Capping a primary line - IV ?

[lpn2a]

I am a new lpn and am learning how to cap a primary line (saline loc). I am having a terrible time holding pressure at the site with my non-dominant hand and releasing the IV connection hub with my other hand. It can't be that complicated but I just can't get the darn thing unhooked. Can someone please walk me through this process?

[maryk650]

Try to loosen the IV tubing before positioning your non-dominant hand to put pressure at the site. A lot of the fluids contain ingredients that may make the tubing hub stick to the IV cath. I also carry a pair of small forceps to grasp the tubing with to loosen the tubing before removing it. You will get better with practice and will develop your own technique. Hang in there.

[dorimar, BSN, RN]

hemostats work very well.

[TazziRN, RN]

I learned something from a peds nurse that I have practiced ever since: when an IV is ordered I start a saline lock, then attache the IV tubing to the cap. Two reasons: less chance of losing the IV before it's secured, and much easier when the line is DC'd and a lock is ordered.

[lsyorke, RN]

We "cap" all IV lines when started and then attach the IV fluids. MUCH easier!

[banditrn]

We "cap" all IV lines when started and then attach the IV fluids. MUCH easier!

That's the way we did it too - just takes a little forethought.

[howardsgirlfriend]

As a former IV nurse, I learned to use a T-connector or other type of microbore extension set when starting the IV. These little extension sets make changing the tubing so much easier (and safer.)

[wooh, BSN, RN]

When I start them, I always use some sort of extension, but at my former job, when PACU sent us patients, they always had the tubing directly connected. Very aggravating, especially on old folks with super fragile veins. No matter how much we complained, they refused to add the connectors. My best trick was to use my pinky to hold pressure, so I had most of the rest of that hand for holding the catheter hub, the other hand for the tubing then connector.

If it's a patient that's got fragile veins that really needs that access, I'd get an order to keep the IVF at KVO.

[Anagray, BSN]

I get many of those since in the OR they do not put on extentions to the IV catheter, but connect them straight to the tubing.

What usually works for me is loosening up, like the other poster recommended, and then I use lateral side of my pinky/ball of the phalangie where it connects to the hand itself to occlude the vein, while I use both of my primary sets of fingers to do the disconnecting and connecting. Works most of time even with bleeders.

good luck

[DarlinNurseRed]

Oh I HATE it when the IV is connected straight to the site without an extension. Our O.R. has a habit of that too. I always make sure I put a towel underneath,,,you never know when it will make a mess.

[Daytonite, BSN, RN]

I often use the entire side of my non-dominant hand to press down over the area of where the tip of the end of the cannula should be to occlude any backflow of blood and fluid. It leaves the fingers of that hand free to hold the device while I'm messing with the tubing and the cap in my other hand.

Something else I've done, and I don't recommend everyone do this unless they are careful about it (you have to remember I was an IV therapist for many years) is to place a tourniquet at the point just barely above where the tip of the cannula is sitting in the vein. And, I don't mean tighten it very snuggly. It doesn't take that much to collapse and occlude that vein. That way, both hands are free to work on the IV device. Just remember to remove the tourniquet when you are done.

You should also have a pair of hemostats in your pockets at all times to help you with these things as well.