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When the decision to pursue vascular access is made, the preparation for the procedure is just as important as the skill itself. Striving for speed in the prehospital setting, assumptions regarding the patient’s health, or other neglectful behavior deviating from the practice of universal precautions can result in occupational exposure. When possible, wash hands prior to putting on gloves.

Prepare the equipment (Figure 8.1). An IV start kit is optimal (tourniquet, alcohol wipe or other cleaner, tape or a commercially available adhesive device). Select an IV needle with a catheter (Figure 8.2), saline lock, saline flush, and/or IV fluids. Check the IV catheter for integrity.

Prepare the patient for the procedure. When appropriate, discuss with the patient the reason for the procedure along with risks and benefits. Unless a true emergency exists or the patient is not able to make his or her own decisions, verbal consent should be obtained.