From the Research
After achieving flash in the chamber during IV catheter placement without a guidewire, the next step is to reduce the angle of the catheter assembly and advance the catheter over the needle into the vessel. This technique is crucial for preventing complications such as through-and-through puncture of the vessel or accidental arterial catheterization. The initial flash confirms proper vein entry, and advancing the catheter while stabilizing the needle prevents further complications. Maintaining a lowered angle during advancement helps ensure the catheter follows the vein's natural path rather than puncturing the posterior wall, as noted in various studies on central venous catheter placement 1, 2, 3. However, the most recent and highest quality study on the topic of intravenous catheter placement, specifically addressing the use of guidewires in peripheral intravenous catheters, suggests that the technique of advancing the catheter into the vein while simultaneously lowering the angle of approach is effective, but the study focuses on guidewire use rather than the specific step after flash is observed 4. Given the context of the question, which specifically asks about the step after achieving flash without a guidewire, the emphasis is on safely advancing the catheter into the vein. Thus, the recommended step prioritizes reducing the angle of the catheter assembly before advancing the catheter over the needle into the vessel to minimize risks and ensure proper placement, aligning with general principles of vascular access and catheter placement 5. Remember to dispose of the needle safely in a sharps container immediately after removal to prevent needlestick injuries. Secure the catheter with appropriate dressing and connect it to the IV tubing or cap it according to your facility's protocol. This approach prioritizes patient safety and the quality of life by minimizing the risk of complications associated with IV catheter placement.