Specific IV problem

  1. Hey,

    I have been reading the forums for a couple of months now and I would like to thank allnurses.com and all its members! I have gained much knowledge and pearls of wisdom simply by hanging around

    I am a paramedic student in MD and I have this nagging problem with starting IVs. I either underestimate the resistance of the vein and end up causing a nasty lac or I push too hard, infiltrate and leave a nasty hematoma. I cant seem to find the right amount of force and I don't want to go around hurting more people lol. I have tried slow insertions and quick jabs but nothing seems to help. Any suggestions?
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  2. Visit taidan profile page

    About taidan

    Joined: Jan '05; Posts: 15

    12 Comments

  3. by   USA987
    I enter the skin at a slight angle with bevel up. When I see flashback I lower my angle almost flush with the skin and I advance the IV the most of the rest of the way...sometimes I open the IVF and float the catheter in the rest of the way after I remove the needle.

    Good luck!
  4. by   bobnurse
    Being a student im to assume you havent started a whole lot of IV's....It just takes practice and learning what technique will fit you...
  5. by   actioncat
    Quote from USA987
    I enter the skin at a slight angle with bevel up. When I see flashback I lower my angle almost flush with the skin and I advance the IV the most of the rest of the way...sometimes I open the IVF and float the catheter in the rest of the way after I remove the needle.

    Good luck!
    Do you mean IV fluids? What is the advantage of this? What do you mean by "float the catheter in"? Do you mean you remove the stylet befor moving the catheter all the way in? Doesn't it bend. What is the advantage? I'm confused.

    I am asking these questions sincerely. I'm sure you have more experience than me and I want to know.
    Also, do you use an angiocath or butterfly?
  6. by   Choircat
    Sometimes as people are beginning to learn how to insert it is very easy to go throught the veins. I find it much easier to have people make the initial puncture right beside of the vein and then go into the vein. Basically, the more you do the easier it will get. Good Luck!
  7. by   bobnurse
    Floating the catheter dilates the vessel, making it easier to advance. Also if your close to a valve, it will open the valve, making it easier. Many times dehydrated patients have very small, constricted veins, or the veins constrict when punctured. Dilating them with fluid helps get it in. I have saved many IV's that way, and saved the patient another stick.
  8. by   USA987
    Quote from bobnurse
    Floating the catheter dilates the vessel, making it easier to advance. Also if your close to a valve, it will open the valve, making it easier. Many times dehydrated patients have very small, constricted veins, or the veins constrict when punctured. Dilating them with fluid helps get it in. I have saved many IV's that way, and saved the patient another stick.

    Thanks Bobnurse...couldn't have answered the question any better myself!!!!
  9. by   meownsmile
    Try using a doubled tournaquet along with technique from USA987. Two tournaquets one on top of the other,, put them on at the same time. Sometimes it just needs a little more pressure to help dilate the vein a little more. The ones ive had a hard time with before, ive doubled the band for a second attempt and had success.
    When you stick,, just nice even pressure is all thats needed ususally, unless you have someone who has been out in the sun a lot they have skin like leather.
  10. by   Hairstylingnurse
    Quote from bobnurse
    Floating the catheter dilates the vessel, making it easier to advance. Also if your close to a valve, it will open the valve, making it easier. Many times dehydrated patients have very small, constricted veins, or the veins constrict when punctured. Dilating them with fluid helps get it in. I have saved many IV's that way, and saved the patient another stick.
    :uhoh21: :uhoh21: :uhoh21: This sounds like an totally awesome technique but can someone put it in english. I am IV certified but never seem to have any IV's. Have done bloodowork in homehealth with butterfly,but never heard any of this above mentioned terminology. Thanx in advance.
  11. by   meownsmile
    Floating,, you pull the stylet and connect your fluid source to the catheter hub and let the flow of the iv fluid help dilate/advance the catheter into the vein.
  12. by   actioncat
    Oh, okay. It is becoming a bit clearer.

    Thanks.
  13. by   DutchgirlRN
    Quote from meownsmile
    Floating,, you pull the stylet and connect your fluid source to the catheter hub and let the flow of the iv fluid help dilate/advance the catheter into the vein.
    Going in just next to the vein and then entering has helped me tremendously with not blowing veins. I think it's the pressure of the tourniquet that causes the problem.

    We use J-loops so that we can hep-lock. I use a 10 cc syringe with NS and prime the J-loop. Once I stick and get the flashback and can't seem to advance, I pull the stylet, connect the J-loop and float it in with the 10cc of NS. Works like a charm.
  14. by   Hairstylingnurse
    Thanx ,I think I'm finally catching on

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