An intravenous (IV) line ratchet system is used to start an intravenous line to introduce or withdraw fluids from the vasculature of a patient. The IV line ratchet system includes a rotating member that causes a needle and catheter to be inserted into the vasculature of the patient. The rotating member further causes the needle to be removed from the vasculature of the patient while the catheter remains in the vasculature of the patient.