HealthPhone™: Inserting an IV - Newborn Care Series
The IV route should be a last resort due to the danger of infection and fluid overload. It’s safer and very effective to give antibiotics by the intramuscular route or to treat low blood sugar with breast milk or glucose through a gastric tube.
But very sick babies need medications absorbed quickly. The IV route then, is best especially for babies in shock or with sepsis, tetanus, or meningitis. Once the baby is stable, switch to IM or give the medicine by mouth.
This baby has early tetanus. The video will show you how to insert an IV into her tiny veins and then give her life saving antibiotics through the IV port.
First gather your supplies:
Tourniquet, cotton balls, the smallest cannula (23- to 25-gauge;), pour antiseptic on the cotton, fill a syringe with 2 milliliters of sterile water, tear your tape, make a splint, and, remember, clean exam gloves.
Wash your hands.
Now look and feel for the best vein. Use a tourniquet or your hand encircling the baby’s limbs. Check the feet, the hands, the crook of the arms and the scalp.
After choosing the best vein, wrap the baby snugly. Put on gloves now or after you tie the tourniquet.
Clean the skin with antiseptic. Let it dry. Then stretch the skin to stabilize the vein.
Keep the opening of the needle facing up. Take a shallow approach to the vein. The slight flash-back of blood into the needle shows that you’re in the vein.
Pull the needle out gently as you push the cannula carefully forward.
Release the tourniquet. Then remove the needle and discard in the sharps container. Apply a little pressure at the site to control bleeding.
Here’s another example.
Stretch the skin and take a shallow approach. Here’s the flashback of blood. Now, pull the needle out as you push the cannula slowly forward. Then apply pressure above the site.
Now ensure that the vein is undamaged by slowly flushing sterile water through the IV.
Swelling along the vein indicates the vein is damaged or perforated.
You will then need to remove the IV and start at a different site.
Tape the IV securely, right over the site. If using a limb, immobilize it with a splint and tape.
The scalp is a good site for veins in a newborn. Shaving the baby’s hair makes it easier to see the vein. The IV cannula is directed downward. You may need to very slightly move the needle to get the flashback.
To give medication through the IV:
Open the stopper.
Attach the syringe, and push the medicine in slowly over several minutes.
Remove the syringe and replace the stopper.
Take time to find a good vein
Stretch the skin to stabilize the vein
Practice makes perfect.
This film shows how to insert an IV into the tiny vein of a newborn. It illustrates gathering supplies, finding a good vein, applying a tourniquet, the insertion technique, taping and splinting the IV, and administering medication. The primary audience are frontline health workers in primary and district level facilities. This video was filmed in Nigeria and the Dominican Republic and produced by Global Health Media Project with support from USAID/MCHIP. visit us on-line at http://healthphone.org
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