After blood return,then what?

[ohbet]

After venipuncture blood return,using an over the needle catheter,how do you then procede?

Do you insert the needle half way then withdraw it and insert the catheter all the way?

Do you "float" the catheter in with NS,then secure it?

Once the catheter is fully inserted do you then secure it or do you flush it then secure it?

Is it better to secure the catheter first or flush it first?

When flushing the vein do you flush with NS in a syringe or do you attach it to the IV line and flush via IV pump?

Ive seen nurses procedure a number of different ways,whats best for you?

[Coldfoot]

Like Dawn said, IMO it's better to tape after you know you've got a good line. Some people want to get A LOT of tape in place as quick as posible then have to pull it because the line's infiltrating or not flowing. About the only time I put any tape on an unconfirmed line is with squirmmy kids. Get a feel for yourself, you'll get a system you like down.

[MomNRN, BSN, RN]

I have to tell you guys all this IV talk is making me sad. I left floor nursing over a year ago to be a school nurse. The IV's are the only thing I miss. I loved doing them. Nobody at school will let me practice on them for "old times sake!"

[Tweety, BSN, RN]

I stop, advance the catheter in, then flush, then secure.

[globalRN]

After the flashback(blood return) using an over the needle plastic cannula...you should advance a tiny bit before threading the plastic. Reason: the plastic cannula is not as long as the needle

so the needle may be in the vein but when you try to advance the cannula..you are not in the vein. Advancing a tad more ensures that the needle and the cannula are both in the vein

[sjoe]

Momnrn writes: 'The IV's are the only thing I miss. I loved doing them. Nobody at school will let me practice on them for "old times sake!" '

Find a local junkie with shakey hands who might welcome the help.

[RNforLongTime]

I was pretty good at IV starts when I was using the ProtectIV by Johnson and Johnson. Now we use BD InSyte IV's and I HATE THEM!!!!!!!! Can't get a stick to save my life! Anybody else use this kind?

[Mimi2RN, ASN, RN]

We use Insytes, some problems at first as you can't always tell if you are in the vein. We use 24 ga on all the babies. Have some success with flushing the caths before we start.

Once I pulled out my catheter when I withdrew the needle, the little wings grabbed and oops! out it came......................

Floating it in means having a syringe of saline attached to your t-tube(or whatever you call it). Attach the tube to the catheter after you have removed the needle, and have someone else push a little saline in, sometimes this will open a valve and give you a good IV. Do this when you get a good flashback, which has stopped and the catheter won't advance. Tape the site last.

[sbic56, BSN, RN]

I was pretty good at IV starts when I was using the ProtectIV by Johnson and Johnson. Now we use BD InSyte IV's and I HATE THEM!!!!!!!! Can't get a stick to save my life! Anybody else use this kind?

We went from the protectIV to the Insyte where I am, too. They must be very competitive pricewise as that is their only possible selling point. We have all had trouble with them...way more failed attempts than I have ever had with a new brand of IV. Of course, the patients think we are merely inexperienced...shesh. Yeah, they are pretty much worthlesss in my eyes.

[NicuGal, MSN, RN]

I think I do a little of both LOL It depends on if it is a big whopper of a vein or a teeny little varicosity that this kid has LOL Big ones just get pushed in, the little ones I float in.

It just takes time. I have found with these safety caths that I blow a lot more than I used to...you don't get an immediate blood return and then I tend to "fish" and then it blows! Ugh!

We use the BD ones I think...I don't like any of them!

[MomNRN, BSN, RN]

Sjoe - thanks for the tip! Not that I know where shaky junkies hang out or anything. Of course, some of the parents of our BD kids might qualify.