IV tips and tricks - page 20

Hi all, I am starting to compile a list of tips and tricks concerning starting venipuncture. The goal is to share experiences and tricks of the trade. Tips e.g. on how to find that elusive "best... Read More

  1. by   LMPhilbric
    Lay off on the caffeine??? No, then I'd be in a coma. Seriously, if the shaking is from nerves, then you just have to be confident in your own skills that 1) Yes, I WILL (not try) get this IV started 2) Let the family watch - now they'll see my mad skills. If the shaking is a physical problem like an essential tremor, you might talk to your doc and see if there is some medication that might help you. Some people take low dose propranolol for stage fright. Maybe something like that might work for you. I used to shake when I was starting IVs on kids, but now I'm very confident in my IV skills so I don't worry. One of the best Paramedics turned RN that I know shakes like a leaf every time he starts an IV and he has mad skills so I think that's just him. If I had that problem, I would probably tell the patient ahead of time so that they knew that I was a shaker and it in no way affected your ability to start the IV.

    Good luck!

  2. by   shinneh
    what if you are not sure whether that is really the vein because you can't see it clearly? how will you know that what you palpate is the vein?
  3. by   Pixie.RN
    Sometime you can go by anatomy -- i.e., it's in a place typical of having a vein. With some practice and experience, you'll be able to tell if what you're feeling is a vein -- in most patients. And there are some patients where you'll be able to see it, but not palpate it at all.
  4. by   LMPhilbric
    Bounce your finger up and down on the spot. Veins bounce. Other structures don't. Once you think you feel the vein, take the tourniquet off. If it goes away, that is the vein. Tendons, ligaments, etc will feel the same without the tourniquet.
  5. by   inteRN
    How can you avoid blowing the vein?? It seems I have that problem alot
  6. by   Pixie.RN
    Typically that happens when you go out the back or side of the vein. Just be careful that, once you get a flash, you only advance the catheter just a smidgen (precise unit, I know ) more than the length of the bevel -- don't go sticking the whole needle in there. If you just advance slightly more than the length of the bevel, you should be able to thread the catheter in without going out the back/side/whatever of the vein.
  7. by   inteRN
    thank you! no one at work has really been able to explain that well to me! Also, how come alot of the time you get a flash but the catheter wont advance?? is it valves maybe??
  8. by   Pixie.RN
    Could be a valve, or you could be right up against the vein wall, or you could have already gone out of the back or side of the vein with the needle.
  9. by   MissIt
    What I was taught to do when that happens is to back out just a little and sometimes you can still save the IV.
  10. by   inteRN
    Yeah..its so hard to know what you are doing wrong without "seeing" it. Are they're any websites or anything that actually show the mechanics of IV starting? Not necessarily the technique but maybe pictures of the needle going into the vein and the catheter advancing, problems, etc....
    I know, a weird question, but thats how I learn best.
  11. by   Pixie.RN
    I dunno ... I just kind of visualize it in my head. When I look at the vein I'm going to cannulate, I also consider the length of the IV catheter I'm using, and where I want it to end up in the vein, when I consider where I want to start to pierce the skin. That way I don't end up with the tip up against a valve when I can feel or see them.

    Have you tried YouTube for any videos?
  12. by   inteRN
    YES..today i did look all over the internet for good videos but not much luck. do you know of any?
  13. by   Blueorchid
    Still a relative newbie at IVs (in my ER we can start them as techs) but just my :

    -I like to set up things in advance where the patient can't see it (really learned this one the hard way) and throw on a tourniquet to go hunting for the vein. When I tell them I'm just looking first if they get a weird look on their face I add "you wouldn't build a house on a swamp would you? its like real estate, location is everything" (learned that from some youtube video) and it usually gets a laugh.

    I've yet to master the float technique but I'm getting there. Also...I can't imagine someone letting anybody stick them with needles 6 times...2 is my limit. But...I feel like we all have to learn somewhere (still trying to figure out how to finagle this...I'm far from perfect and I really want to get better but I don't want to be a pincushion either!) Still...a no go at 2 and I find the IV queen on the floor.

    I do have a question for people that like to move though. Was starting this 22 on a girl a couple days ago and set everything up only to get 2 seconds away from sticking her and she suddenly jerks her hand away to go "you're going to put THAT in?"

    Once I explained that its the plastic tube that goes in the vein and not the needle I got ready again and saw her tense up. When I stopped and said "I need you to hold your hand still" she wigged out. A nurse came in she didn't even know and she asked her to put the IV in. She started complaining about how "most nurses just stick the needle in- you hestitated" and I had to refrain from adding "well I would have if you hadn't jerked your hand away." Was it the request for her to hold her hand still? She ended up having a few psych issues but I'm mulling over the idea that asking someone not to move their hand instead of a "surprise jab!" might do more harm than good...