IV Insertion Angle

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Chance Reaves
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Outline

Nursing Points

General points for IV insertion angles

  1. General Rules
    1. Shallower veins require more shallow IV insertion angles
      1. i.e. attempts to the hands should be made at 10-20°
      2. Deeper veins require a steeper approach
    2. Always begin the attempt at a 20-30°
      1. Starting a shallow attempt can be painful, can damage the catheter and can cause tissue damage
      2. Starting a very steep attempt can cause going through both sides of the vein
  2. Approach each attempt individually
    1. Identify the vein first, then consider the insertion angle.
  3. Hands
    1. Hand veins are typically shallow, requiring a shallower insertion angle
    2. Identify the appropriate vein
    3. Begin at 20-30° insertion to break the skin, then change the angle to 10-20° and continue insertion
  4. Arms and Legs
    1. Most arm and leg veins have a more significant covering of tissue to penetrate
    2. Identify the appropriate vein
    3. Begin at 20-30° and continue that angle during insertion
  5. Deeper Veins
    1. Antecubital Fossa
    2. Identify the appropriate vein
    3. Begin insertion at 20-30°, then change the insertion angle (which might be steeper, depending on the patient – up to 40-45°
  6. Pro-Tips
    1. If you miss, don’t fish
      1. This causes shearing and tearing and can be painful.
      2. Retract the catheter almost to the point of removal and attempt the angle again
        1. Don’t remove the catheter completely!
    2. These rules aren’t hard and fast
      1. Try steeper angles on typically shallow veins and try more shallow angles on deeper veins
    3. Practice, practice, practice
      1. Use peers or other experts to help you in weak areas of insertion, when possible
      2. Watch others, who are far more experienced
      3. Volunteer to place every IV, every time – you will only get better with practice!

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Transcript

All right guys. In this lesson, we’re going to talk about IV insertion angle when you’re doing an IV catheter. So the first thing you want to do is kind of remember this rule, the shallower the vein, the shallower the angle. And what that means is if I have my hand like this and it’s a really shallow vein, I want that angle of the in the angle of insertion to be almost a parallel to it and what, and the reason is is because as you go deeper, so places like the elbow places like the bicep, they can sometimes be deeper, especially like bariatric patients and that means your angle of insertion is going to be more upright. So that’s just kind of a rule of thumb. One other rule of thumb is always to start in the 20 to 30-degree angle range. It’s not a hard and fast rule, but always use that kind of as the guide.

The next thing that you want to do is approach each attempt individually. What you want to do. Look at the IV, where you’re going to start and then say, what insertion angle do I need to start this out? One really important thing that you need to remember is that anytime when you’re starting, one of the really deep veins is to approach it a little bit judiciously. So start at 20 or 30 degrees and then if you need to change that angle, just be careful that you’re not going perpendicular. Alright, and now for a couple of pro tips, if you miss, don’t fish. That always causes tearing and shearing. It’s uncomfortable for the patient. This is not something that comes easily to everybody. And for people that struggle with IVs, the only real way that you can get better is to practice. Always try to volunteer, always learn and look for the opportunity where you can use someone else’s knowledge and experience to help them guide you through the process or even looking at how you can get better.

I hope these tips have been helpful.

Like we always say, go out and be your best selves today. And as always, happy nursing.

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Study Plan Lessons

EKG (ECG) Course Introduction
Fluid & Electrolytes Course Introduction
Respiratory Course Introduction
Electrical A&P of the Heart
Respiratory A&P Module Intro
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid Pressures
Lung Sounds
Alveoli & Atelectasis
Alveoli & Atelectasis
Fluid Shifts (Ascites) (Pleural Effusion)
Gas Exchange
Gas Exchange
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Lung Diseases Module Intro
The EKG (ECG) Graph
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Asthma
EKG (ECG) Waveforms
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Calculating Heart Rate
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Phosphorus-Phos
Normal Sinus Rhythm
Normal Sinus Rhythm
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Influenza (Flu)
Sinus Bradycardia
Sinus Bradycardia
Sinus Tachycardia
Sinus Tachycardia
Nursing Care and Pathophysiology for Tuberculosis (TB)
Atrial Flutter
Pacemakers
Nursing Care and Pathophysiology of Pneumonia
Atrial Fibrillation (A Fib)
Atrial Fibrillation (A Fib)
Coronavirus (COVID-19) Nursing Care and General Information
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Oxygen Delivery Module Intro
Hierarchy of O2 Delivery
Nursing Care and Pathophysiology of Hypertension (HTN)
Artificial Airways
Artificial Airways
Airway Suctioning
Airway Suctioning
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Respiratory Trauma Module Intro
Blunt Chest Trauma
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Chest Tube Management
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Pulmonary Embolism
Respiratory Procedures Module Intro
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acute Coronary Syndrome (ACS) Module Intro
Bariatric: IV Insertion
Base Excess & Deficit
Blood Flow Through The Heart
Bronchoscopy
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Course Introduction
Cardiovascular Disorders (CVD) Module Intro
Chest Tube Management
Combative: IV Insertion
Coronary Circulation
Dark Skin: IV Insertion
Drawing Blood from the IV
Fluid Compartments
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
Hemodynamics
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
Lactic Acid
Lung Sounds
Maintenance of the IV
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
MI Surgical Intervention
Needle Safety
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Pneumonia
Pacemakers
Performing Cardiac (Heart) Monitoring
Positioning
Potassium-K (Hyperkalemia, Hypokalemia)
Preload and Afterload
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Selecting THE vein
Shock Module Intro
Supplies Needed
Tattoos IV Insertion
Thoracentesis
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms