IV tips and tricks

[kloock]

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 vein", would be greatly appreciated. (and if you have a few that are not to be taken entirely serious those would be welcome as well).

Please answer me directly - no need to clutter up the board with this. I will post the text once it is finished.

Thanks in advance!

------------------

Katharina Loock, RN, BSN

Department of Education

Wadley Regional Medical Center

1000 Pine Street

Texarkana,TX 75501

[mhull]

1-Apply a tight band and start looking at hand up first (unless you need a specific Iv site i.e. 18g AC for CT to r/o PE)

2-Use only the gauge apporiate for the vein

3-Assess the vein before you stick it

4-Apply a warm compress to raise veins if needed

[mhull]

1-Apply a tight band and start looking at hand up first (unless you need a specific Iv site i.e. 18g AC for CT to r/o PE)

2-Use only the gauge apporiate for the vein

3-Assess the vein before you stick it

4-Apply a warm compress to raise veins if needed

[thanatos]

this has been discussed ad nauseam. try a search.

[thanatos]

this has been discussed ad nauseam. try a search.

[TraumaInTheSlot]

this has been discussed ad nauseam. try a search.

Regardless, we have the opportunity to teach someone something, so lets take that opportunity.

IV's just take practice, stick everyone you can until you feel comfortable. soon you will be able to do it with your hands tied behind your back. however, we all have our days when we cant miss and then theres days we couldnt hit a cannon with an angio cath.

the first thing i tell everyone is that selecting a vein is never ever something you do with your eyes. you have to do it by feel. one vein might look good, but it is too frail. get to know your veins.

a lot of people are afraid to use the bigger 18 and 16 gauges in the beginning. im the exact opposite, i cant remember the last time i used anything smaller than an 18 gauge. the needle is firmer and doesnt give as much.

stay away from thick veins right below a bifurcation (where the thick vein turns into two small veins, like a junction in the road, these ivs almost always blow in the first hour)

women have the "rule of thumb". theres almost always a vein that comes off of the thumb where the forearm begins. look around, youll see im right.

any patient, and i mean any patient who has even the slightest chance of being a surgical patient, be it an AP or abd pain or trauma, should have a large bore iv 18g or less. the anesthesiologist will put a second larger line in if you dont.

anyone receiving anticoagulant clot busting therapy like TPA or equivalent should have three lines, one 18 or 16 gauge for blood draws before the med is given. pop away.

even if you dont know what you are doing, try and make it seem like you do. be professional, dont let your hands shake, and read your patient. their eyes can tell you alot.

TIE THE TOURNIQUETTE TIGHT. DONT FORGET TO TAKE IT OFF!

good luck if i think of more, ill post it later.

[TraumaInTheSlot]

this has been discussed ad nauseam. try a search.

Regardless, we have the opportunity to teach someone something, so lets take that opportunity.

IV's just take practice, stick everyone you can until you feel comfortable. soon you will be able to do it with your hands tied behind your back. however, we all have our days when we cant miss and then theres days we couldnt hit a cannon with an angio cath.

the first thing i tell everyone is that selecting a vein is never ever something you do with your eyes. you have to do it by feel. one vein might look good, but it is too frail. get to know your veins.

a lot of people are afraid to use the bigger 18 and 16 gauges in the beginning. im the exact opposite, i cant remember the last time i used anything smaller than an 18 gauge. the needle is firmer and doesnt give as much.

stay away from thick veins right below a bifurcation (where the thick vein turns into two small veins, like a junction in the road, these ivs almost always blow in the first hour)

women have the "rule of thumb". theres almost always a vein that comes off of the thumb where the forearm begins. look around, youll see im right.

any patient, and i mean any patient who has even the slightest chance of being a surgical patient, be it an AP or abd pain or trauma, should have a large bore iv 18g or less. the anesthesiologist will put a second larger line in if you dont.

anyone receiving anticoagulant clot busting therapy like TPA or equivalent should have three lines, one 18 or 16 gauge for blood draws before the med is given. pop away.

even if you dont know what you are doing, try and make it seem like you do. be professional, dont let your hands shake, and read your patient. their eyes can tell you alot.

TIE THE TOURNIQUETTE TIGHT. DONT FORGET TO TAKE IT OFF!

good luck if i think of more, ill post it later.

[TraumaInTheSlot]

oh, and if a heroin addict says "thats not a good vein" , they are right.

[TraumaInTheSlot]

oh, and if a heroin addict says "thats not a good vein" , they are right.

[NICURNtobe]

Thank-you, Thank-you Trauma!!

[NICURNtobe]

Thank-you, Thank-you Trauma!!

[Fergie]

Do not be afraid of the needle. I was taught to go in slightly to one side of the vein.