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Getting an IV

IV stands for intravenous (inside the vein).

An IV is a small tube called a catheter. It is inserted into a vein. The IV is about the size of a small straw or coffee stirrer.

Childhood cancer patients may need an IV for several reasons. It can be used to deliver fluids, medicines, and/ or nutrients into the body through a vein. An IV can also be used to remove blood needed for laboratory tests.

When a patient has an IV, it means he or she does not have to be stuck with a needle each time he or she needs intravenous treatment or to have blood samples taken. IVs may stay in for up to 3-4 days.

Patients who need chemotherapy or other procedures that require access to veins over an extended period of time often get central venous access devices. They are designed to stay in the body more than a few days. However, even patients with these devices may need IVs to receive certain liquids. For example, an IV may be needed to deliver contrast agents for diagnostic imaging tests such as X-rays, computed tomography (CT) scans, or magnetic resonance imaging (MRI).

Preparation for an IV

Before the procedure, patients sometimes need to change into a hospital gown.

An IV is inserted using a small needle. Once the IV tube is in place, the needle is removed.

Since IV placement involves a needle, the patient will experience some pain. Some children are afraid of needles.

Sometimes the health care provider placing the IV can apply a medicine such as lidocaine to numb the area where the IV will be placed. The patient will still feel the pressure of the needle going into the skin. But the medicine should remove the pain.

The topical pain medicine may be a cream. It must be applied 30-60 minutes before the procedure to have time to numb the skin. Plastic is put over the cream to keep it in place. It will be wiped off when time for the IV to be placed.

Another option is a needle-free device such as a J-TIP®. This device uses pressurized gas to spray lidocaine quickly onto the skin. It makes a hissing or popping sound similar to opening a can of soda. It numbs the area within a minute.

Other techniques can be used to help patients manage the pain of the needle stick. Parents may want to ask a child life specialist to be present during the IV procedure. Child life specialists are trained to help explain medical procedures to children and teens and to help them cope.

One pain management method is distraction. It takes the patient’s attention away from the needle. Patients can talk to someone or listen to someone reading to them. They can watch a video on an electronic tablet or listen to music. Younger patients may want their parents to hold them during the procedure.

Relaxation is another technique. Activities may include deep breathing, watching soap bubbles, or listening to relaxing music or nature sounds. Child life specialists or parents can use a form of guided imagery with the patient. Using guided imagery, the patient focuses on the details (colors, sounds, smells, tastes, feelings) of an imagined pleasant experience.

Some pediatric centers use pain relief devices such as Buzzy®. The Buzzy® uses vibration to block pain sensations.

Placing the IV

  • Once the patient is ready for the procedure, the first step is for the health provider to find a vein that can hold an IV.
  • It will usually be a vein under the skin on the back of the hand or the inside of the arm between the wrist and elbow.
  • The provider may tie a tourniquet (a wide plastic band kind of like a rubber band) around the arm to increase pressure. The tourniquet makes it easier to feel vein. Sometimes providers use a heat pack to make veins easier to find.
  • The provider will likely press lightly on different places to find the best vein to hold an IV.
  • Normally this process doesn’t take long. However, childhood cancer patients who haven’t been able to eat because of procedures or side effects of treatment may be dehydrated. This condition can cause veins to become flat. Flat veins are not appropriate for an IV tube.
  • It may take the nurse 2-10 minutes to find a good vein. He or she may examine both arms.
  • At some pediatric centers, the provider may use imaging equipment such as ultrasound to find a vein for the IV.
  • The provider will clean the area (usually with a chlorhexidine or alcohol) and allow it to dry.
  • The provider will stabilize the arm. Another staff member may help. It is very important that the patient’s arm remains still.
  • The provider will insert the needle, which is attached to the IV tube. Sometimes it takes more than one try to insert the needle into a vein.
  • Once the tube is in the vein, the provider will remove the needle.
  • The IV is taped in place. A dressing and/or plastic cover may be placed on top for protection.
  • A connector will be attached.
  • The IV in the skin is connected to another long tube that is hooked up to a plastic bag or tube of liquid medicine or fluid. A pump may be used to regulate the flow of the liquid. Patients may feel a cold sensation when fluid goes into the body.

The patient is then ready for procedures that require an IV. It will remain in the vein until the tube is taken out later.

does not endorse any branded product mentioned in this article.

Reviewed: June 2018

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