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Position the patient’s extremity to help straighten the desired vein. Apply the tourniquet proximal to the targeted area (Figure 8.3). When possible, look distally first to allow additional, more proximal attempts on the same extremity, if necessary. Once the tourniquet is applied, have the patient pump his or her fist open and closed several times to help the vasculature become engorged. Feel for a soft, spongy, nonpulsatile vessel.

Figure 8.1 IV starting equipment.

Figure 8.2 18‐ and 20‐gauge IV catheters with needles.