IV tips and tricks

dale434 · Oct 30, 2008

Some good points in several of the replys however I would like to add bit of knowledge to the subject. Dont always use a tournequet...with some patients having one on will ause the vein to blow as you start the angiocath. Do not have the patient pump their hands, much better to take and alcohol pad and rub the site briskly but not too hard and this will cause the vein to stand up for you and the minimal heat form the friction is all you need. Always place your angiocath on top of the vein and do not "slide" it into the patient but advance in short brisk jerk like motions until you feel the "pop" (remember this are "short") Learn the main anatomy of the vein layout and feel for your veins. In patients that are dark skinned you may never see a vein and have to know how to feel for them..with out touch you are many times lost. Even in fair skinned patient if you are only able to see veins and not know how to feel for them you will probably miss a huge vein someplace that has never been tried...also with someone who gets poked a lot always look on the backside of the forearm...simply because it is away from the nurses starting the iv it is often not even examined...there are some big viens back there my friends. Placeig the cath on top of the vein eliminates a lot of the side action you get from veins if they are hard to enter and you are attempting a sideways stick. But whatever works for you best stick with it. and Practice Practice Practice:yeah:

JessicRN · Nov 21, 2008

I only have one more point about IV insertion. Sometimes you hit a valve it you did not blow the vein (there is blood return. sometimes you can "float through the vein" remove the needle if you have an extension atach it then attach a fluid filled syringe) just pull back on the IV sheath until you get blood flow then an inject some fluid very slowly in the vein if the vein does not blow up flush some more and slowly advance the sheath. It works about 50% of the time if you take your time.

The other thing is when you do an AC you cannot see valves, if you hit one and can't advance the sheath, do not feel bad it is not your fault . Hand veins are different you if you see a lump it is probable a valve, try to avoid it.

If you stick a pt and hit a valve or you miss totally do not remove the IV. Sometimes you can restick the pt using a vein above the first one or very close to it.If you remove the first IV you have to tape it thus blocking the whole area. Once you get the vein then you can take out the one or ones you missed.

MrsMommaRN · Nov 24, 2008

I really stink at IV insertion. I can get a flash every time. When I go to flush it ends up being a bad insertion. I can do blood draws with my eyes closed and I am often called on for those that others can't get. What gives?

Iam46yearsold · Nov 30, 2008

praying helps

jbirdee · Mar 14, 2009

I am about to graduate as an RN. I am looking for just this kind of information because I am a new nurse. This is education and like the next poster said, an opportunity to teach. Why would you say something so rude? Maybe you are too advanced and experienced for this website. I love this site and welcome the information and experience I receive from nurses that have been working for many years. Sorry it is making you yawn but I NEED this and there are many of us that welcome the "ad nauseum" information. You must be the best nurse going.

ERjodiRN · Mar 14, 2009

shoulder and chest veins are often overlooked on hard sticks.....and when you get iv drug users (females), nipple veins work to. i literally had a female pt. slapping her breast to help me find a good one, since you can't really adequately use a tourniquet there. they aren't ideal, obviously........but when they're just to receive pain meds and then be on their merry way, it will suffice. also with peds...especially on the really little ones...the best thing you can do is get the right person or persons to help hold the little one. that's the hardest part about it. and if your hospital carries them, the little 24g's come in two different sizes with most companies. some hospitals don't purchase both sizes, but there is a .75 and .5in length catheter. i love those .5's....they're GREAT for those little 3dayers!

roses1130j · Mar 14, 2009

No way, through the nipple? I guess whatever works. For some reason I feel like if I attempted anything like that in my ED, the other RNs would look at me like I was a nut. I have yet had a situation where I have had to go beyond the upper extremities. I had a 600 ilb patient and after 10 trys he was given a central line. Does anyone have any tips/tricks for obese pt's and IV insertion?

Daytonite, BSN, RN · Mar 14, 2009

Does anyone have any tips/tricks for obese pt's and IV insertion?

We had a 500 pound guy that came in a lot and only a few of us could get an IV in him.

(1) Know your major vein locations and how to feel for a vein. I always went for one of his radial or basilic veins.

(2) I got 2 inch cannula IVs from one of the anesthesiologists that I used exclusively for obese patients. Because you end up going deeper you need a longer catheter. These short 1-inch things just aren't practical for these people.

(3) Try wrapping their arm in an ACE wrap and elevating the arm for 15 minutes. Remove the ACE and then apply the tourniquet and see what pops up.

okienurse68 · Mar 15, 2009

A good trick for finding veins on people with deep veins or who are try is to use 2 tourniquets one about six inches below the first. It's amazing the number of veins that will surface from the increased vascular pressure that the second tourniquet creates.

AtomicWoman · Jul 4, 2009

OK, I feel like a total idiot for asking the most basic question in the world. But next week we have our IV lecture (first semester of NS), and I can't find the answer to a burning question I have: Why do we put medications intraVENOUSly, and not intra-arterially? Is it because the arterial system is too high-pressure? I am mortified to ask this question, but I can't tell you how many books I've looked at and Google searches I've done. I'm probably not putting in the right search term.

Thanks!

okienurse68 · Jul 4, 2009

Because of the back pressure and because an accidental air bolus is much more dangerous arterially than venous. It is estimated that unless the patient has an unknown heart defect it would take approximately 60 cc of air in a venous line to hurt them whereas 1/100th of that would harm you arterially. I know that in nursing school they are anal retentive about getting absolutely every bubble out of your IV tubing but in actuallity it's not totally critical just recommended.

FlyingScot, RN · Jul 5, 2009

Not only that but can you imagine sending "Amphoterrible" directly to some poor patient's right hand. :uhoh3: