Any tips for starting IVs?

Mystery5 · Jan 19, 2005

Approach the vein at a shallow angle. Don't let the catheter tip slide over the needle. Don't forget to take off the tournaquet! Take time to look carefully for a good vein. Try and anchor the vein from both top and bottom. Use a small cannula, esp while learning. Diabetics have thick vein walls, use a smaller cannula for them.

medic1488 · Jan 19, 2005

Put the catheter in the vein:) . Just being a smart a**. Good site selection, and good distal traction.

kesneysmom · Jan 19, 2005

I agree with the above. You will be fine. Everyone that is a nurse has been where you are right now. It takes practice. Just take deep breathes and remember you are not going to be successful with everyone you stick. Hold the skin taunt to steady you and the persons skin. Practice as much as you can (not on the same person or they will hurt you!!)

errn7 · Jan 19, 2005

Every one has their own technique...after years of practice. Starting out, ALWAYS, prepare everything first......Nothing worse than having the cannula in the vein and nothing to hook to it. No tape torn or anything like that....I always measure to see where the hub will be so that I can make sure its going to fit. You dont want it sticking somewhere, where it can get pulled out or pushed deeper........Personally I start beside the vein I want the needle to go into that way you can get it under the skin and stabilize it before introducing it into the vein.....Always use a shallow angle of approach and learn how they feel before sticking them....once u find the vein close your eyes and rub your finger over it several times to get the feeling of how they feel. It takes lots of practice on different types and even skin colors to get comfortable sticking.....and then there are some days you couldnt stick the broad side of a barn standing beside it.....

cabbage patch rn · Jan 19, 2005

It takes lots and lots of practice. At least attempt every IV start you can get your hands on, the more often you attempt, you will get the feel for the procedure and an idea of what works and what does not. Some tips: Lower the patients head if that is an option, the veins in the arms will dilate better. Try to follow where the vein goes in order to determine which vein to stick. Place the tourniquet 2-3 in. above the insertion site. Place a towel or blue pad under the arm prior to starting the IV to avoid messes. Stabilize the vein with the thumb of your non-dominant hand prior to venipuncture to keep the vein from rolling. Stick through the skin first bevel up right above the vein, then advance very slowly and shallow until you see the "flash" of blood in the cathlon. Advance the needle at the same angle just a little bit farther (this is something that you get a feel for) maybe a couple of mm's and then remove the stylet and advance the catheter. We use a connection device (the name of it escapes me at the moment) that is screwed onto the catheter hub before connecting to fluids, so we have the option to draw labs before hand. After connecting to fluids, open up all the way to check for patency and watch the site for swelling in case of infiltration. Another tip for hard to see veins: When I used to work for a blood donation service we would "mark" our veins with the plastic end of the betadine swab. Just make a little "o" target on top of the vein with the swab's end before you apply the actual betadine to the site which can further conceal the vein. It was a great tip that I learned from our director. When I started out, I would get so nervous and almost weak kneed while starting IV's, and I would end up psyching myself out. Find a stool or a chair and pull it up to your patient's bedside if possible and get comfortable. Remember to take your time and talk to your patient. Carry on a conversation with them the entire time to ease their nerves. You will appear much more confident and it will really calm your patient which will make your procedure go much more smoothly, as well as less painful. If you can't sit during the procedure, raise the bed up to a comfortable level and assemble all of your supplies ahead of time so that they are right there at your fingertips. Confidence is key when doing IV's and is something that will come with experience. I hope that something I've said helps you. Good luck!

Mommy2Katiebaby · Jan 19, 2005

Well, CabbagePatch RN, it helped me! I haven't started an IV in like twelve years, and I wasn't all that great at it even then, but I know I'll get to do a few where I work now...

sbroughman · Jan 19, 2005

One of the best things I was shown was to truly make the vein as accessible as possible. With older patients, and those with hard to find veins, apply a warm compress for several minutes to encourage vaso dilation. Having the patient hang their hand over the side of the bed helps as well. Stroking the vein with your finger before cleansing will encourage blood flow as well. Rubbing the vein gently works much better than slapping or flicking the vein.

DR2004RN · Jan 19, 2005

I have been reading all of these tips and they all sound very good. I too am terrible at starting I.V.'s (pts can have veins the size of garden hoses and I will still screw them up.) So I could use a few pointers. I will use some of these skills the next time I try to start an I.V.

mwbeah · Jan 19, 2005

Here is a nice trick, take a manual BP cuff and inflate it to 15-20 mmHg past the diastolic pressure to allow arterial flow but not venous return and watch the veins engorge....hope this helps

Mike

SproutRN · Jan 19, 2005

Here is a nice trick, take a manual BP cuff and inflate it to 15-20 mmHg past the diastolic pressure to allow arterial flow but not venous return and watch the veins engorge....hope this helps
Mike

This IS a great trick taught to me by one of my MDA's during my first clinical rotation! Too bad it took me 7 years of critical care experience and CRNA school to learn it. :chuckle

Like anything else it just takes practice, don't get discouraged and keep trying!

Sprout :nurse:

Jamesdotter · Jan 20, 2005

I found that if I visualized the entire procedure before I went to the bedside I had much better success than if I just bounced in semi-prepared. Visualization was especially helpful when I only did a couple starts a week.