I need HELP!! with IV starts - page 4

I find that IV starts are the most frustrating thing that I've ever had to do in nursing, perhaps the most frustrating thing I've ever had to do in my life. I could be, and very likely am, the worst... Read More

  1. by   Jasano
    Quote from sunny.shine
    become one with the vien , relax ask for help from a higher power..I go for God..pull skin up so its not too lose..but dont make it too taunt go shalloowneedle is very close to angle with skin..go in slowly ..its not a race ( if its pediatrics have a good holder)..once you get flashback ..pause then pull skin above Iv slightly more taunt..advance needle just a little bit more slowly..this is not a race then with fingernail start to thread off needle, once threaded pull needle out then put lslight prressure on site so youre not getting blood all over, hold catherther so it does not move hook up extention dry iv site with gauze put piece of tape to secure slowly start iv ..then come back an complete tape job ..always keep hold of the iv cathether so at this critical point it does not twist and pull out..stay out of your left brain..its really a right brain thing..let it flow! good luck! :Melody: :Melody:
    I agree with the posters who say: practice, practice, practice, BUT, that is not to say that the classroom has nothing to offer. Putting in IV's is a complicated process, where plenty can go wrong. It is best to get the basic mechanics and idea down in a classroom, before you go hunting for veins.

    Here's another tip that might help in starting ivs. Have you ever noticed that when you apply pressure to that juicy vein, that you lose all sight of it? Try marking the vein with the needle tip, by just knicking the surface of the skin before you pull it taut. (Do not draw blood here - i'm talking about a surface knick only - this should drag up a little bit of skin marking your position). Then, when you do apply pressure, you'll see the tiny mark you made and know where the vein is.

    I like what you said about it not being a race - this is where a number of beginners go wrong - they see the flash back, get all excited, and forget to advance, advance at too sharp an angle, or too far. Since i've only fairly recently caught on to the whole iv thing, I can tell you newbies out there that this tip is gold. A higher power might help too, though you'd have to have established lines of communication.
    hey, sounds like you need a confidence boost. i would recommend you spending a few days in day surgery where you are going to see many patients in a short time period, and be around nurses who start IVs all the time. everyone has their own tricks.

    when i am teaching, i always urge nurses/paramedics to take the extra time when selecting a vein, if you rush it, and you are not confident, you will blow it. tap the vein, warm it up, drop the hand, make sure tourniquet is tight.

    when you approach the vein make sure you have secured it so it does not roll. if you are starting iv with your right hand, use your left to anchor the vein. when starting the iv, how you hold the catheter is extremely important. i use ProtectIV and BD catheters. i hold the catheter with my thumb and third finger. i use my first two fingers to anchor or lean my hand on the patients hand to steady my catheter, i keep my fourth finger on the push off tab and use it to "direct" or steer the catheter in the right direction.

    i always teach that going into the skin is the hardest because skin is either thin, frail, stretchy, or firm, rough and sometimes really tough. guaging the pressure you use to go through the skin comes with experience.

    here is what i teach our medics: skin/vein entry is one step, then you see flashback, so advance a little, then push off the catheter and retract the stylette.

    it works like minute rice every time!

    the other thing you can do is shadow someone who is really good and watch their technique first.

    and lastly, be confident, when you approach the patient, say "I am here to start your IV".

    i cringe when i hear the medics say "I am going to try your IV" there is no guarantee of success in trying. anyone can try, you want to DO.

    hope this helps

    in addition, manikin work is really valuable especially if you have the ones with fake blood
    you can see flashback and you can see when you are in

    i start my paramedics on skin pads, then they move to hands, then to the IV arm simulator

    once they get all that, they start them on each other in class so that they get their hands on real people before they get to clinical

    if you can get a great instructor to help you, the hands and arms are really valuable.