A. A tourniquet is applied tightly to the proximal arm. Loosen the tourniquet if the patient complains of excessive pain. B. Insert the 30-gauge needle intradermally and inject a small (0.1 to 0.2 mL) volume of 1% to 2% lidocaine proximal to the planned IV insertion site. It is important not obscure the IV site with the wheal.

1.    Palpate the vein with one hand and direct the IV with the other.
   
2.    Stop when a flash of blood is seen. Advance IV 1 to 2 mm further.*
   
   

C. Gently palpate the vein with the non-dominant hand. Puncture the skin wheal and advance toward vein. D. Stop advancing the catheter when a flash of blood is seen. The needle extends 1 to 2 mm past the catheter tip, so the assembly should be advanced 1 to 2 mm further to ensure the catheter is in the vein.

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