I am a moron--I need I.V. help

**canoehead, BSN, RN** · Mar 31, 2003

Practice, that's the only way. And go very slowly, the more trouble you anticipate, the slower you do it. It helps me to sit down when I start the tough ones.

BBFRN, BSN, PhD · Mar 31, 2003

What gauge I.V. are you using?

Sleepyeyes · Mar 31, 2003

Biff, there could be a lotta reasons that you have problems, but keep trying, because this is one thing you get better with when you practice.

Try #22 guage needles, try having the pt dangle their arm over the edge of the bed for a couple minutes before you use the tourniquet, and there are several good websites that can give you other tips.

Good luck!

Sleepyeyes · Mar 31, 2003

This site was a big help to me:

http://www.enw.org/IVStarts.htm

gwenith, BSN, RN · Apr 1, 2003

Two pieces of advice 1) Line yourself up in the direction of the vein. Before you start to cannulate make sure that not only your hands but your whole body is facing the direction that you wish to cannulate. sounds crazy but it WORKS. 2) make sure that one hand/finger is holding down the vein as they may LOOK old and ropey but usually those are "coward veins" they run away from anything sharp. 3) find a vein junction - looks like an upside down "Y", place the cannula in the centre of the junction just where the two viens meet this site is usually more secure than single veins and will not roll around under the skin

kaycee · Apr 1, 2003

If you have an IV team in your hospital, ask to go around with them for a day. They can be very helpful and give you lots of pointers while you're doing it. Good luck!

niteshiftnurse · Apr 1, 2003

practice,practice,practice. Sleepyeyes, good website

renerian, BSN, RN · Apr 1, 2003

I could not enter from the side I always go through the top. Maybe that might help.

renerian

flashpoint · Apr 1, 2003

I almost always sit on the floor when I am starting IVs...I learned to start in a moving ambulance, so it's only natural for me to do that. On a lot of the big ropey little old lady veins, I won't put the tourniquet on too tight, or I won't use one at all. Anchor your vein of choice well, but not so well that you actually end up flattening it out. Unless the veins are very small and fragile, I won't use anything smaller than a 20 gauge. Also, with some brands of IV caths, the 18s have the same outside diameter as a 20, so if it looks like you can get a 20 in, you can probably get an 18.

abnurse · Apr 1, 2003

I know exactly where you are at! I was there a few weeks ago. I had no problems with IV's at another hospital but when I went to a new ER they used a different Jelco. What worked for me was closing my eyes and feeling the vein. Also, practice on finding your friends and families veins. Relax and tell yourself that you are successful and it will happen. Confidence is the key to good IV access. Good Luck

BiffMalibu · Apr 2, 2003

This is GREAT, you all are really helping me and giving some great ideas, I'm committing them all to memory! Please keep 'em coming. Does any of you use b.p. cuffs as your tourniquets?? I sometimes feel I don't have the ones I tie myself tight enough on some people, and too tight on others. I mean how can you really tell whether or not it's snug enough to occlude vein pressure but not arterial?

Also, if you can't see anything at all (patient might be a little heavy), can anyone give me an idea on where I should at least attempt to search?

Again thanks, reading this really is helping me confidence so don't hesitate to post....thanks again!

Biff