Quote from Asystole RN
If you are asking which veins to look for I would suggest the radial vein, basilic, cephalic, ulnar.
On a personal note: This week I have really been into sticking shoulders for some reason. Out of the patient's way, doesn't inhibit movement, confused patients leave it alone, nice large virgin veins...many people forgot to look above the AC.
The radial and ulnar vein are deep vessels, and not ones that are easily assessed without U.S. I'd also be concerned sticking a vessel in the shoulder area... First there usually aren't vessels found in this area as they are buried deep here. So the fact that you are sticking them, (though you aren't stating whether you are using US or not) is a concern. because you must question WHY IS IT THERE???
But to answer the question: Start distally, if possible to save the proximal veins for future VP. There are many factors to consider when choosing a vein, however, not just its location. One factor is how long of therapy are you looking at? You wouldn't want to have the pt being stuck q 72 hours for 14 day, much less 6 weeks of IVAB
Rx. Also, is this an emergency setting and you're looking for advice... Most of those professionals in ER go for the ACF veins as they are easy to palpate and access. Another important point is what are you infusing? Digital veins only for isotonic solutions without additives. Avoid metacarpal veins of those with obvious arthritic hands and avoid metacarpal veins for those who have those ropes, on the back of their hands, or for those who use walkers, or are compulsive hand washers. Do not place short term peripherals on the underside of the patient's forearm as the nerves of the brachial plexis are plentiful here and infiltrations/extravasations can be determental here. Any solution with an osmolarity > 600, a pH <5 or >9, a dextrose concentration>10% or an amino acid > 5% should go centrally.