Where do you prefer an IV?

Nurses General Nursing

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This thought was triggered by the IV size discussion at https://allnurses.com/general-nursing-discussion/size-matters-iv-836846.html

If you are a patient, where would you prefer an IV to be placed? Personally, I can keep my arm straight if it's my off side, and I am not a fan of hand vein IVs for myself, so an AC for me please.

I was just released after 10 days & surgery. The very best IV I had was in the back of my forearm...a little awkward to insert but that's a huge mostly unused ever vein. I absolutely refuse to have one in the hand or wrist because they hurt but mostly because of the risk and complications associated with medication infiltrations. My IV meds infiltrated 3 times and I'm pretty sure my formerly best veins are sadly no longer among the living!

Specializes in ICU/PACU.

I had one in my ac. It didn't beep. Great vein.

Specializes in ED, Critical Care.

Forearm ideally.

When I work EMS, I've put lines from the feet to the EJ (neck).

Now with the IO drill, difficult IV's are almost a thing of the past.

Specializes in LTC, CPR instructor, First aid instructor..

Anywhere but the foot or the hand.

I am both sides of this argument. I started in ED, where I was taught to go for larger veins in or near the AC because a) they're often easier to find and b) if you code/need blood/whatever, it's easier to shove an 18 in you and administer fast.

When I'm floor nursing, I'm constantly frustrated by AC IVs because they're positional as hell, patients hate them because it makes it difficult to sleep, and my confused patients can never keep their arm straight for very long. I also hate ones in the hand, because if you have it for more than a couple hours, it gets really sore.

Last time I had to have one, I begged them not to place an AC on me, and they put a midline in my upper arm. Best placement I've ever had. No IV pump alarms, it didn't hurt, it wasn't positional, I was able to sleep without worrying about messing it up.

The forearm is least problematic because no joints to flex, although I had one on underside of my left forearm last year (I'm right handed) and it was pretty uncomfortable. I work in Peds and we often use the AC in our little kids and tape arm to a board so they can't flex. That's probably the best way although not always practical, especially in dominant arm in an older patient. My hospital is a trauma center, and most patients who come in through EMS have an AC IV and we will keep using it until it goes bad.

They go for the a/c because you are having iv contrast and that is the preferred site, a nice big vein. Can't use anything below the wrist for IV contrast, especially if it is a r/o P.E. Also, many places have policies that the IV site will be changed within 24 hours for an IV placed in ER or ambulance, so it doesn't really matter.

If I had my ideal, outer aspect of the non dominant fore arm, 20 or better. That only seems to happen on the mostly healthy 20 year old makes, though. I hate AC because they kink constantly and I've had patients refuse iv anti biotics because they're "sick of that machine beeping at me all the time, just tell the doctor I want a pill, no, you can't put another one of those iv things in me because you guys didn't do it right the first time."

Sigh.

I also like having the AC open for blood tests. The pt is going to be stuck at least once a day, so why not stick them where it hurts the least and works the best? Were not supposed to get labs out of the iv, after all.

For use in the OR we try to place the IV in the hand - mainly because of patient positioning in the OR and the fact that the anesthesiologist is at the head of the bed using the IV, they can keep an eye on it better if it is in the hand. Personally I do not like the wrist as the veins seem to roll worse there, and more nerve damage occurs there than any other place.

Specializes in Psych ICU, addictions.

Left forearm preferred. If you must, the top of the left hand is fine too. Please, not the AC if you can help it.

Specializes in Emergency Room.

Forearm for sure! I had a 22g IV place in my AC for a hyda scan w/ contrast and it was so darn annoying and pretty painful every time I bent my elbow. As far as the hand, I would find it annoying not to be able to wash properly. When I place IV's, I usually go for the forearm if there are decent veins, but if not I go wherever I am confident I'll get it. I find patients would rather not be poked more than once.

Specializes in ER/ICU, CCL, EP.

I try to start them in the forearm. Having said that, tons of my patients wind up with AC IV's. I hate doing it, but when they have been puking for a few days or just arrested, I figure we can put a more comfortable IV in later.

I HATED my own IV in the AC.

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