IV insertion tips, tricks, hints, sites, etc.

dura_mater · Apr 24, 2010

As a student nurse, I was taught a trick by one of my staff buddies. She said while you are "shopping to find the vein you want to stick", take an alcohol swab and rub the area. The veins become much easier to see.

I know for myself at least, that I am not quite comfortable just going by feel, hopefully this will come with experience.

Also, dangle the arm below the heart to allow the veins to engorge.

cardiacmadeline, RN · Apr 24, 2010

Take your time! I think this is some of the best advice I have received on inserting IV's.

Learn to rely more on feel than visualizing the vein.

Remember the needle is slightly longer than the cannula. So once the needle is in the vein, insert it a little bit farther before retracting the needle. You want to make sure the cannula is in the vein.

Never say to a patient, "I am here to try to insert your IV." Instead say "I am here to insert your IV." This gives the patient confidence in you and confidence in yourself!

For the patients that forget to bring their veins to the hospital :), remember there are veins on the underside of the arm and above the elbow. If you ever insert an IV on the underside of the arm, make sure you are inserting it towards the heart and not the hand.

~Mi Vida Loca~RN, ASN, RN · Apr 24, 2010

I was just reading this the other day, it's a 24 page list of tips and tricks on IV's

https://allnurses.com/emergency-nursing/iv-tips-tricks-3793.html

kcochrane · Apr 24, 2010

I was just reading this the other day, it's a 24 page list of tips and tricks on IV's
https://allnurses.com/emergency-nursing/iv-tips-tricks-3793.html

Awesome..I'll read it tonight.

rotteluvr31, ADN, RN · Apr 24, 2010

use a warm blanket or wash cloth to help bring the veins to the surface.

brownbook · Apr 24, 2010

In no particular order of importance. A nice straight big superficial vein is not a sure bet. Often they will roll more than a vein that is a little "deeper." Put the tourniquet a little closer above the vein than you might normally, lift the tourniquet and "stretch" the skin towards the patient then release the tourniquet so the tourniquet holds the skin a little taut. Stretch the skin towards you with your non-dominant thumb below the insertion site. This will flatten out the vein, but it won't roll. HEAT, HEAT, HEAT, don't cause any patient burns, but warmth really brings out veins. Having patience and getting it in one stick saves A LOT of time over blowing it. Patience! If you can't see any veins, as long as the patient can tolerate it, leave the tourniquet on a while longer, stroke the skin over a "maybe" vein towards you. "Lightly" tap the vein with your fingernail. Keep the extremity dependant. Have the patient relax and squeeze their fist rapidly at least 10 times while the tourniquet is on. Patience!! If nothing looks good, or your "gut" tells you the vein your're thinking about isn't going to work, step away, don't be to lazy (I say that because I am bad about doing it) to go around to the other extremity and re-look at all your possible sites. Believe in valves, if it looks a little lumpy, valvey, it probably is. You can work with valves but beginners may want to get more experienced first. I seem to always blow it whenever someone says "Oh, there is a good one, go there;" or "I always use such and such vein." Trust your own gut feeling.

CaLLaCoDe, BSN, RN · Apr 24, 2010

CC's tips:

1. Slap the vein for it to pop up; some like to tap (nursing school!); however, I like to slap that baby! Veins pop up, making them more visible, especially on people of color.

2. Use landmarks (visible veins) present on one arm to try for invisible veins on the other. I first saw a veteran use this technique and has worked for me ever since. A lot of times the visible veins will be overused and shot, so go for the "hidden gold."

3. Enter vein with needle at high 45 degree and, once entered, level off to 15 degrees. Advance catheter sooner than later!

4. If your vein is "blown" try advancing beyond the blown area; I've seen this work! No kidding!

4b. Use lidocaine if patient reports they are sensitive to pain.

5. Once vein is spotted, ask the patient a stupid question right before the insertion, like "How many kids do you have?"; "How long have you lived in Memphis?"---insert IV while patient verbalizes their answer. Patient may report that they didn't feel a thing. Smile and say, "No kidding!??"

6. To increase blood flow to arm: Have patient drop their arm and flex their fist to advance blood to the area. Apply warmed blankets to area to help dilate veins.

7. Tell patient that you need their help. Make them part of the team. It's not only on you but it's on them to nail that IV the first time!!! Then when you get it, you can both celebrate!

8. Important step...mighty pitfall: Make sure you undo the tourniquet prior to flushing the IV or you'll end up blowing that vein!

9. Don't be afraid to ask other nurses for help ;-0

RelloydRN · Apr 24, 2010

if you decide to hit that vein, hit it without hesitation. If you do it slowly the vein will roll.

schack · Apr 24, 2010

I learned to "float" my iv's in. I started in med/surg with lots of old, frail veins, and I still do it even now in OB (and most of my pts have huge, lovely veins!). I find my site, cleanse and insert the needle- once I have a flash I stop. I stablize the cath- withdrawl the needle (my needles you just push the button to retract the needle, not sure what you use) then I attach my tubing and slowly flush the cath in to position. Secure my site, tape my tubing and run my fluid. When I was working med/surg. I would float the cath into position with a saline flush then attach tubing. But once I switched units, I just started floating them in with the actual iv fluid that I will be using. So maybe one of these ways would help you.... I wasn't taught in nursing school how to float the cath in but a very experienced outpt surgery nurse showed me and it works very well for me.

I am not sure what unit you work on, but it can be helpful to go to outpt surgery or an endo. lab to start iv's on healthy pts! Or even L&D- if you can.

Good luck- it just takes lots of sticks!:)

mrmiyagi · Jul 24, 2011

wow. just a flash and you turn on the fluid?

kybreyes54 · Dec 27, 2017

I've been told I'm one the best, fast and usually one stick. My tip is when inserting Cath and get flash, I hold the needle in place and I ease the iv cannula into vein so no danger of blowing vein. When in place I remove needle and attach and tape in place.