IV suggestions

sjoe · Nov 19, 2003

You may be maintaining too steep an angle after the flashback. If this is the case, try lowering your hand more toward the patient's arm to decrease the angle before advancing the catheter.

Erin RN · Nov 19, 2003

I agree with SJoe once you are in then drop your angle down so you can thread the vein..as far as valves. and this takes practice if you think you hit one you can flush a little and try to advance the catheter, the saline will open the valve and allow you to thread through it..I will bet it is the angle thing though...Good luck.Erin

SmilingBluEyes · Nov 19, 2003

check out the Intravenous Therapy Nurse thread here at allnurses for some expert advice.....

good luck! the above posts are great.

TinyNurse, RN · Nov 19, 2003

hi, i've had this problem before, and one of the nurses I work with told me to "back it up" a little until the line would run, and then check the site for a bit. The angio in that case wouldn't be "completely in" but the line would run, and site after backing it up was ok.

xo Jen

NsgTiger · Nov 19, 2003

Thanks guys! I will certainly try your tips. Anything to keep my patients from getting bruised and stuck unnecessarily I'm kinda thinking that it may be the angle. We'll see! Thanks again for your expertise.

Long Term Care Columnist / Guide · Nov 19, 2003

If possible, choose a vein that is firm to the touch, not rubbery or lumpy, as these tend to have lots of valves. Try to use as small a catheter as possible for the vessel you've chosen, and once you've pierced the skin, the stylet should be almost parallel with the surface. The instant you get flashback, advance the catheter slowly but steadily with your dominant hand, while simultaneously withdrawing the stylet....this is the important part, as you will punch right through the vein if you continue to advance the catheter with the stylet still inside. Attach your Y-site (or whatever your facility uses) with the NS flush, remove the tourniquet if you use one (also very important, as too much pressure can easily blow the vein as well) and flush a small amount of saline through the line. If it flushes OK and no lump appears under the skin, tape according to your preference and flush the rest of the solution, then attach the IV tubing or saline lock as ordered.

This works for me about 90% of the time. Try it, and see if it helps your performance. Like anything else, it takes time and LOTS of practice to become proficient, so don't be too hard on yourself while you're perfecting your technique.:)