Fishing for a baby vein?

Carlalily · Jan 9, 2015

Does that mean guessing where the vein is?

**NICU Guy, BSN, RN** · Jan 9, 2015

vein illuminator

sassynerd · Jan 9, 2015

Yes, they seem to palpate and feel for the vein, mark it and then go for it. Unfortunately, when there is not flash of blood, they start to move it, in and out, back and forth, like fishing for it. I am just thinking, this baby is crying, scared and in pain. I just wonder if that's how you are supposed to go about it.

sassynerd · Jan 9, 2015

vein illuminator

Unfortunately, we don't have that though I learned about them in school.

AnnieOaklyRN, BSN, RN, EMT-P · Jan 10, 2015

The most painful part of an IV stick is putting it through the skin. Sometimes kids and babies, unfortunately, must experience pain in order to make them better. It is less painful to salvage a stick than to start a whole new one in my opinion. Most kids are more upset and crying because you are holding them down!

HPRN

CoolKidsRN · Jan 16, 2015

Our unit just purchased the vein illuminator and it is extremely useful. Mostly it takes experience and practice to stick these babies. On our unit for IV starts, we go for the saphenous vein and 7/10 it is a successful stick. I know it is difficult given that these babies can be incredibly cute and chunky. I would recommend looking at the hands and feet (I would know your major landmark veins in those areas).

brownbook · Jan 18, 2015

I don't understand what is "not allowed" in placing IV's.

Once you pierce the skin and you don't get immediate blood, or just get a flash and it stops, you have to "fish" a little to try to access the vein. You may need to pull back and advance a little bit a few times. The IV catheter is sterile, you cleaned the skin, so I don't know if some white tower person thinks you could be causing an infection?

How long, how often, you advance and pull back should be reasonably limited per your frustration, the patients discomfort, and causing trauma to the tissue around the vein. Maybe too long a fishing expedition could bring up infection concerns. But you cannot make a blanket statement "no fishing."

If you have an ill patient who needs an IV, urgently or critically needs an IV, you have to do whatever you can to get one placed, even "fishing". If you caused a little trauma to the area, put heat or ice on it. If you caused an infection, give antibiotics.

LoveMyBugs, BSN, CNA, RN · Jan 26, 2015

I would rather poke once do a little fishing than have to poke again.

If you need a line you need a line.

Usually I poke through the skin then pause wait for the baby to take a breath then slowly advance, it is the initial poke through the skin and the holding down is what is making them cry.

jrt4 · Feb 5, 2015

I agree with most of what has been said above. There is a skill and and art to getting IVs on a baby. On one hand their veins are more elastic but they are smaller. Sometimes it does take a little "fishing" to get the vein...I would not recommend using this technique for a long period of time. If you are unable to get it after 30-60 seconds...you are probably not going to get it, at least not without damaging tissue and ending up with a bruised site.

Something I have found with many RNs who do not have a lot of experience starting IVs on babies is that they are too impatient. When a baby is screaming, this often causes the vein to spasm... there is no need to "fish around" if you just let the baby catch its breath and calm down...if you think you are in the right spot...just sit there for 10-15 seconds and you are likely to see a flash.

**canoehead, BSN, RN** · May 2, 2015

I agree, with smaller veins there a delay of a few seconds for the flash to show. With babies I have to sit down and slow down and it doubles my success.

canned_bread · May 6, 2015

Baby veins can be really really hard to see without technology, and honestly sometimes if you really need a vein, that is all you can do. It is of course, painful, but the best thing is to get it done quickly and put emotions aside for that moment or it hurts the nurse too!

Of course it's not the "best" case scenario to do this, it can cause bruises and pain amongst other problems. But sometimes it's all we have. Feel and go for it.

For you, I would suggest looking for your own personal vein illuminator, if your facility doesn't have one. You could recommend they get one if they don't have one. But I did research some time ago and found ones for about $100. I don't know if that's worth it for you or how good they are.