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Inserting I.V. lines in obese or edematous patients
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- Use anatomic landmarks to locate veins.
- Displace edema near a vein to the side of the vein or above it to flatten the area.
- Use deep palpation to identify hard-to-palpate veins.
- Use a 22G or 20G catheter.
- May need a longer catheter to pierce tissue or extracellular fluid.
- Use several tourniquets, progressing distally from the most proximal joint toward the site, to distend veins.
- Maintain skin tension during the procedure.
- Use areas with the least edema or underlying tissue, such as the dorsum of the hand or palmar surface of the forearm.
- Avoid circumventing the arm with tape; this may restrict flow and increase edema in the extremity.
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