IV ROTATION GUIDELINES
- SRNAs will attend a workshop for IV starts during YNHHSNA Orientation, before their IV rotation in the pre-op area begins.
- SRNAswith no prior IV start experience will spend a day(or more if needed) with a member of the IV team before they are assigned to patient care areas.
- SRNAs are to attempt an IV start only on patients with good veins. If you are in doubt, please alerta pre-op RN or member of the anesthesia team to assist you or to perform the IV start themselves.
- Only one attempt is to be made per patient. If you miss the IV on your first attempt, please seek assistance from a pre-op RN or member of the anesthesia team.
- WASH IN, WASH OUT! Before making contact with the patient, wash your hands. Wear gloves while starting the IV. After the procedure is finished, remove your gloves and wash hands again.
- Prep the skin using the chlorhexidine wipes, NOT alcohol wipes.
- Please consider administering a skin wheal of lidocaine 1% using a TB syringe before starting the IV. 0.1-0.2 mL injected SLOWLY into the dermis is all that is required to anesthetize the area prior to inserting the IV.
- Please do not insert larger than a 20g IV catheter in any patient. If they require a larger IV, it can be started in the OR once they are sedated/anesthetized. DO NOT START > 1 IV in any patient, even if you know that they may require additional access for the planned surgery.
- Please clean up the area of needles, wipes, etc. as soon as you finish your IV start.
- If you have difficulty with IV starts after the rotation has concluded, please let us know and we will schedule additional IV rotation time for you as needed.
For your rotation weeks, please report to the charge nursein the pre-op area by no later than 5:45 am.A few things to remember:
1)Please avoid the antecubital vein if:
- The patient will be in the sitting position
- The patient will be in the prone position with the arms on armboards/bent at the elbow
- You are planning to insert < a 20g IV catheter
2)LOOK FOR PURPLE BANDS – these designate limbs that shouldnot have IV starts (post-mastectomy with axillary node dissection, presence of AV fistula, PICC line, etc.).
3)In the case of UE surgery, avoid use of the affected side.
4)Avoid small diameter hep lock clave tubing. Fluids run too slowly through these.
5)If using the dressing supplied in the IV start kits found in pre-op, be sure that the IV still flushes without resistance after the multiple components of the dressing are applied.