and seem to blow more veins for me.
  8. by   AHarri66
    I advance the needle just beyond the flash, then advance the catheter. I'll float it in if there seems to be a bit of resistance, or if I'm unsure about the vein. I attach the extension set, then tape, flush to be sure, then tegaderm. Flushes are in 10cc prefilled syringes.
  9. by   fab4fan
    Originally posted by WalMart_ADN
    i stop and slide the catherter in....then attatch extension set and flush with NS via syringe...then secure....with lots and lots and lots of tape!! kids are active little buggers and like to pull on tubes...but i agree..you will find what works for you!
    That's how I do it, too. Everyone has his/her own way of doing it, and as long as your technique is good, I don't really think it matters.
  10. by   das
    A agree with AHarri66 and fab4fan. If you get the flash and don't advance any farther you might be only catching the bevel of the stylet and not be able to advance the cath.

    We use angiocath/Intimas and I love them!!!
  11. by   zudy
    On the elderly, I usually get the flash , advance just a tad, then float it in because thier veins are usually so fragile, they seem not to blow when I do this. On young, basically healthy pts I usually just advance the cath, unless I meet resistance. It really depends on the pt.
  12. by   dawngloves
    What do you guys mean' "float" it in?
    I advance a litttle after I get a flash, less I blow the vein, flush and then secure, flush again. I'd hate to tape the bejesus out of an IV just to try and flush it to find it not patent!
  13. by   zudy
    I guess floating is like flushing. I have the iv at slow KVO while I finish advancing and while I tape it down. Then I set the rate I need.
  14. by   Coldfoot
    Like Dawn said, IMO it's better to tape after you know you've got a good line. Some people want to get A LOT of tape in place as quick as posible then have to pull it because the line's infiltrating or not flowing. About the only time I put any tape on an unconfirmed line is with squirmmy kids. Get a feel for yourself, you'll get a system you like down.

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