[moonshadeau]

Does anyone have any good nursing tricks that they would like to share with a relatively new nurse? I am particularly interested in learning how to use lidocaine before starting an IV and not losing the vein in the process (This was a patient demand and with very poor success on the IV start from several nurses). Thanks

[hollykate]

Hi There,
I have never done this by many of the RN's I worked with on a Med SUrg floor did not use lidocaine or Emla cream, they used ICE. It numbed the skin very temporarily, but the pts seemed quite happy with it. I'm not sure, it seems ice would also cause the vein to shrink up some? Good Luck.

[Zee_RN]

Better check hospital policy, too. Emla cream and lidocaine are medications requiring a doctor's order....unless your hospital policy specifically allows Emla cream (I doubt they'd allow lidocaine as a standing order).

[windancer]

Originally posted by moonshadeau:
Does anyone have any good nursing tricks that they would like to share with a relatively new nurse? I am particularly interested in learning how to use lidocaine before starting an IV and not losing the vein in the process (This was a patient demand and with very poor success on the IV start from several nurses). Thanks

Moonshadeau it would be a good idea to check your hospital policies because here in La. ONLY CRNA and MDs are allowed to start
IVs in That Manner.

[lkushen]

Same in Ohio, only MDs and CRNAs use topical and SC agents to numb prior to initiating IV therapy. If the patient is a tough stick and "ouchy" to the max, get an order for anesthesia to start the line for patient satisfaction. Once you've developed proficiency at IVs, most ADULT patients are quite tolerant.

[crschlup]

Normal saline works as well as lidocaine and you don't need a doctor's order. EMLA is very expensive and takes an hour to numb the skin. Make a small bleb like a TB PPD skin test on top of the vein at the anticipated venipuncture site. No waiting needed. Insert the intercath into the needle hole in the bleb and proceed as with any venipuncture. Practice makes perfect. Try it on some easier ones first to build your confidence. Your patients will love you! It doesn't always work well on elderly patients with loose skin because the skin isn't tight enough to hold a good bleb. Good luck and thanks for wanting to do the best for your patients.

[lagala]

Originally posted by moonshadeau:
Does anyone have any good nursing tricks that they would like to share with a relatively new nurse? I am particularly interested in learning how to use lidocaine before starting an IV and not losing the vein in the process (This was a patient demand and with very poor success on the IV start from several nurses). Thanks

Make a bleb with the lidocaine, 0.1-0.2ml just above the insertion point, massage in first. Qualified RN's can do in our area
Good Luck
You can make a bleb with 0.1-0.2 ml lidocaine just above the insertion site. Massage in prior to insertion. Qualified RN's are able to do.