[morrisonrn]

Anyone have tips on starting an IV on an IV drug abuser?

[danfif]

My best and only advice is to just ask them where the best vein to hit is, cause they know them the best as you could only imagine.

I have had guys with tree stumps for veins that shoot up, and you can't get into them they are so hard. So again, just ask them, they will tell you.

Dan

[PICC ACE]

Obviously,wear yer darn gloves. I have heard of some health-care workers telling their 'shooters' to save a vein for the hospital--if they ever OD,the Narcan has to go somewhere. Don't know how much good it does but can't hurt. Also,if you have a needle-exchange program in your community,refer them to it. If they're going to shoot up,at least get them clean syringes.

As an anecdote-- One abuser I
have had to deal with needed access pretty urgently one day (broken ribs and PTX after a motorcycle accident),and the only thing I could find at the time was a saphenous site. Guess what--it was news to him that you could use a saphenous vein. He came in a few months later with two open ulcers on the inside of both calves. "Oh,I was climbing a tree and skinned them" said he. Yeah,right. After I discharged him,the housekeeper came up to me and asked where the sharps container was so he could take it out with the rest. Seems my buddy managed to rip it off the locked bracket and left with it.

[VivaLasViejas]

Originally Posted by danfif

My best and only advice is to just ask them where the best vein to hit is, cause they know them the best as you could only imagine.


Dan

Exactly what I was going to say.

Seriously........these folks know their veins, and it pays to listen to 'em. I once had an admission who told me he'd used up all but ONE vein........in his right thumb! (As a right-hander, that was the only one he couldn't hit very well.) They couldn't even put a PICC in, his ACs were completely shot. Fortunately for all concerned, I was able to get a 22-gauge in the thumb on the first try (the patient was in for sepsis so antibiotics were needed STAT), and then the MD put in a central line later that night.

Sometimes I've been tempted to let them start their own IVs....they're so much better at it than I am!

[Darlene K.]

Originally Posted by mjlrn97

Exactly what I was going to say.

Sometimes I've been tempted to let them start their own IVs....they're so much better at it than I am!

I was thinking the same thing!