IV tips and tricks - page 8

Hi all, I am starting to compile a list of tips and tricks concerning starting venipuncture. The goal is to share experiences and tricks of the trade. Tips e.g. on how to find that elusive "best... Read More

  1. by   hal248
    Quote from kloock
    Hi all,
    I am starting to compile a list of tips and tricks concerning starting venipuncture. The goal is to share experiences and tricks of the trade.
    Tips e.g. on how to find that elusive "best vein", would be greatly appreciated. (and if you have a few that are not to be taken entirely serious those would be welcome as well).
    Please answer me directly - no need to clutter up the board with this. I will post the text once it is finished.

    Thanks in advance!

    ------------------
    Katharina Loock, RN, BSN
    Department of Education
    Wadley Regional Medical Center
    1000 Pine Street
    Texarkana,TX 75501
    When I start my IV I have my Vacutaner barrel hooked up to the end of a dry extension set that I attach to the cathere. Catheter is then secured using a chevrion or what ever device you use to secure the IV catheter to the patient. Then draw the required blood, disconnect the barrel and flush the line with 10cc of Normal Saline, finish taping it in place. I have not had a single line pull out using this technique, and have only had 2 or 3 hemalized. blood samples. The mess is no greater then you would get putting the Extension set on with out drawing blood and less irritation to the vein, all of the manipulation from changing vials is absorbed by the extension set tubing.
    Last edit by hal248 on Oct 17, '04
  2. by   lpnstudentin2010
    Quote from USFbsn2b
    Very informative thread. I think that is my major concern...I don't want to cause any more pain to a patient.

    Use EMLA (if you have time). I am not a nurse but have had many IV's and EMLA works like a charm. You do not feel the needle enter. You may feel it being pushed into the vein further (like after it is already in the vein) but that just feel wierd does not hurt at all (and I even have a low pain threshold)
  3. by   labman
    I can't wait to start IV's. I am currently a phlebotomist I even learned some tricks that will help me with my job. I have been doing this for 2 years.
    Just remember that practice makes perfect (really intiminating at first ). I remember starting I was a mess. When starting don't get to upset if you miss a lot. It takes a lot of practice to hit veins.
    -Remember to anchor the veins (pull back on the skin the skin) this really helps.
    -Get a good feel. That is a big trick. Don't just go on looks. Veins should feel like a stretched latex tournequet (stretched rubber band).
    -If you don't get it after 2 attemps ask someone else to go for it. After 2 tries you will have a very low chance on the third time.

    That is all I can think of now. I hope this isn't just repeat or will help.
    KENT
  4. by   Cherre
    Quote from Fergie
    I am shocked that the thoughts have changed on IV needle sizes.

    Old school maybe, I would never even consider giving blood with any thing but an 18 gauge or larger.

    I would like to see more studies on this. I always go for a 18 gauge, don't even consider a 20 or a 22.

    Maybe it depends on the acuity of the pt? Or as previously stated the policy of the hopital?
    I'm a nursing student, we've been taught that blood needs transfused by nothing smaller than a 20. We've had our IV certification class, unfortunately the class was a joke. It lasted less than an hour, we practiced on rubber blocks that had cannon size "veins". I haven't had a chance to try one yet, but I sure appreciate all the tips I can get.
  5. by   military girl
    I don't know if you are male or female. You are certainly not helping our profession with comments like that. Remember, you were once new. If you have this attitude, get out.
    Nurses do eat their young, and it seems like you feel you need some more.

    Quote from thanatos
    this has been discussed ad nauseam. try a search.
  6. by   Cherre
    Quote from military girl
    I don't know if you are male or female. You are certainly not helping our profession with comments like that. Remember, you were once new. If you have this attitude, get out.
    Nurses do eat their young, and it seems like you feel you need some more.
    I'm sorry you feel that way, the fault of that class was on the instructor, not the nursing profession. I'm not so much worried about helping our profession as I am in helping the patient.
  7. by   mommatrauma
    Quote from Cherre
    I'm sorry you feel that way, the fault of that class was on the instructor, not the nursing profession. I'm not so much worried about helping our profession as I am in helping the patient.
    Cherre, I don't think that comment was directed at you...
  8. by   z's playa
    Quote from military girl
    I don't know if you are male or female. You are certainly not helping our profession with comments like that. Remember, you were once new. If you have this attitude, get out.
    Nurses do eat their young, and it seems like you feel you need some more.

    Hi. I'm all for reviving past threads that have been out of circulation for years sometimes but since this person actually wrote their comment back in July of 2004... :chuckle

    I know it would bother me if I said something wrong and had to get balled out for years to come.

    Soooo...that being said....I don't have any tips to starting ivs but I do have a comment. I have received a ton of IVs and not once did the nurse EVER wear gloves to start it or take it out. EVER. I found that strange. Is this normal? Is there a time wear no gloves is called for? When there's an accident and a significant amount of my blood is spilled on the nurse's hands, I automatically tell them I don't have anything they could catch. Is that wierd? Thanks.

    Z
    Last edit by z's playa on Jun 2, '05
  9. by   alaskagirl
    I always try to use a vein that is on the forarm. Having worked with nurses that only try the hands first, when the pt is getting large doses of iv abx the ones in the hands will go bad first(in my exp.) Not only that but if the one's in the hand are hep-locked they also tend to go bad way before the 3 days. And if they are ortho pts on crutches. If you will put them mid way on the forarm then the pt doesn't tend to hang them on things. And please don't forget that there are also veins in the upper arm. I have had so many good iv starters that came to me and said that they were unable to get a vein, i go in there and look at their upper arm and they have a whopper! Be aware of those young guys who have veins that you can see across the room, their skin is so thick i always blow the vein trying to get past the skin. Hope that helps
  10. by   hidesert
    Quote from gwenith
    Looooove the background sounds on this one!!

    http://www.enw.org/IVStarts.htm

    wowwwwww! thanks for the site info. i really apreciate it, any tips to help us.
  11. by   hidesert
    Don't tie your tourniquet too tight on patients with big ropes...you'll risk blowing the vein.

    When you don't succeed the first time, try sometime different the second time...change arms, try a smaller cath, move the tourniquet higher or lower...

    just a thought- when I was a student, I read an article about IV starts which recommended with elderly/frail people that a tourniquet NOT be used. I have had several successes this way. My most proud stick was a 97-yo teeny oncology pt, no tourniquet and it went in the first time. I have used this method on other pts also. My instructor was leery but it worked.
  12. by   amykobus
    WHEN YOU HAVE ONE OF THOSE LITTLE OLD LADIES WHO HAVE NO VEINS, YOU CAN RUB BETADINE ON THE SKIN AND SOMETIMES YOU CAN SEE SOMETHING HIDING BECAUSE IT KIND OF LOOKS BLUE. ALSO APPLYING WARM COMPRESSES HELPS ALOT.
  13. by   ciwill
    Before I would use any of the tips, I would make sure they are the standards of the INS. That is what standard you are going to be held to. First, Alcohol is not the standard for cleaning it is chloroprep.

    Second the hand should not be used with vesicants and should be avoid for IVs to stay in place due to possible damage. The acutual practice is the smaller the needle the less damage to the vessel.

    There are many chagnes with IV Therapy and if I was educating staff, I would make sure you follow the right standards.

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IV tips and tricks