Failed IV attempt

[Achoo!, LPN]

I had an opportunity at work to start an IV and failed after 3 tries. My confidence has been shot down. I was able to get a blood return, so I must have punctured through the back wall. I am not sure what I can do to improve my chances next time. I was not comfortable using the spring loaded needles. Bummer!

[AnnieOaklyRN, BSN, RN, EMT-P]

Take your time, do some vein shopping. Insert the needle at a 45 degree angle or less depending on how deep the vein is and once you get a flash remember to flatten the cather and insert it a tiny bit more before taking the needle out. Hope this helps

Swtooth

[moongirl]

wow- 3 tries? we are allowed one, then have to hand it back to the nurse. no sense making the pt into an expiremental pin cushion.

This was your first IV..? there will be plenty more and I personally dont know a soul who is 100 percent for IV starts until they get some time under their belt

[RN BSN 2009]

skills take time, otherwise they wouldnt be called skills :)

[Achoo!, LPN]

This was at my job. I tried twice, then asked the pt if he wanted me to try once more or forget it. He is the one who let me do it again. I even had the doctor in with me. I got a flashback and tried to " float" the rest of the catheter in, but it infiltrated. I have been a CMA for 15 years and done TONS of venipuncture- even worked in a lab. I thought I'd have a better chance since I know how to find a vein. Threading it is a completrely different skill.

[Sheri257]

I've missed my share of IV's. There was one day where I couldn't get a single stick. These patients' vasculature is shot and it can be really hard. But I wouldn't feel too bad about it. I've seen a lot of veteran RN's miss IV's also and they usually called someone else in to do it.

:typing

[JentheRN05, RN]

Idea is once you get flash advance just a smidgen then advance the catheter all the way in. Don't try to float on your first go. Floating isn't 'supposed' to be done. Not sure why, but I do it all the time. But floating is yet again a SKILL you acquire. Good luck next time!

Jen

[angel337, MSN, RN]

during your nursing career you will miss MANY iv's. don't sweat it. it happens. even the best iv starters miss. there are some patients that just have crappy veins and it usually takes 2 times to get them. i used to worry about it too, but i don't any more and i consider myself pretty good when it comes to iv starts. i also was a medical asst. before and could draw blood on anyone but iv's are totally different.

[SteveNNP, MSN, NP]

Once you insert and see a flash, FLATTEN your angle slightly, THEN advance the needle a hair before sliding the catheter off the needle. Sometimes you don't need a tourniquet. I've been starting IV's on preemies almost every shift for 2 years, and I still have "ruts" when I can't get a single one, and "runs" where I get them on the first stick. It takes time, practice, and luck.....mostly luck.

Stephen

[jschut, BSN, RN]

skills take time, otherwise they wouldnt be called skills :)

:yeahthat:

[Daytonite, BSN, RN]

as you said, bummer! i was an iv therapist for a total of 6+ years. when i first became an rn i was terrible at starting ivs. there are just so many nuances to the art. the problem is that you can't see what's going on inside the veins. if we could, every stick would be perfect.

here's a thread that has lots of information on it about all those little nuances:

https://allnurses.com/forums/f18/iv-tips-tricks-3793.html

[GardenDove]

On the older folks if I can see a vein, I do without the tourniquet. You don't need a vein to pop up in order to get in it, you just need to see it. I usually go for the anterior aspect of the forearm where the veins don't pop up, but they're more stable and can be seen. A tourniquet will blow the vein, try doing it without one.