Help Please...IV Tips

it sounds as though you may have gone through the vein, once you get the initial flash, advance just slightly with the needle intact before proceeding to advance the cath. this should help.

Thanks. That's what we thought. I was not too nervous going in, and my friend (also a nurse) said my technique was ok. I guess it is something I will get used to with more practise. Harder than I thought it would be...

Other tips on this thread too:

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

When you've done about 10,000 you'll get pretty good. Just keep going.

you have a very good friend ....

Find a straight vein and hit it. When you got a backflow of blood advance a little before finally inserting the cannula and secure it.

it sounds as though you may have gone through the vein, once you get the initial flash, advance just slightly with the needle intact before proceeding to advance the cath. this should help.

this! and one way to tell you're still in the vein...you have active bleeding through the catheter :)

and to prevent from making a mess: once you have established access, release the tourniquet and then take a finger and put pressure a little above the catheter site (remember the catheter tubing is kind of long, so don't put your finger right above the plastic part sticking out but instead a little bit above that, that way you are compressing the cannula that is inside the patient, if that makes sense?). i always prep everything (flush, prime the heplock, etc) before attempting an iv start. i also put a chuck underneath the patient's arm/hand just in case, too.

Since you tried to flush then I presume that you were able to advance the catheter without difficulty which indicates that you were in the vein. Likely, you blew through the side or bottom of the vein.

Be sure to go in at a sufficiently shallow angle, inline with the vein, and slowly - and stop when you get the flash (and then, as stated above, progress just a bit more to ensure that the catheter is also in the vein, not just the needle tip).

Since your friend is a nurse I'll also presume that you were using a properly sized angiocath for the vein and that you had secured the vein in keep it from sliding or rolling.

I had the same problem for a long time: getting a flash but blowing the vein. One tip I learned is to untie the tourniquet after you get a flash, but before you advance the catheter. An experienced chemo nurse taught me this and explained that very fragile veins are more likely to blow when a tourniquet is tied. I have had quite a bit of success using this technique. Good luck! Practice lots!

Thanks everyone for your tips and advice. Appreciated :) I am a new nurse, and we cannot learn these techniques till we are licensed. My good friend is a nurse and a teacher, so she had all the supplies. As you said, I will just keep practicing. Taking off the tourniquet seems like a good idea. I only had 3 pokes though, so overall, not bad...

The most common mistakes that I have seen over the past 29 years are:

1. NOT threading the catheter a bit farther after you get your initial flashback. The needle is longer than the catheter so you can have the tip of the needle in the vein (thus blood seen in the flashback chamber) and NOT the catheter...SO if you pull the needle back to advance the catheter you just pulled it out of the vein and cannot advance it. So drop your angle flush to the skin once you see the flashback and /or feel the characterisitic "pop" into the vein and advance approx 1/8 of an inch or so before you pull the needle back and slide the catheter into the vein

2. Attempting to insert a the catheter through the skin at a very sharp angle...you should rarely have to go greater than a 15 degree angle unless you are performing an advanced technique with US. Too deep of an angle can cause a through and through puncture....yes... you get a good blood return initially but you will not be able to advance the catheter

3 Not taking simple measures that increase your success.....looking carefully and feeling the vessel before you stick it......AVOIDING areas of flexion...Avoiding the wrist (high lawsuit location)....putting the bed up to a comfortable level...applying a warm pack...selecting the appopriate catheter size for the selected vein (smallest and shortest that will meet the need)...applying a secure proper dressing....plus many more