THERAPEUTIC PROCEDURES - Medicine for Mountaineering and Other Wilderness Activities - page 535

The technique for administering fluids intravenously is basically simple. Individuals
planning outings to wilderness areas where intravenous fluids might be required should
learn the technique beforehand from an experienced individual who regularly inserts IVs.
Although minor details in the way intravenous fluids are administered by different indi-
viduals vary, the basic technique is as follows:
1. The protective cap should be removed from the container of fluids to be administered,
thetubingonthedispensingapparatusshouldbeclamped belowthedripchamber,and
the apparatus should be inserted into the proper opening. The drip chamber, a small
reservoir that keeps air bubbles from being carried into the person's vein by the fluid,
should be half filled by squeezing it repeatedly. (Compressing the drip chamber forces
airoutofthetubingbetweenthechamberandthefluidcontainer.Whenthepressureis
released,thechamberexpandsanddrawsfluidbackintothespacepreviouslyoccupied
by air.) After the chamber is half full, the tubing should be filled by briefly releasing
the clamp. The container (with its tubing) should be suspended two to three feet above
the body of the person who is to receive them ( Fig. B-2 ).
2. The person should be placed in a supine position and a tourniquet that blocks venous
but not arterial blood flow should be placed around the upper arm. (The pulse must be
palpable at the wrist.) The person should open and close his or her fist several times to
engorgethesuperficialveins.Lettingthearmhangdownforafewminutesorcovering
it with a warm, moist towel helps make the veins more prominent if they are small or
obscured by subcutaneous fat.
3. A large, prominent vein in the lower arm, preferably on the inner, flat surface, should
beselected,andtheoverlyingskinshouldbecleanedwithsoapandwaterandswabbed
withalcohol oradisinfectant. Aftertheskinhasdried,theperson'sarmshouldbeheld
in one hand with the thumb stretching the skin over the vein into which the cathet-
er is to be inserted. (Intravenous catheters consist of an outer thin sheath—the cath-
eter—that has a hub into which the intravenous solution drip chamber injection port
intravenous tubing is inserted, and an inner metal needle that protrudes beyond the tip
of the catheter and has a handle but no hub.) The apparatus should be held almost par-
allel with the vein, with the bevel of the needle upward. The needle should be inserted
throughtheskin,intothevein,andthecatheter threadeduptheveinforaboutoneinch
( Fig. B-3 ). A slight “give” can be felt as the vein is entered, and blood flows back into
the needle.