IV Starts

debbyed · Mar 5, 2002

1. In our ER both RN's and ERT's (Emergency Room Tech's) start IV's:)

2. Rule of thumb is two tries........if you think you have something to try :confused:

3. We NEVER call the house supervisor, sometimes she calls us. :eek:

4. In the ER AC's are used frequently; they are quick, most often successful, and can handle a 14 or 16 gauge when needed. :rolleyes:

5. Some staff are (for lack of a more politically correct word) better than others, so if you don't see something you think you can hit, you call for help.:imbar

sgavette · Mar 5, 2002

I work in a very small hospital. Everyone is suppost to start their own IV's but many times they ask the ER nurse to do it. We attempt 2 or 3 times until someone else is asked, but we don't have too many people to pull from. I work ER at night and on the med/surg floor you are lucky to have a RN and LPN. Many times there is an RN and CNA. We don't have a supervisor to call. If we really need that IV, we can ask the PA/NP that is in the ER. If the patients condition is poor we will go right to the AC because it is fast and able to hold a large gauge, otherwise we will try to avoid the AC because the lab gets upset it you take "their spot."

Shandy12 · Mar 6, 2002

I'll try twice and then find another nurse on the floor. I don't use the antecubital unless there's nothing else available. The lab needs somewhere to stick 'em......

I'll always try first before getting another nurse. The only way to become a "good stick" is to practice, practice, practice..

Lynda

CEN35 · Mar 8, 2002

two times here max..........and i hate to gloat but i rarely have to attempt a second time.....and can say only fail on my second attempt about once every 4-6 weeks. i think the bottom line is get what you can.....every situation is different. if they need a 14g and they have it do it. if they don't seem to have much, don't force it. i see the majoraty of the people saying, well they need at least a 20 and then it blows. it was too big for that spider vein.

short of multiple drips and blood, it doesn't have to be big. i have had quite a few older, dehydrated people come into the er. they appear to have nothing, and usually don't. i can always squeak out a 24 in the thumb.......and guess what? i can give most of them up to 800cc in an hour.

me :)

crazedredhead · Mar 17, 2002

Hank, I look before I leap. I am a pretty experienced stick, but if I feel that there is a good chance that ALL I will do is stick, then I will pass it on, but with an honest answer. don't believe that every patient CAN be stuck successfully. If they look like a possible stick, then I will try it twice, max. House supervisors arethere for you, no matter what their attitude. ! Good luck

Bermuda · Mar 20, 2002

Hospital policy 2 sticks per nurse...then call for help...all nurses do their own..no IV team...personally haven't had too many problems actually I enjoy doing my own..some are better at starting IV's than others and they will call for help before even trying..no problem...at least they know to call for help..saves the patient additional trauma...when it is big trouble than anesthesia WILL come to the floor.....

amyBSN · Mar 21, 2002

I will always try at least once, but never more than twice. At our hospital we have CRN's who float the hospital and we call them for any difficult sticks, midline's, PICC line's ect.

scrappy · Mar 25, 2002

Originally posted by Susy K
Hmmm
Let's see..we start our own IVs.
I attempt x2 or x3 before getting someone else - depending on the situation.
I don't call the house supervisor - we'd call the Anesthesiologist if we can't get it.
I will use AC (I'm assuming antecubital) as a last resort.
I always try before passing on. Always.

You said it all. I do it the same. :cool:

lady_jh_98 · Mar 25, 2005

I generally do not stick my patient more than twice; depending on the situation. If I'm not able to start the IV I get the charge nurse or a more experienced nurse involved. If still unsuccessful I call an ICU or ER nurse. MD is notified if unable to start IV. I try AC as a last resort

RNKPCE · Mar 26, 2005

I will only stick a patient twice. Sometimes once if there aren't many useable veins left.

If I can't see/feel vein I will grab a sharp shooter before I attempt.

We call our resource nurse first then a supervisor to help with ones we can't get on the floor ourselves.

I rarely use antecubitals espec if they will have fluids running vs a saline lock. In my surgery center job we use ac a lot.

We have staff that don't even look for veins prior to asking for help, or they say they will have looked but no evidence of tourniquet in the room or other supplies. They will always be IV dependent that way.

cranky · Mar 31, 2005

We start our own IVs. I stick 2x. I will use the AC as a last resort. We dont have a house supervisor, only the charge nurse. They usually call on me for the tough ones.

humglum, BSN, RN · Mar 31, 2005

Who starts IV's on the floor? (not including peds)
How many attempts before you have someone else try?
When do you call the house supervisor?
If you see an AC will you try?
Finally... To see how honest people are..
How many don't even try and pass it on?:)
Thanks
Hank

I work peds, so this might not be info you're interested in.

We (RNs) start all of our IVs.

I'll make 2 attempts before I have someone else try.

We don't have a house supervisor (weird, I know). If someone can't get an IV start, they'll usually ask me (I'm known for being quite skilled at IVs and venipunctures, and am the resource person during night shift for these things). If I can't get it, then we'll call the house doc to try.

If a kid REALLY needs an IV and there aren't any other veins available, heck yeah I'll take the AC. I've started IVs in scalps, necks, ACs... even the occasional IO. If its an emergent situation, we'll find something. I'd rather have a kid with an IV in the AC (that we can attach to an armboard and protect) than one in the hand that is positional and will blow with any appreciable fluid flow.

On nights, the buck sort of stops with me. I can't pass it on.

HTH!