IV Starts

[ashleyjean3]

I am having trouble with my IV's.....I can hit the vein no problem...great return but I go to thread the catheter into the vein and blow it 9 out 10 times. What am I doing wrong??? Any tips???? I just started in the ER and hate having to get someone else to stick my patients with great veins

[ERRNTraveler, RN]

and when you teach a patient this...there ususal response is why didn't the ER put it in the FA to begin with. It's a judgement call. I wasn't talking about Trauma patients that need the largest bore IV available. Blood can be drawn and contrast can be infused into a FA IV.

Michelle

It's not just trauma patients that may need blood or fluids fast. Anyone who might have a drop in BP might need a fast bolus- GI bleeds, syncope, dehydration, etc.

I cannot tell you how many times I have had pt's return from CT with blown hand or forearm IV's from the contrast- it's injected by a machine, and it's pushed FAST. Also, if we are giving meds like adenosine, it needs to injected FAST in a vein as close to the heart as possible, it's half-life is so short, if it is injeced into a hand, it may not work. A lot of smaller veins can't take the pressure.

Also, at many hospitals, depending on the rad tech, they require nothing less than an 18g in the AC for some scans, especially nuc med scans like V/Q scans.

[ritaPHIL]

that helps a lot then. maybe i should try to do it the next time i have my duty at the hospital... i will remember it. there is always a first time and practice makes it perfect. thanks a lot then TeleRNer

rita from philippines

[scattycarrot, BSN, RN]

PS PS PS confused patients are the best patients to practice on ;-)

:yeahthat: :yeahthat:

Only if they are not throwing themselves around and risking a needle stick as they are also the most unpredicatable.

[Megsd, BSN, RN]

Because the opportunities to start IVs as a student are usually limited, I usually practice the thing I can do anywhere, any time: assessing veins! I poke mine, my boyfriend's, in school we sit in circles and show off our veins and poke each other's!

I figure aside from the technical sticking-the-needle-in-the-arm thing, being able to spot a good vein is an important skill too (sometimes you can see them but not feel them, and sometimes you can feel them but not see them) so I do that a lot.

[pannie]

On the other side of the needle - if a patient says a repeat attempt doesn't bother them, believe them. Those of us that are a hard stick are used to it. IT REALLY DOESN'T BOTHER US!