IV Starts - page 2

Help! How many times do you all try to start an IV on a baby? I get so frustrated sometimes. We will normallly try a total of 4 - 6 times(different staff RN's) before calling the NP's. I was ready... Read More

  1. by   MEtheBabiesRN
    Two sticks is the max for anywhere I've worked. My favourite is the saphenous vein. Least favourite baby to start an IV on is the big term babies. Can't see a thing.
  2. by   Darlene K.
    Two sticks is our limit.
  3. by   cindyln
    I will try 2 times and then call anesthesia. I have never seen one of our docs attempt much less put in an IV but anesthesia will give it a try. I love scalp veins.
  4. by   Mimi2RN
    We do two sticks and then someone else tries. Sometimes everything blows on a term baby, but the little skinny vein on top of the foot will be a good IV, even if it doesn't look big enough to hold a catheter at first. I will also go for a scalp vein, I think they work well, even in breast feeding babies. I've never looked at the back of the head, though........The vein that I don't use is on the inside of the wrist. I think that hurts the babies most, it certainly would hurt me!
  5. by   LilgirlRN
    I work in the ER and we usually don't have to start IV's on babies that small...I recall reading somewhere about trying a thin film of NTG paste over the site on newborns although I've never tried it myself. Has anyone?
  6. by   KRVRN
    We try 2 sticks each until we've come to what we all agree is the best IV starter on the unit at the time (usually a veteran RN or NNP--never an MD) and then that person will try over and over until we get something. If it seems like it's going to be a hard baby we go to the best person either right away or after maybe 1 other person tries. How funny... scalp veins are ALWAYS our last resort. I like the hands the best and just about always go for those first. I also like to use the transilluminator, sometimes after a visible hand vein blows I can find the same vein a centimeter or 2 up and then hit it.

    We have never tried NTG paste. I'm sure it would work but I can see even a small amount on a preemie messing up the BP. Then again tiny preemies are a lot easier to start IV's on than big babies.
  7. by   NICU_Nurse
    Speaking of transilluminators, what type do you use and/or prefer? We don't have these on the unit, but I noticed in the journal I got a few months ago an ad for a cool-touch transilluminator for around 150$...was thinking of getting it for my own use but have no experience with them. Any thoughts? ;>)
  8. by   travelingtweety
    Don't spend that kind of money on a transilluminator. A penlight will usually work just as well for IV starts. Just make sure it doesn't get too warm. I have a tiny light I take with me on air transports, works great. I think it came from a camping/hiking supply store. Make sure it's the kind that stays on without having to hold a button down.
    Laura
  9. by   NICU_Nurse
    Laura, that's a GREAT idea!! I'm going to try that at work tomorrow. Isn't it funny how those simple ideas just never occur to you sometimes? Thanks for the tip. ;>P

    Kristi
  10. by   NiteNICUNurse
    Transilluminators usally don't work as well for term babies. Iv'e found that putting heel warmers on the area for a while seems to help. Our policy is 3 sticks and then fentanyl SQ before trying again. Of course this can be a problem with non vent babies! I usually go for the deep veins in the leg and near the knee. But a lot of my co workers like the small vein by the thumb, even though its small it seems to last. Also not using a tourniquet for an infant whose veins tend to "blow" seems to work.
  11. by   kmaryniak
    It's always been my practice to a limit of 2 attempts per nurse. I love scalp veins, personally. I know parents don't like the look of them, but they work great, and tend to last. I've noticed at my recent hospital that some nurses take as many attempts as they want (even 4 or 5). The worst is, I've seen some nurses re-use the same needle/cannula, after flushing it with saline. I think that is the worst! I prefer not to use an elastic for a tourniquet, because sometimes it does more damage than good.
  12. by   Bikerchic
    I used to like starting IV's on adults, but after 7 months of trying on the babies and not being successful I am real frustrated. I can get a blood return many times but then it blows when I advance it. I have never tried a scalp vein yet, but I think they work well. We have a transilluminator; I like it but it can be awkward. And I learned from a more experienced nurse that it is easier to start an IV in a bigger baby without it.
    Has anyone had problems with their catheters? We have been through 2 different types since I started. One type was sent back to the manufacturer who tested them and found them to be troublesome also. I forgot what happened since I never saw it, but I think it left a small lump under the skin next to the insertion site. What type do you use? I just started back to work 2 days ago after being gone since Nov. but I think we are back to using Jelco, which was discontinued before my orientation, so I never used it myself. We had an angiocath after that.
    Any tips on how to get proficient at starting IV's? Or how to advance them without blowing them?
    Thanks.
  13. by   Heather333
    I had the same trouble with IV's that you did when I first started. I would get a blood return then BOOM there goes the vein. I found out that I was going through the vein because I was aiming too deep. The veins are much more superficial than you think sometimes. I rarely use a transilluminator and have never used one on a big baby.

    Heather

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