Blowing IV's - what am I doing wrong?

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I've been and RN now for about 10 months and I've been working mother/baby now for about 8 months. We don't get many chances to start IV's as they are usually already done in L&D and the only reason we would need one is if one accidentally came out on a pt needing IV abx or meds. In the past few months I've had the oppurtunity to start about 5 IV's. Every time I blow the view! I am good at finding viens and can flashback no problem. But when I advance the needle and cath sligtly and then go to advance the cath the vein is blown. I suspect that I may have an angle that is too high. Anything else that I could be doing to cause viens to blow? Like should I pop the tourniquet when I see flashback or wait until I have the cath in the vein completely?

When I was in school I was great at starting IV's. I don't know what happened :down:

Specializes in Telemetry & Obs.
I have a question...during several different attempts at IV insertion, I have gotten good flashback, but when I go to advance the catheter, I meet resistance and it ends up unsuccessful. When I pull the catheter out after the failed attempt, the catheter is bent/kinked. WHY is this happening and how can I avoid it? It is so frustrating to know I am right there in the vein and then I'm obviously doing something to lose it. Someone earlier in this post mentioned to try advancing the need just a tad farther once you get flashback..do you think this is it? I have been trying to do that but maybe I'm not going far enough? I'm always worried about going through the other side of the vessel. Seriosly any advice is welcome, I need to get much better at IV starts, and quick!

You're not advancing the needle far enough....the catheter is getting bent when it meets resistance at the vein wall.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

THIS set of great tips and tricks, by an ED nurse (face it they are the best at this) ROCKS:

http://enw.org/IVStarts.htm

Emergency Nursing World: Improving Your Odds!

I tell you, talk about amazing success tips. I learned a lot even being a nurse with 11 years' experience!

good luck.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

PS: when you "hit the vein" always advance the needle JUST A TOUCH MORE and THEN advance the catheter slowly. This will help you immensely. Also "floating them in" is a trick that works, whereby you advance and push just a tiny bit of fluid from the saline lock or IV at the same time as you advance. It really works!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I agree with those who say a tourniquet is not always helpful. More so, if you "see" a tough stick (and we know who they are) before you even touch her or look for veins, get some warm compresses and place them on the extremeties and dangle them low. Have her pump her fists on and off. This alone will show you veins that previously you had no idea were there, esp in dehyrated people. If you do use a tourniquet, don't have to use much pressure and release it now and again to let blood flow if you are taking more than a minute or so to get going.

Hope this helps.

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Specializes in Labor and Delivery.
I've been and RN now for about 10 months and I've been working mother/baby now for about 8 months. We don't get many chances to start IV's as they are usually already done in L&D and the only reason we would need one is if one accidentally came out on a pt needing IV abx or meds. In the past few months I've had the oppurtunity to start about 5 IV's. Every time I blow the view! I am good at finding viens and can flashback no problem. But when I advance the needle and cath sligtly and then go to advance the cath the vein is blown. I suspect that I may have an angle that is too high. Anything else that I could be doing to cause viens to blow? Like should I pop the tourniquet when I see flashback or wait until I have the cath in the vein completely?

When I was in school I was great at starting IV's. I don't know what happened :down:

What you might find helpful is to spend the day in same day surgery department..no body starts more iv's than them!! Or the iv team..you get the idea. Starting iv's is a real skill and kind of an art, just takes time and practice...

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I have a question...during several different attempts at IV insertion, I have gotten good flashback, but when I go to advance the catheter, I meet resistance and it ends up unsuccessful. When I pull the catheter out after the failed attempt, the catheter is bent/kinked. WHY is this happening and how can I avoid it? It is so frustrating to know I am right there in the vein and then I'm obviously doing something to lose it. Someone earlier in this post mentioned to try advancing the need just a tad farther once you get flashback..do you think this is it? I have been trying to do that but maybe I'm not going far enough? I'm always worried about going through the other side of the vessel. Seriosly any advice is welcome, I need to get much better at IV starts, and quick!

Watch out for valves. They feel like tiny knots. Try and go either above them or at least inch and half below. Those can be tricky. Sometimes if you time it right, the catheter can go through the valve, but I won't recommend it.:bow:

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