Help Please...IV Tips

[joanna73, BSN, RN]

Hi Everyone;

I am very new to starting IVs. I have had three practise pokes on a friend. Twice, I was successful and got the flash. It seemed as though the catheter was situated properly in the vein, but when I flushed, we could see infiltration and swelling. So it wasn't. How can I avoid this? Any suggestions or advice would be appreciated. Thank you :)

[bsyrn, ASN, RN]

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.

[joanna73, BSN, RN]

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...

[CaLLaCoDe, BSN, RN]

Other tips on this thread too:

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

[nurse2033, MSN, RN]

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

[shynurse]

you have a very good friend ....

[calamarifries]

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.

[turnforthenurse, MSN, NP]

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.

[Music in My Heart]

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.

[MoLee228]

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!

[P_RN, ADN, RN]

Try this site: Assisted Learning For All

It's a composite of many videos. About half way down the page is IV starts. It's from Saddleback College in California.

[joanna73, BSN, RN]

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...