Help Please...IV Tips

[joanna73]

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 :)

[iluvivt, BSN, RN]

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

[joanna73, BSN, RN]

Thanks for your advice above. This is helpful :)

[MommaRN86]

Just keep practicing is good advice. Also, with the elderly, take off the turniquette as soon as you get a flash. One of the older nurses showed me a cool way to practice. Grab some IV catheters and also some IV tubing. Tape a piece of tubing to something and then practice with it like its a vein. It will help you get the motion down of advancing the catheter. Just doing it a lot will help though. Jump at every opportunity. And don't feel bad if you miss a few in a row. Thats how it goes. Good Luck!