Why 24G × 0.75" with Passive Safety for Fragile and Small Vein Access

The 24-gauge catheter (0.7mm outer diameter) with 0.75-inch (19mm) length is specifically designed for fragile, small, or difficult veins commonly encountered in pediatric patients, elderly adults with thin-walled vessels, oncology patients with compromised vasculature from chemotherapy, and any patient requiring the gentlest possible venous access where larger catheters would cause excessive trauma or insertion failure. The smaller gauge significantly reduces insertion pain and vein trauma compared to larger catheters, improving first-stick success rates in challenging vascular access situations while still accommodating maintenance fluids, most IV medications, and blood sampling. The Auto-Guard passive safety mechanism activates automatically upon needle withdrawal without requiring additional clinician action, eliminating human error that compromises active safety devices while protecting healthcare workers from needlestick injuries in fast-paced clinical environments. BC (Blood Control) technology features an integrated valve that minimizes blood exposure during catheter insertion and connection, maintaining clean insertion sites and reducing blood-borne pathogen exposure risk. The short 0.75-inch length is ideal for hand veins, distal forearm veins, and pediatric patients where longer catheters would be excessive and increase malposition risks.

Key Features & Benefits

Key Features:

• 24-gauge (24G) catheter with 0.7mm outer diameter for delicate veins
• 0.75-inch (3/4", 19mm) catheter length for hand and distal vein access
• Auto-Guard passive safety mechanism automatically shields needle
• BC (Blood Control) technology minimizes blood exposure during insertion
• Vialon™ biomaterial softens in vein, reduces mechanical phlebitis
• Notched needle design improves blood visualization on insertion
• Transparent flashback chamber confirms vein entry
• Yellow color-coded hub for 24G identification (ISO standard)
• Tapered catheter tip facilitates smooth entry into small veins
• Universal hub compatible with standard IV tubing and extension sets
• Single-handed insertion technique possible
• Sterile, individually packaged
• Latex-free construction for allergy safety
• DEHP-free materials for patient safety
• Meets ISO standards for IV catheters
• Manufactured by BD (trusted global medical device leader)

Benefits:

• Smallest gauge reduces pain and trauma in fragile veins
• Short length ideal for hand veins and pediatric patients
• Passive safety eliminates human error in needle shielding
• Reduces needlestick injuries up to 95% compared to non-safety devices
• BC technology protects workers from blood exposure
• Vialon material extends catheter dwell time by reducing phlebitis
• Appropriate for patients with small or compromised vasculature
• Notched needle provides clear flashback confirmation
• Color coding prevents gauge selection errors
• Universal compatibility simplifies IV setup
• Sterile packaging ensures infection control
• Latex-free protects sensitive patients and staff

Clinical Applications

BD Insyte Auto-Guard BC Pro 24G × 0.75" catheters are appropriate for:

✓ Pediatric IV access (infants, children, adolescents with small veins) ✓ Geriatric patients with fragile, thin-walled veins ✓ Oncology patients with compromised vasculature ✓ Patients requiring gentle venous access (small or fragile veins) ✓ Hand and distal forearm vein access ✓ Patients with difficult IV access requiring smaller gauge ✓ Maintenance fluid therapy and hydration ✓ Continuous medication infusions (antibiotics, analgesics) ✓ Intermittent medication administration ✓ Blood sample collection from peripheral IV lines ✓ Outpatient infusion center treatments ✓ Emergency department stabilization ✓ Post-operative IV access for minor procedures ✓ Hospice and palliative care IV access ✓ Home healthcare IV therapy ✓ Ambulatory patients needing mobility during therapy ✓ Patients requiring extended peripheral IV therapy (3-7 days) ✓ Neonatal IV access (verify facility protocols for neonatal use)

Usage & Application

Pre-Insertion Preparation:

1. Verify order and assess patient:
   • Confirm IV therapy ordered
   • Review allergies and contraindications
   • Assess for infection at potential sites
   • Consider patient age, vein condition, therapy duration
   • Explain procedure to patient/family
2. Select appropriate catheter:
   • 24G × 0.75" suitable for:
     • Fragile veins (elderly, pediatric, oncology patients)
     • Hand and distal forearm veins
     • Maintenance fluids and non-viscous medications
     • Patients where larger gauge failed or inappropriate
   • Consider limitations:
     • Not appropriate for rapid fluid resuscitation
     • Not suitable for blood transfusion (typically requires ≥20G)
     • Limited for viscous medications
3. Gather supplies:
   • BD Insyte Auto-Guard BC Pro 24G × 0.75" catheter
   • Tourniquet (single-use preferred)
   • Chlorhexidine or alcohol antiseptic
   • Sterile gauze pads
   • Transparent semipermeable dressing
   • Clean gloves
   • Normal saline flush syringes (10 mL prefilled)
   • IV tubing or extension set
   • Tape or securement device
   • Sharps container
4. Hand hygiene and glove up:
   • Wash hands for at least 20 seconds
   • Don clean gloves
5. Position patient:
   • Adequate lighting essential for visualizing small veins
   • Position arm extended and supported
   • Place absorbent pad under arm

Vein Selection:

1. Apply tourniquet:
   • Place 4-6 inches above intended site
   • Use gentle pressure for fragile veins (elderly patients)
   • Tight enough to distend veins without occluding arterial flow
2. Assess veins:
   • Palpation critical for small veins
   • Look for veins that are:
     • Straight (at least 1 inch for 0.75" catheter)
     • Springy when palpated (indicates healthy vein)
     • Adequate size for 24G catheter
     • Visible and palpable
   • Avoid veins that are:
     • Hard or cordlike (sclerosed)
     • Over joints
     • In areas of bruising or previous puncture
     • Tortuous or bifurcated
3. Preferred sites for 24G × 0.75":
   • Best choices:
     • Dorsal metacarpal veins (back of hand)
     • Cephalic vein (lateral wrist/distal forearm)
     • Basilic vein (medial wrist/distal forearm)
     • Dorsal digital veins (if absolutely necessary)
   • Acceptable:
     • Median antebrachial veins (center forearm)
   • Avoid when possible:
     • Antecubital fossa (reserve for blood draws, short dwell time over joint)
     • Lower extremities in adults (DVT risk)

Catheter Inspection:

1. Open sterile package:
   • Check package integrity and expiration date
   • Remove catheter aseptically
2. Inspect catheter:
   • Verify 24G gauge (yellow hub)
   • Check catheter and needle for defects
   • Confirm safety mechanism not activated
   • Verify BC valve intact

Site Preparation:

1. Clean insertion site:
   • Chlorhexidine (preferred): 30-second scrub, 30-second dry time
   • 70% alcohol (alternative): Concentric circles, 30-second dry time
   • Do NOT touch site after cleaning
2. Maintain venous distention:
   • Keep tourniquet in place
   • Patient may make gentle fist (not aggressive pumping)

Insertion Technique:

1. Hold catheter correctly:
   • Grasp by finger grips/hub with dominant hand
   • Position thumb near push-off tab
   • Rest hand on patient's arm for stability
   • Use very gentle, controlled movements (small veins easily roll or rupture)
2. Stabilize vein:
   • Use non-dominant hand to anchor vein below insertion site
   • Apply gentle traction (excessive pressure collapses small veins)
   • Stretch skin taut
3. Insert catheter:
   • Bevel up (visible through catheter)
   • Insert at very shallow angle (10-15 degrees) for superficial veins
   • Use smooth, slow, controlled motion (not too fast for fragile veins)
   • Advance until you see primary blood flash in flashback chamber
   • Note: Flash may be slower/less dramatic with 24G in small veins
4. Lower angle and advance:
   • Once flash appears, immediately lower catheter nearly parallel to skin
   • Advance entire unit 1-2mm further to ensure catheter tip in lumen
5. Thread catheter:
   • Hold needle steady
   • Use push-off tab to advance catheter smoothly off needle
   • Advance to hub—do NOT force
   • BC valve controls blood during threading
6. Release tourniquet:
   • Remove tourniquet before needle withdrawal
   • BC technology minimizes blood spillage
7. Activate safety mechanism:
   • Withdraw needle straight back
   • Auto-Guard mechanism passively shields needle automatically
   • Listen/feel for click as needle locks in safety chamber
   • Needle safely contained
8. Apply gentle pressure (optional):
   • BC valve controls flow, but light pressure over vein can minimize residual leakage

Connection and Securing:

1. Connect IV tubing or flush:
   • Remove catheter hub cap
   • Attach primed IV tubing or saline flush syringe
   • Flush gently with 3-5 mL saline (small veins sensitive to rapid flush)
   • Watch for infiltration signs during flush
2. Verify patency:
   • Flush should inject smoothly without resistance
   • No swelling, coolness, or blanching at site
   • Patient reports no pain or burning
   • Blood return may be minimal with 24G (don't rely solely on this)
3. Secure catheter:
   • Clean residual blood if present
   • Apply transparent dressing over site and catheter hub
   • Ensure dressing allows site visualization
   • Smooth out all wrinkles
   • Secure tubing with strain-relief loop (critical for small catheters—prevent dislodgement)
   • Additional securement device recommended for hand placements
4. Label catheter:
   • Document gauge, length, date, time on dressing label
   • Include inserter initials
5. Dispose of needle:
   • Place safety device in sharps container immediately

Post-Insertion Care:

1. Remove gloves and hand hygiene
2. Document insertion:
   • Date, time, site location
   • Catheter gauge and length
   • Number of attempts
   • Patient tolerance
   • Site appearance
3. Educate patient/family:
   • Report pain, swelling, redness, dampness
   • Protect IV site (especially hand placements)
   • Keep site dry
   • Don't pull on tubing
   • Extra caution with 24G (easily dislodged)
4. Monitor closely:
   • Assess site every 4 hours (minimum)
   • Before each medication
   • 24G more prone to infiltration—vigilant monitoring critical

Catheter Maintenance:

1. Site assessment (every 4 hours and before each use):
   • Inspect for redness, swelling, drainage
   • Palpate for tenderness or firmness
   • Assess dressing integrity
   • Small catheters infiltrate more easily—increased vigilance needed
2. Flushing protocol:
   • Every 8-12 hours if saline lock
   • 10 mL syringe minimum (smaller syringes create excessive pressure)
   • Flush slowly and gently (24G in small veins sensitive to rapid flush)
   • After each medication
   • Push-pause technique
   • Maintain positive pressure when clamping
3. Dressing changes:
   • Transparent: every 5-7 days or when compromised
   • Change immediately if damp, loose, soiled
   • Use gentle technique (avoid catheter dislodgement)
4. Infusion rate considerations:
   • 24G has lower flow rate than larger gauges
   • May not accommodate rapid infusion needs
   • Gravity flow typically adequate for maintenance fluids
   • Consider pump for precise rate control

Troubleshooting:

No blood flash on insertion:

• Flash may be slower/less dramatic with 24G
• May have missed vein—withdraw and redirect
• Vein may have collapsed—release pressure briefly
• Try transillumination device if available

Flash then loss when threading:

• Catheter may have hit valve or vessel wall—withdraw 1-2mm, rotate gently
• Small vein may be tortuous
• Don't force—risk of vein rupture in fragile vessels

Difficulty threading catheter:

• Never force 24G (extremely fragile catheter)
• May have entered at too steep angle
• Vein may be sclerosed or tortuous
• Withdraw and attempt new site

Infiltration (more common with 24G):

• Stop infusion immediately
• Small gauge infiltrates more easily than large
• Remove catheter
• Elevate extremity
• Apply warm or cold compress per protocol
• Restart in different location (opposite hand/arm preferred)

Slow or stopped flow:

• Check for kinks in tubing
• Verify clamps open
• Reposition patient's hand/arm
• Small gauge more prone to positional occlusion
• Check for infiltration
• May need to replace catheter

Catheter dislodgement:

• 24G more easily dislodged than larger gauges
• Remove if partially out (never reinsert)
• Apply pressure, cover with dressing
• Restart in new location

Blood backing up in tubing:

• IV bag may be empty or nearly empty
• Patient arm may be elevated above IV bag
• Lower arm below heart level temporarily
• Replace empty bag
• Consider flushing to clear blood from tubing

Special Considerations:

Pediatric patients:

• 24G × 0.75" excellent choice for children
• Smaller gauge = less pain and trauma
• Short length appropriate for pediatric anatomy
• Use topical anesthetic (EMLA, Synera) 30-60 minutes before insertion
• Distraction techniques critical
• May need assistant for stabilization
• Parent presence often helpful
• Extra vigilance for infiltration (children can't always communicate discomfort)

Neonatal patients:

• Verify facility protocols (some use even smaller gauges: 26G)
• May require specialized training
• Scalp veins may be option in infants
• Umbilical access alternative in newborns
• Consult neonatal team

Geriatric patients:

• 24G ideal for elderly with fragile veins
• Use minimal tourniquet pressure
• Very shallow insertion angle (10-15 degrees)
• Insert slowly and gently
• Fragile skin tears easily from adhesives
• May have decreased sensation—monitor closely
• Vialon material beneficial for thin-walled veins

Oncology/chemotherapy patients:

• Veins often damaged from previous chemotherapy
• May have thrombosed veins
• 24G often only option for compromised vasculature
• Verify peripheral line appropriate for chemotherapy agent
• Some vesicants require central access
• Consider port or PICC for ongoing chemotherapy

Obese patients:

• May need to palpate deeply for veins
• 0.75" length adequate for hand/distal veins
• Consider longer catheter (1") if deeper veins
• Rely on palpation over visualization

Very thin/cachectic patients:

• Excellent choice for emaciated patients
• Minimal subcutaneous tissue
• Veins very superficial
• Use extremely shallow angle
• Gentle technique critical

Patients with bleeding disorders/anticoagulation:

• Apply pressure longer after insertion (3-5 minutes)
• Smaller gauge reduces bleeding compared to large
• Monitor for hematoma
• Document anticoagulation status

Difficult IV access:

• 24G may be only successful size in very difficult access
• Use vein visualization technology (ultrasound, transillumination)
• Warm compresses before attempt
• Position arm below heart
• Consider specialist (IV team, anesthesia) after 2 failed attempts

Hand placement considerations:

• Hand IVs more prone to dislodgement
• Splint or arm board may be needed
• Instruct patient on hand movement limitations
• More frequent site assessment needed
• Consider alternate site if patient very active

When to Remove/Replace:

Remove immediately if:

• Phlebitis Grade 2+ (pain, erythema, palpable cord)
• Infiltration or extravasation
• Occlusion unable to clear
• Site infection
• Catheter no longer needed
• Patient discomfort
• Partial dislodgement

Do NOT routinely replace:

• Replace only for clinical indication
• No routine time-based replacement (per CDC guidelines)

Infection Prevention:

• Hand hygiene before all catheter contact
• Aseptic insertion technique
• Chlorhexidine skin prep preferred
• Maintain clean, dry, intact dressing
• Scrub hubs before each access (15 seconds)
• Remove when no longer needed
• Monitor closely for infection signs

When to Contact Provider:

• Signs of catheter-related bloodstream infection
• Severe phlebitis
• Unable to establish access after multiple attempts
• Extravasation of vesicant medication
• Suspected catheter fragment retention
• Allergic reaction

Technical Specifications

Product Details:

• Brand: BD (Becton, Dickinson and Company)
• Product Line: Insyte™ Auto-Guard™ BC Pro
• Catheter Gauge: 24G (0.7mm outer diameter)
• Catheter Length: 0.75 inch (3/4", 19mm)
• Catheter Material: Vialon™ biomaterial (FEP)
• Catheter Features: Tapered tip, softens up to 70% in vein
• Needle: Stainless steel with notched design
• Safety Feature: Auto-Guard passive safety (automatic needle shielding)
• Blood Control: BC technology with integrated valve
• Flashback Chamber: Transparent for blood visualization
• Hub Color: Yellow (ISO standard for 24G)
• Hub Material: Medical-grade polypropylene
• Hub Compatibility: Universal for standard IV tubing/extension sets
• Flow Rate: Approximately 13-22 mL/min at gravity flow (patient-dependent)
• Priming Volume: Approximately 0.3 mL
• Sterility: Sterile, single-use only
• Sterilization Method: Ethylene oxide (EtO)
• Latex Content: Latex-free
• DEHP Content: DEHP-free
• Packaging: Individually wrapped in sterile peel-open package
• Shelf Life: Typically 3-5 years (check package)
• Intended Use: Peripheral IV access for infusion therapy
• Dwell Time: Up to 96 hours or as clinically indicated
• Patient Population: All ages, particularly pediatric, geriatric, fragile veins
• Regulatory Status: FDA-cleared medical device, Class II
• Standards Compliance: ISO 10555 (sterile single-use intravascular catheters)