How to Secure an IV (chevron, transparent dressing)

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Chance Reaves
MSN-Ed,RN
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Study Tools For How to Secure an IV (chevron, transparent dressing)

Chevron IV securing (Image)
IV Therapy (Cheatsheet)
Starting an IV (Cheatsheet)
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Outline

Nursing Points

General

  1. Assess the site where the IV will go
    1. Check skin integrity
      1. Excessive hair
        1. Use clippers if necessary, but only as a last case resort
      2. Oily skin
        1. Clean and dry skin prior to setting the IV
  2. Different IV securing devices
    1. Taping techniques (Chevron IV taping)
      1. Chevron
      2. 2 piece Chevron
      3. Chevron over wings (if applicable)
      4. Single strip
    2. Transparent Dressing
      1. Use manufacturer recommendations
      2. Do not cover IV entirely
        1. Can dislodge the IV
      3. Secure the dressing when necessary
  3. Securing the entire IV
    1. After insertion, place tape over hub of IV
      1. Use facility recommended or best practice technique
      2. Do not kink catheter at hub
      3. Do not occlude cap or pigtail with tape
    2. Secure IV with transparent dressing
    3. Secure pigtail with tape
    4. Reinforce as necessary

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Transcript

All right guys. In this lesson, we’re going to take a look at securing the IV. So after you put it in your IV, you want to make sure that you secure it and this kind of starts prior to you putting in the IV. It takes a little bit of being aware and thinking critically. For instance, if you have a really hairy patient, you have to think, how am I going to secure this? So one of the things that you can actually do is use the Clippers. You never want to use a razor because there’s a risk for injury risk for messing up the actual skin. The normal bacterial, balance of the skin. You never want to do anything that’s going to cause potential harm to your patient. But using Clippers is actually indicated by the infusion nurses society and by lots of other education specialists that say, Hey, this is the best way to remove hair without actually causing skin integrity issues. 

So if you have a patient who you know is going to be hairy, but you’ve got to make sure that I’ve used in use those Clippers to do that. Another thing you want to be aware of our patients with oily skin or dirty skin. You always want to make sure that that skin is clean and dry before you ever try to put an IV in. Now when we look at securing the IVs, we do it several ways. The first one is you can just apply the transparent dressing directly to the IV that’s very commonly used and it’s totally safe. What you want to do is you want to make sure that you’re doing it efficiently and that you’re keeping the site clean and dry. Another thing that you can do, and it depends a lot on your patient, is you can do these things called chevrons and a Chevron is just a method of taping. 

chevron iv taping technique

What happens is there’s the tape that’s inserted underneath the hub of the IV catheter and it’s actually done sticky site up. Now once it’s in place, then you take one side and wrap it over and then you take the other side and wrap it over. There’s also an extension of this called the two step Chevron where you actually apply another strip of tape over that commonly in the ICU setting. That’s the one that I did along with one called the wingtip Chevron method. Some IVs have these things called wingtips. And what it does is allows you to put the Chevron in a good position and then flip that tape over and then you can also add a second one first securing. The big takeaway here is that you want to apply it number one in a way that’s based on evidence that’s safe for the patient. 

And you also want to do it in a way that’s gonna make sure that it’s secure. Once you get that IV secured with tape, what you want to do is you want to use the transparent dressing to reinforce them. And what that does is that creates more stability for the IV and it also keeps the site clean, dry and intact afterward. Then you can apply tape either around the edge, especially for those accessibly carry patients. The other thing you can do is it also provides stability, um, with the J loop. And it keeps the J  loop from getting caught on things. Once you get that transparent dressing intact and you get that pigtail secured, the last thing that you need to do is make sure that you timed it an initial. You always want to that and make sure that they’re, you’re providing that safety, you’re putting that safety feature in place. Sometimes some patients need a little bit of reinforcement and that’s okay. So if you notice that your patient has that excessively oily skin or if they have extra hair there, what you can do is you can use tape to reinforce it.

I hope that these tips have been helpful in helping you to determine what you need to secure your IV sites. Now go out and be your best selves today and as always, happy nursing.

 

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How to Secure an IV (chevron, transparent dressing)
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