I need HELP!! with IV starts - page 5
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 of the worst, the baddest of... Read More
- 0Aug 2, '11 by MUSKOKA MEDICShey, 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
- 0Aug 2, '11 by MUSKOKA MEDICSin 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.