Best ER Tricks what it meant is like putting two tourniquet to get the IV

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I saw a ER Doc twisting a bag of saline to create like a pressure bag system because we did not have one at the moment. it seem to me like a very good idea we were in the middle of a code. So i though to share it here and i would like to hear your tips and tricks too. thank you guys. Just post no matter how silly it seems!

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If your having trouble getting a large bore IV in a critical pt with low b/p I have found one trick that has helped at times. If possible start a small IV in the hand or wrist and hang NS on it. Place a turniqutte on the pt and let the NS run wide open may even need to apply slight pressure. If all works correctly the veins in the upper forearm and AC area should start to rise up as they fill with NS and make then easier to get into. I've done this a couple times on pt's by starting a 24g in the hand because we could not get anything else. After applying the NS the veins popped up and I've gotten 14's and 16's in the AC. just be aware that you may not get a blood return and may actually have NS running out of the IV you just stuck. It was really bizarre the first time I saw it. Anyway just my two cents.

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Edrn10 that is just amazing, that's just one of the best tricks i have heard. Hopefully people would keep posting new tricks not only for ivs for anything hypotension, drug seekers, anything that you wont find in a book! Thank you for your reply!

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It's amazing how patients always say they can't provide a urine sample, but when I inform them of our policy to give them 20 minutes to pee, then we will go in after it (I&O cath) they are able to miraculously give me a voided sample! :)

When giving kiddos PO meds when they're not willing, I always hold both arms straight over their head (stabilizing their head) so that they aren't able to squirm so much. Works like a charm and they tolerate it so well. So much better than having them thrash their heads back a forth getting meds all over the place! Of course, I always try having the parent administer first, what ever is easier and less stressful for the kid, but sometimes you gotta make it happen!

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Specializes in ED.

If I can't get my hands on a pressure bag and I gotta have one NOW, we use a manual blood pressure cuff and inflate it on the NS bag.

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Specializes in ER.

My personal take on the drug seeking thing: I pull a sympathetic face and tell them how worried I am that their pain is so poorly managed because one day...when they have horrible pain from cancer or something, they will allergic to all the narcotics they presently have to take. I then make a super sad face and administer whatever it is they have been prescribed.

Works like a charm...

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Awesome the urine trick that is so true, hey either you pee or i will get it with my I&O cath. Awesome trick and this stuff made sound mean but at the end is just for their own good because the faster they give you the sample the fast the either get admitted, transferred or DC home. SO cool thank you for your post!

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Hey that is so true very good tip to deal with the D-seeking patients maybe it would even go as far as making them quit on the drugs. I'm trying to be positive. thank you for your comment.

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I love this one no pressure bag ok, get the BP cuff everybody is gonna be like what:eek: and it is true it works just as good. Sometimes when i want to get the iv fast i also use the bo cuff to squeeze those veins out!

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Not a nurse yet, but I'm an ER Tech and I have seen a doc use the bp cuff in replace of a tourniquet when the pt was a hard stick. Completely dehydrated, dialysis, hypotensive.

I should add he kinked the tube by holding it pinched. I was afraid the whole arm was going to pop off from the pressure :redbeathe but the nurse had access in a few seconds!

I was in awe! But then, that's how I spend most of my shifts these days!!! :bowingpur :nurse:

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Always ask an IV drug abuser where their vein is.

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ESME- That works sometimes so long as they haven't OD'd and are unconscious. Depending on you facility but our ED lets RN's pt lines in EJ's. IV drug users usually resort to shooting up there after all other veins have failed, so unless you get a hardcore user you can usually get an EJ. If they are gone then it's time for a central line in my experiences at least.

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