Extension Tubing and Protection of Intravenous (IV) Site (Nursing)

by Samantha Rhea

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    00:04 Now that we've inserted the IV, let's look at how we attach the extension tubing or if you remember, the pigtail.

    00:11 So, attach the primed extension tubing to the catheter hub.

    00:15 We're gonna apply our transparent dressing without obstructing the view of the insertion site.

    00:21 This is really important. We need to see where that catheter went in.

    00:25 Now, slowly draw back on the plunger of the attached saline flush to aspirate or pull back and see if we have blood returned.

    00:34 This is gonna let us know if we were successfully in the vein or not.

    00:39 Now, after visualizing blood return, slowly inject the saline flush into the extension tubing and through the catheter.

    00:47 Now, clamp the catheter and remove the saline flush.

    00:56 So, when we're doing this, if we can, avoid as much as possible that insertion site.

    01:03 Main thing is that we have destabilized and now, we can put on our transparent device, excuse me, our transparent dressing.

    01:13 The reason why I'm doing this, I wanna cover this as quickly as possible and hold that catheter steady so it doesn't budge out of that vein.

    01:22 Now, because I've got soiled gloves, I'm gonna remove these quickly and throw these in the trash.

    01:30 Alright, so you noticed, this person's arm is a little bit messy. That is okay.

    01:36 So, we were clean and we can clean this up later.

    01:45 Alright. So, now, that the transparent dressing's on, this is why I do this, so that way, this is stabilized and I can pull back on this plunger slightly.

    01:54 The reason why I'm doing this is you see there's blood flow, and I've got flash or blood return when I'm assessing to make sure I'm in the vein, and clearly, as you saw earlier, we're definitely in the vein.

    02:06 So, I'm going to push this slowly, and you see how that clears up, there's the saline that's in there. That means we're definitely good.

    02:14 When I flush the vein, I see there's no blebbing.

    02:17 Also, I was gonna ask you, did you have any pain when I flushed? - Nope.

    02:21 Okay, great. So, we wanna make sure that's not blebbing, leaking at the side, it's not painful for our patient.

    02:27 So, this is nice and flushed, so now what I'm gonna do is clamp this.

    02:33 So, this is why if you noticed, why I kept the plunger attached.

    02:39 That way I'm not trying finagle this later when I'm trying to hold pressure.

    02:44 So, because our patient has such nice veins, I was in a good one.

    02:48 It got a little bit messy, obviously, but that's okay, cuz we can definitely clean all of this up later, make this look nice and pretty.

    02:57 But now that I've got this, I can un-take this off, keep this nice and down.

    03:06 So, here's the transparent dressing. So, here's the difference from facility to facility.

    03:12 Some facilities put a stabilization device underneath there.

    03:16 Now, a lot of the times a lot of facilities do not do that or put or allow tape underneath the transparent dressing because that's another microbe attached or attract or something like that to get under there.

    03:33 Now, that we've attached the extension tubing, now, we need to protect that IV site we just put in.

    03:39 So, we're gonna place the extension tubing in a desired location and make sure to tape that down securely in place.

    03:46 Then we need to label the dressing with date, time, initials and the catheter size that we just used.

    03:58 Okay. So, now, that we've just finished up inserting the IV, so now I've cleaning up the patient.

    04:05 So, earlier, you noticed there can be some blood a little bit of that when you're inserting the IV, so notice that when I did that, I kept my cool, made sure I kept the insertion of the IV in and the catheter, and then make sure I promptly added the extension tubing.

    04:21 You don't wanna lose your IV site, so therefore, stay calm if that happens, secure your IV, and then make sure you clean up your patient for comfort, and just to make sure there's not any additional tape or anything like that or blood that can add for microbes and cause infection.

    04:39 So now that we've got this all taped down, I'm gonna secure this much better just because anytime this in a patient arm, this can get tugged, it can move around, so there's lots of different ways you can tape. I'm gonna show you how I do that.

    04:53 Okay, one thing also to keep in mind about tape.

    04:57 Notice, under the transparent dressing, unless your facility says that use a stabilization device, we should not do this tape method underneath that.

    05:07 We wanna keep everything clean and sterile underneath the transparent dressing.

    05:12 So, let me show you what I do.

    05:15 This tape is very nicely torn, so I'm gonna do a nice little generous piece of tape here and if you take the middle of this, it very easily splits, which is really nice for you, and you can even save this tape and put it on the back of your glove.

    05:33 So, notice how much thinner that is, which is nice, and I'm gonna slide this underneath the extension tubing.

    05:41 So, notice, my IV's already in, my insertion site's covered, nothing is underneath that transparent, and then I'm gonna crisscross this tape here.

    05:51 So, I'm just gonna cross this here, and cross this here.

    05:56 Then, I'm gonna take an additional piece of tape, and then I can put this around where the catheter attaches, and this will just help stabilize that as well.

    06:08 So, if you notice and I tug on this a little bit, it's much more secure for the patient.

    06:13 Alright, now, we also have our extension tubing and so, this isn't draping around, we're gonna secure this in place for our patient too.

    06:23 I love this tape, very easy to tear.

    06:25 Now, one more thing to consider when you're inserting an IV, some patients are allergic to adhesive so if that's the case, there's alternatives that you can use.

    06:36 So, I'm just gonna make a nice little loop and I'm going to secure this down for my patient so it's not dragging all over the place for him when he moves his arm.

    06:47 Also, don't forget, now every little piece of transparent dressing has a little label and it makes you, remind you to put your initials, the date and what size, or we call it the gauge of the catheter is.

    About the Lecture

    The lecture Extension Tubing and Protection of Intravenous (IV) Site (Nursing) by Samantha Rhea is from the course Intravenous (IV) Catheter Insertion and Removal (Nursing).

    Included Quiz Questions

    1. To ensure air is not injected into the extension tubing
    2. To ensure there are no blood clots at the end of the IV catheter
    3. To ensure that the extension tubing clamp has been opened
    4. To ensure that the dressing is securely holding the catheter
    5. To assess for blood return in the inserted IV catheter
    1. Apply tape to the tubing to hold it in the desired position
    2. Cover the tubing with the transparent dressing
    3. Ask the client to hold the tubing in place
    4. Apply an arm brace to limit the client's movement
    1. Date
    2. Time
    3. Initials
    4. Catheter size
    5. Age

    Author of lecture Extension Tubing and Protection of Intravenous (IV) Site (Nursing)

     Samantha Rhea

    Samantha Rhea

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