Putting in butterfly IV needle

 

Good for venepuncture and medicine administration in people with small, thin veins

Attention

  • Ensure needle is not inserted into artery or over a nerve
  • Always lie person down in case they faint
  • If young child — consider wrapping them first
  • Can use same veins as for IV cannula or smaller veins in back of hands, feet, ankles or scalp
  • If using for subcutaneous infusion — use an area with good depth of subcutaneous fat (eg abdomen)

What you need

  • Helper if possible
  • Bluey
  • Tourniquet
  • Sterile dressing pack to use as sterile area (optional)
    • Chlorhexedine 2% in isopropyl alcohol 70% swab or solution
    • Butterfly needle with plastic tubing and screw-down bung of right size — Figure 4.15
    • Syringe
  • Blood tubes as required
  • Tape
  • 8cm x 6cm transparent IV dressing, if needed
  • 10mL normal saline in syringe if giving IV medicines or attaching IV infusion
  • IV bag sticker and drip stand or somewhere to hang fluid bag if needed

Figure 4.15   

What you do

  • If medications is to be infused prepare and label infusion bag label
    • Connect IV fluids to line. Prime line with fluid and let out any air bubbles
    • Choose insertion site and put bluey underneath
    • Lay out dressing pack and equipment
  • Wash hands and put on gloves
    • Clean site with skin cleanser as per local guidelines
    • Put on tourniquet OR use helper’s hands to squeeze child's limb
    • Wait for vein to swell
    • Unscrew bung ¼ turn before inserting needle. Lets blood flow back into tubing during insertion so you know you are in vein
    • Fold up wings of butterfly to get good grip — Figure 4.16
    • Angle needle with bevel upward, parallel to skin then down into vein — Figure 4.17
    • Blood will flow back into needle and plastic tubing. Tighten bung

Figure 4.16     

Figure 4.17   
If taking blood
  • Take screw top off bung, connect syringe or have syringe attached before starting. May need to tape butterfly wings to skin to stop movement
    • Take enough blood to fill blood tubes needed
If giving IV medicine or IV infusion
  • Gently flush using 10mL syringe in a pulsatile (push-pause) motion with 10mL sodium chloride (normal saline) OR as per medication order or local guidelines 
  • Small babies need smaller volume (2mL)
  • Let blood flow most/all the way back to bung before connecting to drip
  • Then take off tourniquet and tape butterfly ‘wings’ firmly to skin
  • If leaving butterfly needle in place for an infusion
    • Check skin at site for signs of redness, swelling or pain
    • Place small cotton wool ball or gauze underneath hub of the cannula to prevent pressure areas
  • Remove butterfly needle as soon as infusion completed