Fearful of infiltrating IV's

Nurses New Nurse

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I always try to aspirate for blood before starting a new bag of solution, or starting an antibiotic. When I am unable to see blood, but the saline flush goes through OK, I am still worried that the IV isn't in the vein and that I am going to infiltrate the solution into the pt's tissue.

I think I am having a hard time with IV's in general, starting, saline locking, and IV push medication. Does this fear go away with time?

Specializes in med/surg, telemetry, IV therapy, mgmt.
sometimes the only way you get blood return is to turn off the fluids and place a tournaquet...if it flushes well, without resistance you can be confident that you have a good vein...linda

I hope you just forgot to say that you remove the tourniquet first before flushing the the vein, otherwise, POW! Blown vein!

Let me also point out to everyone that a slimy sheath surrounds the IV cannula within 24 hours of it being placed in a vein. This is called the fibrin sheath. Sometimes a flap of this fibrin sheath will cover the opening of the cannula and create something similar to a one-way valve. Then, if you try to aspirate blood from the hub of the cannula, even with a tourniquet on the person's arm, you're not going to get one drop of blood. You can also flush that IV until the cows come home and you are still not going to get a flashback of blood. So, no blood return is not necessarily a reliable sign that you have a bad IV.

Specializes in Internal Medicine Unit.

Let me also point out to everyone that a slimy sheath surrounds the IV cannula within 24 hours of it being placed in a vein. This is called the fibrin sheath. Sometimes a flap of this fibrin sheath will cover the opening of the cannula and create something similar to a one-way valve. Then, if you try to aspirate blood from the hub of the cannula, even with a tourniquet on the person's arm, you're not going to get one drop of blood. You can also flush that IV until the cows come home and you are still not going to get a flashback of blood. So, no blood return is not necessarily a reliable sign that you have a bad IV.

Thanks for this one.:p I have told student's and new nurses that this happens (no flashback) at times, but I couldn't remember "why."

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