IV tips and tricks

Don't know if it's already been mentioned, but I love the UA veins on elderly folks who like to have "picking parties" with lines they can see. Thin, elderly men seem to have the best veins in the upper arms and IV sites there can easily be hidden with the gown. Out of sight, out of mind.

Also, I do tend to ask people if they have an arm that's particularly good for an IV and I will always feel that arm up first. As someone who has a very deep, flat right AC, I can appreciate what kind of hell it can be to have someone digging around that AC when there are huge veins elsewhere on my arms.

24s suck, even on infants.

Good information. I just recently Graduated Nursing School......and it seems like when I was doing my clinicals and preceptorship, I couldn't miss...... but now that I graduated.... I can't hit the side of the barn..... I'm scared to death to of starting IV's in the hand....I'm going to try the suggestions tonigt and I'll let you know how it turned out....

IVs are a huge problem for me too. I feel so incompetent, though I have confidence in all of my other clinical skills. This is an amazing thread! Now I've got some new stuff to try to take my mind off my failing record.

From a patient, experienced w/long-term IVs, hand sets are THE worst for most patients. I recognize the need in many instances, BUT - I've yet to have a hand IV set that didn't leave me w/bruised nerves in that hand and/or wrist. I've had no problems w/IVs set anywhere else, long or short term. My longest experience w/constant IV was 8 weeks.

Thanks for all the wonderful tips!
I also found this sight that has tips on IV's, NGtubes, catheters and Peds IV's, I found it very helpful!!



http://mynursingtips.com

Um, unless I am completely blanking out Dobutamine would not cause hypotension. Also I dont beleive most hositals would allow a patient to be on that unless they are in an ICU setting.

Sweetooth

sometimes that works, other times you go in right on top of it at a 45 degree angle - also if it's particularly hard to palpate, try a tourniquet above and below the site to pop it up - that works well.

Dobutamine S/E: tachydysrhythmias, VT, VF, HTN, N&V, H/A, AMI -

There are worse things to worry about with Dobutamine... hypotension is not oen of them..

My #1 rule, ALWAYS asses both arm's when looking for a good vein. After 22 yrs I still forget this rule and after an unsuccessful attempt, go to other arm and find the gold mine.

I get a kick out these threads as you can find who the gun-ho I never miss types are. I don't trust anyone who says they never mis or never make an med error. Those are the type of people who will cover up mistakes and not take accountability for mistake because they have to preserve their fragile ego's.

I put in what I can get in. If it's a kid 24 or 22. Medical's get 2o's, traumas get 16. But if a trauma comes in and I blow a 16, my next try will be a 18 to gain access, then when I do get access, I'll do another 16.

I've been doing IV access since 1980. It's practice, gain confidence, but don't get cocky because your as good as your next stick!

I have to disagree. I think you can be a see'r or a feeler when it comes to IV's. I am definately a see'r. If I can see the vein, even if it is a shadow I do MUCH better when sticking. Infact, if I can see the vein, I don't have to feel it to get a good IV. I don't ever put anything less than a 20 g in an adult. I have even started many 20 g IV's in Peds. Now infants I always use a 24 g. The best sites I have found of coarse is the AC and the inner wrist behind the thumb. Also the dorsal aspect of the forearm has a great vein especially in males. You kind-of got to work upside down tho with this one. Here is some good information on IV's.

http://emprocedures.com/peripheralIV/anatomy.htm#sites

http://findarticles.com/p/articles/m...g=rbxcra.2.a.1

http://findarticles.com/p/articles/m...g=rbxcra.2.a.5

Also, be sure to look at all your options before sticking. The first vein you come across might not be your best.

Remember, there will be good days and bad. Some days I can't hit the broad side of a barn, but then others come and I have a good IV day. Not to say I hit everyone, because no one hits every IV on the first stick.