What am I doing wrong?

Nurses General Nursing

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I am pretty good at placing IVs most of the time. The one problem that I seem to be having at times is I place the IV in, get a great blood return, then when I retract the needle and attempt to thread the catheter into the vein, it blows. Any advice would be greatly appreciatied. Thanks;)

When you get a blood return, advance the needle just a tiny tiny bit, then thread the catheter over the needle. The needle is longer than the catheter. The catheter may not be in the vein yet when you retract the needle. Never get in a hurry and use plenty of saline, 10 cc's, to flush. Some shifts I hit them all and some shifts I hit them all. Try a warm blanket or washcloth over the site for a few minutes before you attempt. It's 2 sticks and you're out at our facility. Hope this helps.

Maybe you are going in too far with the needle? Do you stop as soon as you see a flash?

Specializes in post-op.

I am not sure which brand of IV catheters you use, but before I even attempt to stick the person I make sure that the base of the catheter is loosened from the needle (just slightly), because sometimes it sticks and it is hard to get it off once it is in the vein. I also try to "float" the catheter in by using the flush as I am advancing the catheter. Our IV needles have a safety button to retract the needle, which I usually activate as I am advancing the catheter. As everyone else has said, somedays you get em all and others I get none! I also like to use hotpacks wrapped in a pillowcase to help dilate the veins more.

Sometimes if the veins are fragile, I have found that they blow if you use a tourniquet...if the first one blows, and you can do it without using the tourniquet, try that. But of course, if you can't see/feel the vein without it, you shouldn't try to stick them because going in totally blind is NOT a good idea! But I've found that this usually works on the little old ladies where you can see their veins from a mile away...sometimes the pressure from the tourniquet is just too much for them, and as soon as you pop into the vein, it's over.

It's 2 sticks for us, too. But I'm lucky - I work with nurses who have been working with cancer pts for 20+ years - a lot of them could get an IV in a tree branch...so if I can't get it, I just find one of them. :)

If it blows every time you start a line, then the cath isn't in far enough before you retract the needle. When you see a flash, stop. Then either advance the cath in over the needle before pulling the needle out, or advance the whole thing just a bit more, pull the needle out, and advance the cath.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

http://www.nursingcenter.com/prodev/ce_article.asp?tid=583844

http://enw.org/IVStarts.htm

These may help you!!!!

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