IV Insertion

[chuckc, BSN, RN]

We just started IV'S in clinical, did it in lab on each other. Any of you have helpful hints, words of wisdom regarding IV starts? We have only done it on willing, cooperative participants, have not done a patient yet.......Thanks in advance.

[Katnip, RN]

The only advice I have is don't set your expectations to the point where you feel you need to get every stick right the first time, every time.

No matter how good you get you're gonna get that patient who just doesn't have veins. And you'll have some days when you can't hit the side of a barn with a 14 gauge.

Talk your patient before hand. Make sure they know what you're going to do and why. Try to find out how they'd like it done. I've had people who want to watch the entire thing, and people who wanted me to sneak up on them and just do it while you distract them with chit-chat.

[JMBM]

Try ENW.org. Its an ER nurse website with several good articles, including one on IV starts. ....... There are hundreds of "how to" sites, so I'll just suggest a couple odd things that helped me. ....Relax - and that goes for both you and the patient. When patients are nervous, they vasoconstrict and its hard to find constricted veins, let alone hit them. Nervous nurses make patients nervous. Make an effort to chat with your patient while you are setting up. Keep it light. This is all routine. Set up your tape, 2x2's, saline lock, etc the same everytime - it'll help you concentrate on the task at hand. Get a routine. If a patient tells you a best place to stick them - believe them. Everytime I second-guess a patient, I wind up missing and going back to the spot they pointed out in the beginning. If you have the time (and you won't always), take a minute to check both arms/hands. There are BIG differences between arms. Especially on guys, look for that big honker on the underside of the forearm, coming off the elbow. Its inconveniently located, but often worth it. If you are having trouble finding a vein, use a BP cuff instead of those rubber band tourniquets. Its more comfortable and works better. Just like the previous writer said, don't beat yourself up for missing. Its going to happen. Don't be afraid to ask for help. Its amazing what a different pair of eyes can see. Oh, and did I say you should relax?