I am a moron--I need I.V. help

[BiffMalibu]

Hi everybody. I was hoping someone can help me. I am in an awful slump. It seems I can't start an IV to save MY friggin' life. I had an old lady with nice old ropey veins you could see clear as day, went in one side, didn't get a flash but I was sure I was in, went ahead and fished around, got a tiny flash tried to advance, and what do you know, I had blown that sucker to kingdom come.

I was wondering if I could get some recommendations and help, books or manuals or weblinks as well as real advice. If everyone could just post one tip that they do before or during the insertion process I'd appreciate it. I'm quite tall and have big hands and have a hard time precisely moving that little IV around, and I have a hard time telling when I'm in the vein (when I don't get a flash right away, even when I swear I'm in, I get impatient and start fishing and blow it). And when I try to advance the catheter using the one finger method, my whole hand kind of moves forward and I blow through the other side. Anyway, I'm about losing my mind, and my self-confidence is totally blown. Please help...

[BadBird, BSN, RN]

Some things that I find helpful are to make sure all my supplies are ready, tape, etc.. when you find a nice bouncy vein, anchor well, hold it down so it doesn't roll, make sure the angiocath is bevel up when you enter the vein. Once you get blood return release the tourniquet and advance the catheter. Have the extension tubing with the flush hooked up and ready, always check for a good blood return and flush.

Never stick a ecchymotic area, or below one, try not to stick the anticubital area because we will bend our arms and occlude the iv.

The more you try the better you become. Sometimes those big ropey veins are so occluded that you never get blood from them. Once you learn to stick what you FEEL instead of what you SEE and gain some confidence you will do well. Remember to try to feel that bounce. If the vein is small use a #22gauge, I never put in anything smaller than a #22 because many of the meds we give are viscous and will blow anyway, also you can't or shouldn't give blood in anything smaller than a #20 gauge, 18 is preferred.

[kcrnsue]

sweety,(I hope you don't object to me saying that). You just reminded me of the very first I.V. start I did as a student. This LOL had hoses for veins. With my instructor watching over my shoulder, I stuck her, and very slowly tried to advance the catheter. No flash. Palpated. My instructor palpated. There was no way I missed. My instructor fished, I fished. Then, my instructor and this extremely sweet and patient lol, started trading jokes. This lol laughed at whatever it was my instructor had told her, and halleluia, I got a flash! It was the funniest thing ever, but my instructor just chalked it up to a spasm, that resolved after the patient relaxed! Sometimes, things are beyond your control. You will get it!

[sharann, BSN, RN]

Don't feel bad. I miss as often as I try, but I always try to avoid the AC site, and maybe it's my fault then! We had a post-op in PACU 2 days ago. I tried the hand which had a lovely vein, blew it. Another nurse tried..blew it. THEN 2 different Anesthesiologists tried..guess what? Then the 3rd Anesthesiologist got it(On his 1st try the bum). So anyhow, there is some great advice above, which I will follow as well!