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Discussion

Finding places to put IVs

I've been working for almost a year now and I know this comes with time, but I still feel awful about my IV skills. I can put an IV in if the pt has really good juicy veins, but otherwise, I can't feel where I'm supposed to be putting an iv....I have gotten so much better at drawing blood for labs and 90% of the time I can get my labs, but I'm having a lot of trouble with IVs. We aren't allowed to place them in the AC, so just biceps, forearms, and hands. I can do a hand one most of the time and have had luck with forearm ones - when they have great veins...I just need some ideas on what I can do to get better at locating good veins. I can do the IV once a vein has been pointed out. I just can't find the vein! Any ideas?

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I am in a similar situation and we have new I catheters which makes me have to start from. Square one I would suggest asking your fellow coworkers to let you take a whack at some Iv starts that's what helped me and ALWAYS go into a room knowing you're going to start Iv's you are already setting yourself up for failure if you do not! Good luck! God bless

Full disclosure, I am awful at starting IVs (I've only successfully started two...ever), so I am always asking people for tips. The best IV starter on my floor told me a mistake new grads make is going for veins they can see rather than the ones they can feel. Apparently the ones you can feel are stronger and less likely to blow, and it's seemed to help some other new grads.

I, however, am still terrible at it.

Oral hydration. If I know a patient needs a new IV, I will give them 2 cups of water or juice to drink. Heat packs. 3 on each arm from the upper arm down 10-15 minutes before. 2 tourniquets. Always use two. Once you put it on, feel for the radial pulse. If it's cut off, it's too tight. You do not need to push the needle in completely before advancing the catheter. You may puncture the vein all the way through if you do this. Once you get some blood return, push the needle in a tiny bit more (especially if patient is thick skinned), then advance the catheter, being careful not to kink the catheter with the needle. Be creative. I've felt veins in the upper arms. Skinny old ladies with tiny veins many times have larger visible veins in the upper arms. Hope this helps.

I'm not fabulous at finding veins, either. I work in an ASC and have to get them in FAST! I get the tourniquet on and have the patient dangle a little bit. If I think there is a vein in the area, I rub vigorously with an alcohol wipe...this seems to get them to stand up! Also, try to be patient. Sometimes it takes a little while for those veins to stand out!

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