Okay, maybe I just suck but I am having no luck with IV sticks on the trauma side. I had only slight trouble on the non-emergent side of the ED but now that I am orienting to the trauma side, I just can't hit anything without either blowing it or not getting it at all. It is really hard and I know that most likely it is the size of the catheter and the vasoconstricted or really cold patients that we get, but when someone is actively dying (as you all know) you don't have time to do much but just stick and get it in the best you can. My preceptor, although she is excellent, has been a nurse for a very long time and has no trouble with this at all. SHe could stick with her eyes blindfolded and hands tied behind her back and get one every time. I have developed a complex about it and now most of the time just psych myself out before I ever attempt. I worked in the Neonatal ICU before transferring and it is way easier to hit a 2lb babies veins, you can see every one of them. I can't get used to feeling for a vein I can't see and sticking blindly basically. Besides, I can feel the veins good without gloves and then sometimes not at all with gloves. I AM NOT going to rip the finger off my gloves either. I'm having the same trouble with femoral artery sticks for blood gases. Any suggestions?
Dec 28, '06
Do your best. It is not easy to get lines in those vasoconstricted cold shocky trauma patients. Make sure you look at BOTH arms before sticking the patient, as is it important that you go vein shopping completely before picking the one you like. I would also suggest that when sticking IVs in stable patients you feel the vein just to get the feel of them even if you can see it, that way you may be more compfortable sticking someone just by feel when you have too. If the patient is really unstable then they should just have a femoral line put in or even an EJ (providing there are no C-spine concers). Most importantly RELAX the more nervous you are the less likely you are to get the stick, remember you are surounded by other staff members that will get the line if you cannot, and over time and with practice you will become as eficient as they are!
Dec 28, '06
This is why every IV I do on stable patients is minimum 18 guage. Practice shopping for the best iv site all the time ( not just the nuckle (?sp) for the 22 guages), when it comes time to do it for real, it is easier. Daily pokes with a 14 are generally not an option though.