Page 1 of 25 DESCRIPTION/OVERVIEW The purpose of this ...

forceps for the tip. Your gloved hand may be used to hold the catheter hub while placing it
on one end of the tape measure. Do NOT touch the catheter with your gloves as the powder
from the gloves may precipitate a sterile phlebitis.
13. Draw up ten to twenty milliliters of 0.9% NaCl. Flush the catheter before adjusting the
guide-wire. Examine the catheter for any perforations other than at the tip. Withdraw the
guide-wire to the length of the catheter plus one additional inch or two additional
centimeters. At the same time, pull the wire down at a firm angle against the hub. This will
cause the wire to curl for easier manipulation.
14. The catheter insertion technique is per the manufacturer recommendations (see LAC Tray
insert). The catheter is trimmed straight across. Do not cut the guide-wire. Under NO
circumstances should a damaged guide-wire be used. If the guide-wire is damaged, discard
the catheter/guide-wire unit.
15. Discard gloves and apply the tourniquet. Don a new pair of sterile gloves. Apply the 4X4
gauze over the tourniquet end to allow the nurse to release the tourniquet as needed in a
sterile manner.
16. Perform the veni-puncture with the needle/introducer unit at a shallow angle (approximately
twenty degrees). Note that the tip of the needle may be in the vein while the shorter
introducer is not. At this point, if the needle is removed or if the cannula is pushed forward,
the cannula will be positioned outside the vein. After obtaining a blood return, lower the
angle of the needle/introducer unit making it more parallel to the vein. Advance the unit 1/4
to 1/2 inch into the vein and then advance the introducer while holding the needle in position.
The tourniquet may be released at this point and the needle safely withdrawn and placed in
the tray. In some patients, it may be necessary to maintain the tourniquet until the catheter
has been advanced several inches.
17. Using the forceps, grasp the catheter approximately one centimeter from the catheter tip.
Advance it in small sections through the introducer. Work quickly to minimize blood loss.
Do not force the catheter if resistance is met as this could result in vein or catheter damage.
18. If central placement is desired, have the patient turn his head away from the nurse and tuck
the chin to the chest. This will assist the catheter to move into the proper position.
19. When three inches of the catheter remains exposed, withdraw the introducer using the
breakaway technique. Take great care to avoid splitting the introducer while still in the vein.
Advance the catheter to leave one to two centimeters exposed.
20. Withdraw the guide-wire with one hand using a gentle pulling action while stabilizing the
hub with the other hand. Wrapping the guide-wire around a finger will provide steady
tension.
21. Aspirate for a blood return then flush with twenty milliliters of 0.9% NaCl. Follow-up with
the 100 units/milliliter Heparin flush.
_________________________________________________________________________________________________________________
Title: Venous Access Device
Owner: Clinical Education Department
Effective Date: 07/27/05
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