IV starts

[NurseWi_JennJenn]

I've been on a bad streak with starting IV's for the past couple weeks... I swear EVERY TIME I blow the vein. Let me tell you how I normally start them... I obviously follow Policy and procedure so let's just go straight to inserting the needle... (btw policy is to use a saline wheel first), so after I put the wheel in, I come in from the side of the vein (normally the right side). I get it in the vein, start advancing it, and than the veing blows... I'm getting so frustrated. I know I can do it, but don't know what the heck the problem has been lately...

So my question is:

A. Do you go in over top the vein or from the side...

and

B. Do you have any advice/tricks/tips for me to get these in without blowing the vein all the time?

Thanks so much in advance!!!

[augigi, CNS]

Given that this thread is about IV sticks, I highly doubt they were referring to central lines.

[all4schwa]

As far as technique I have always tried to anchor the vein with a side to side grip as well as make sure to loosen the cannula on the needle. I have noticed most problems seen during precepting others come from too acute of an angle and passing through the vein or in many cases not getting the catheter into the vein, by that I mean you will notice an appx 2 - 3mm space between the end of the needle and the end of the catheter so just because you have flashback does not mean the catheter has passed into the lumen of the vein. Once I get flash I ususally advance a little more.

i think both of these were my problem last night. my "hold" is not working for me, but i see how a side to side would...also, i've notice that gap, but hadn't made the connection as to what that means to my stick...thanks!

[Daytonite, BSN, RN]

once you get the flash, hook a 3cc (no bigger) syringe to the catheter and push a small amount of saling into the vein to *open* it up while you advance it. bigger syringes create too much pressure and blow the vein. works like a charm!!!!!!!

whoa! that is wrong! the smaller the syringe, the higher the pressures created in the vein. if you're going to do a direct flush of any solution into a vein, your best choice is to use as large a syringe as possible. those 3cc syringes create a lot of pressure.

[GardenDove]

Whoa! That is wrong! The smaller the syringe, the higher the pressures created in the vein. If you're going to do a direct flush of any solution into a vein, your best choice is to use as large a syringe as possible. Those 3cc syringes create a lot of pressure.

Thank you for reiterating my point. I only brought up central lines as an example of why a smaller syringe creates more pressure. Conversely, a smaller syringe creates LESS pressure when apirating blood and might solve you problem during blood draws from central lines.