NDHnow.com - Clinical Pearls - Infusion Therapy - Inserting I.V. lines in obese or edematous patients


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Inserting I.V. lines in obese or edematous patients

Use anatomic landmarks to locate veins.
Displace edema near a vein to the side of the vein or above it to flatten the area.
Use deep palpation to identify hard-to-palpate veins.
Use a 22G or 20G catheter.
May need a longer catheter to pierce tissue or extracellular fluid.
Use several tourniquets, progressing distally from the most proximal joint toward the site, to distend veins.
Maintain skin tension during the procedure.
Use areas with the least edema or underlying tissue, such as the dorsum of the hand or palmar surface of the forearm.
Avoid circumventing the arm with tape; this may restrict flow and increase edema in the extremity.