IV Insertion Angle

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Chance Reaves
MSN-Ed,RN
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Included In This Lesson

Study Tools For IV Insertion Angle

IV Therapy (Cheatsheet)
Starting an IV (Cheatsheet)
IV Colors and Gauges (Cheatsheet)

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

12 Points to Answering Pharmacology Questions
6 Rights of Medication Administration
Anti-Infective – Antifungals
Antianxiety Meds
Antidepressants
Atenolol (Tenormin) Nursing Considerations
Atropine (Atropen) Nursing Considerations
Barbiturates
Basics of Calculations
Buspirone (Buspar) Nursing Considerations
Carbidopa-Levodopa (Sinemet) Nursing Considerations
Combative: IV Insertion
Complex Calculations (Dosage Calculations/Med Math)
Cyclosporine (Sandimmune) Nursing Considerations
Dark Skin: IV Insertion
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Drawing Blood from the IV
Drawing Up Meds
Drug Interactions Nursing Mnemonic (These Drugs Can Interact)
Eye Prophylaxis for Newborn
Fentanyl (Duragesic) Nursing Considerations
Giving Medication Through An IV Set Port
Glipizide (Glucotrol) Nursing Considerations
Guaifenesin (Mucinex) Nursing Considerations
Hanging an IV Piggyback
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Hydralazine
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Catheter Selection (gauge, color)
Insulin Drips
Insulin Mixing
Interactive Pharmacology Practice
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin
Injectable Medications
IM Injections
Hydromorphone (Dilaudid) Nursing Considerations
Hydrocodone-Acetaminophen (Vicodin, Lortab) Nursing Considerations
IV Infusions (Solutions)
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
IV Pump Management
IV Push Medications
Ketorolac (Toradol) Nursing Considerations
Labeling (Medications, Solutions, Containers) for Certified Perioperative Nurse (CNOR)
Lidocaine (Xylocaine) Nursing Considerations
Magnesium Sulfate
Magnesium Sulfate in Pregnancy
Maintenance of the IV
Mannitol (Osmitrol) Nursing Considerations
MAOIs
Medication Errors
Medication Reconciliation Review for Certified Perioperative Nurse (CNOR)
Medications in Ampules
Meds for Postpartum Hemorrhage (PPH)
Meperidine (Demerol) Nursing Considerations
Methadone (Methadose) Nursing Considerations
Methylergonovine (Methergine) Nursing Considerations
Metoclopramide (Reglan) Nursing Considerations
Montelukast (Singulair) Nursing Considerations
Mood Stabilizers
Nalbuphine (Nubain) Nursing Considerations
Needle Safety
Neostigmine (Prostigmin) Nursing Considerations
NG Tube Med Administration (Nasogastric)
NG Tube Medication Administration
Nitro Compounds
NRSNG Live | The S.O.C.K Method for Mastering Nursing Pharmacology and Never Forgetting a Medication Again
Nystatin (Mycostatin) Nursing Considerations
OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive
Olanzapine (Zyprexa) Nursing Considerations
Opioid Analgesics in Pregnancy
Oral Medications
Oxycodone (OxyContin) Nursing Considerations
Pain Management for the Older Adult – Live Tutoring Archive
Pain Management Meds – Live Tutoring Archive
Parasympathomimetics (Cholinergics) Nursing Considerations
Patient Controlled Analgesia (PCA)
Pediatric Dosage Calculations
Pentobarbital (Nembutal) Nursing Considerations
Pharmacodynamics
Pharmacokinetics
Pharmacokinetics Nursing Mnemonic (ADME)
Pharmacology Course Introduction
Phenobarbital (Luminal) Nursing Considerations
Phytonadione (Vitamin K) for Newborn
Pill Crushing & Cutting
Positioning
Procainamide (Pronestyl) Nursing Considerations
Propofol (Diprivan) Nursing Considerations
Quetiapine (Seroquel) Nursing Considerations
Ranitidine (Zantac) Nursing Considerations
Rh Immune Globulin in Pregnancy
Sedatives-Hypnotics
Sedatives-Hypnotics
Selecting THE vein
Spiking & Priming IV Bags
Starting an IV
Streptokinase (Streptase) Nursing Considerations
Struggling with Dimensional Analysis? – Live Tutoring Archive
SubQ Injections
Supplies Needed
Tattoos IV Insertion
TCAs
The SOCK Method – C
The SOCK Method – K
The SOCK Method – O
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method of Pharmacology 1 – Live Tutoring Archive
The SOCK Method of Pharmacology 2 – Live Tutoring Archive
The SOCK Method of Pharmacology 3 – Live Tutoring Archive
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Verapamil (Calan) Nursing Considerations
Codeine (Paveral) Nursing Considerations
Celecoxib (Celebrex) Nursing Considerations
Cefdinir (Omnicef) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Benztropine (Cogentin) Nursing Considerations
Bariatric: IV Insertion
Anti-Platelet Aggregate
Anesthetic Agents
Amiodarone (Pacerone) Nursing Considerations
Adenosine (Adenocard) Nursing Considerations
ACLS (Advanced cardiac life support) Drugs