IV tips and tricks

  1. 2
    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
    mumarada and ShannonRN09 like this.

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  2. 293 Comments...

  3. 3
    1-Apply a tight band and start looking at hand up first (unless you need a specific Iv site i.e. 18g AC for CT to r/o PE)
    2-Use only the gauge apporiate for the vein
    3-Assess the vein before you stick it
    4-Apply a warm compress to raise veins if needed
  4. 0
    this has been discussed ad nauseam. try a search.
  5. 42
    Quote from thanatos
    this has been discussed ad nauseam. try a search.
    Regardless, we have the opportunity to teach someone something, so lets take that opportunity.

    IV's just take practice, stick everyone you can until you feel comfortable. soon you will be able to do it with your hands tied behind your back. however, we all have our days when we cant miss and then theres days we couldnt hit a cannon with an angio cath.

    the first thing i tell everyone is that selecting a vein is never ever something you do with your eyes. you have to do it by feel. one vein might look good, but it is too frail. get to know your veins.

    a lot of people are afraid to use the bigger 18 and 16 gauges in the beginning. im the exact opposite, i cant remember the last time i used anything smaller than an 18 gauge. the needle is firmer and doesnt give as much.

    stay away from thick veins right below a bifurcation (where the thick vein turns into two small veins, like a junction in the road, these ivs almost always blow in the first hour)

    women have the "rule of thumb". theres almost always a vein that comes off of the thumb where the forearm begins. look around, youll see im right.

    any patient, and i mean any patient who has even the slightest chance of being a surgical patient, be it an AP or abd pain or trauma, should have a large bore iv 18g or less. the anesthesiologist will put a second larger line in if you dont.

    anyone receiving anticoagulant clot busting therapy like TPA or equivalent should have three lines, one 18 or 16 gauge for blood draws before the med is given. pop away.

    even if you dont know what you are doing, try and make it seem like you do. be professional, dont let your hands shake, and read your patient. their eyes can tell you alot.


    good luck if i think of more, ill post it later.
    1heart2lungs, S.RN, doodlenoodle, and 39 others like this.
  6. 48
    oh, and if a heroin addict says "thats not a good vein" , they are right.
    doodlenoodle, MrsCuoco, curlsrocck31, and 45 others like this.
  7. 0
    Thank-you, Thank-you Trauma!!
  8. 0
    Do not be afraid of the needle. I was taught to go in slightly to one side of the vein.
  9. 4
    A friend in nsg school had trouble remembering where her veins were once she had rubbed the site down with the alc pad, so our clinical instructor taught her to pick her vein, pick out where she is going to insert the IV and take the end of a skinny ball point pen (not the marking end) and make an indentation at the site (not enough to hurt the pt...), then clean. The indentation will stay long enough for you to stick. Good trick for beginners.

    I go more for the feel of veins, rather than if I can see them or not. To me, a good vein has kind of a spongy feel to it. My best advice to anyone new at this is to do as many as you can, because that's really the only way to learn the tricks and perfect your technique. That's how I'm learning.
  10. 17
    Quote from thanatos
    this has been discussed ad nauseam. try a search.
    Nurses eat their young is ad nauseam- seems like you have it down pat though?
    JHU2016, LalaJJB, jelly221,RN, and 14 others like this.
  11. 5
    Looooove the background sounds on this one!!

    TeflonNurse, farzzi,RN, Capt_Syd, and 2 others like this.

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