Remote Primary Health Care Manuals

Putting in butterfly IV needle

Well lit area.
Wear gloves.
Wear mask.
Wear safety glasses.
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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   

Short IV needle, hub with flexible plastic tabs that fold for insertion then lay flat and are taped against skin for stability, bung for injections.

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     

Folded up wings act as handle for insertion.

Figure 4.17   

Insert butterfly needle into vein.

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