IV starts - anyone get better? - Page 2Register Today!
- Jul 1, '12 by nicubabies4meI'd love any advice as well. I've been in the nicu for 6 months and I feel like I'll never get one. I get a flash almost every time, but when I flush, the vein always blows. I've tried so many things. Question - do you go right on the vein, or try to go below it and advance up to it. Also, advice for jaundiced veins. Why are they so tough anyways??
- Jul 1, '12 by prmenrsJuandiced kids are tough because they are frequently very dehydrated! If they can tolerate it, feed them 1st. If not, sometimes it's easier to put in a UVC, give some fluids, remove it, and THEN put in an IV. jmo, but docs don't really want to.
If you have a "rolly" vein, try stabilizing it w/one finger above and your thumb below it. After you get your flash, advance the catheter a tiny bit before removing the stylus. Sort of "catheter in, stylus out", if you will.
Even very experienced nurses go thru dry spells when you can't hit the proverbial broad side of the barn. Keep trying!
- Jul 2, '12 by CoraBethNICURNAre you using the pre-filled syringes? Those require more pressure to flush and often cause more veins to blow.
Also, do you have a posi-flow on your IV extension tubing? That also causes you to need to use more pressure to flush. Can you flush without a posi-flow, and once the IV is taped and secured, add the posi-flow?
Another tip (which someone already posted) is to not push the catheter all the way in, but rather "float" it in the vein as you flush.
Try not to get discouraged. Even the best IV start nurses go into slumps.
You'll get it!!
- Jul 14, '12 by kreneeThanks for all the advice & tips! I did get one last week so I felt a little better . . . but I still blew 2 veins getting blood cultures. About floating it in though . . . we always draw our labs when we start our IVs, so I don't see how I could float it in. We get the IV, get the labs, then attach the syringe to flush.
- Jul 14, '12 by prmenrsIn both the hospitals I worked NICU, we did not get labs via the IV start. Yes for Umbi lines, not for peripherals. It's too much pressure, imo, for those fragile veins + the small gauge IV device. Obviously, the pros @ your hospital do it and more power to 'em, but I can see how a newer practitioner might have problems.
It's done all the time on adult pts, esp in the ED. Great. Their veins have lots of layers of cells constructing their integrity. Newborns and premies. Not.
Look for customers who need an IV, but no labs @ that particular moment. Might increase your success and confidence. Then learn the more complicated technique. I wish you all the best!Last edit by prmenrs on Jul 14, '12