IV tips

antidote · Aug 17, 2007

IV's are something that honestly I don't even worry about anymore I have done so many of them! I'm sure it will be like that eventually some day for you.

Here is a very detailed website on starting IV's. Hopefully it will help:

http://www.mrprotocols.com/sset/iv.html

Although it was designed for MRI Technologists, it's all the same.

neneRN, BSN, RN · Aug 17, 2007

Check out this thread for lots of responses...

https://allnurses.com/forums/f8/how-put-iv-any-tips-2152.html

phiposurde · Aug 18, 2007

A few trick. First get use to the IV cath your using. Some of them require different technique. After a few years working with the one we use I came out with some little trick to make it better. But that is IV specific.

-BP cuff at 100. You would be surprise how many time people had trouble finding veins. I put the BP cuff and boom there one right there. It work very good especially on patient with a lot of edema or with a lot of fat tissue.On that note if the patient has edema ++ put pressure at the site you are looking for the vein for a few seconds. It with push the fluids away. Concentrate mostly at the wrist and hand fro that one.

-Rolling vein angle you IV cath more. Use it almost like a Forch then and do a J motion. Hit the vein then role up. It also help to stabilize the vein very well on those people. Sometime i even go pass the skin then I start playing with them.

-Turn the patient on his R side. Since the venous return come back from the right it apparently will help with the pooling of blood. Never really tried it cause the other trick work in 95% of the time.

-When looking for the vein. Close your eyes. Your sens of touch will be enhanced. Then you just move slowly all over the arm.Also sometime( but that one you didn't heard from me). I broke the tip of the glove of my most sensitive finger.

-Practice to start IV with your non dominant hand. It can come handy. In the last month I started 2 difficult IV because of that. One was because of the position of the vein. The person was flexing and very rigid because of some disease. I had to start the IV from the top toward the bottom. The other I use my dominant hand to have a better feeling and stabilize my vein. Then i started with the left hand.

-If you see but cannot feel them. Angle you IV more( close to 45 degree) and go very very slowly. There a big chance you may go through. But sometime if you see a nice blue line but can't feel them it just mean it's very deep.

Try those. Hope it help!!

ERRNTraveler, RN · Aug 19, 2007

-I had to start the IV from the top toward the bottom.

Please tell me you didn't start an IV in the WRONG direction (heading away from the heart)!!! That is a HUGE no-no!

phiposurde · Aug 19, 2007

Oh No. It was going in direction of the heart but is arm was flex( hand toward the head) and no way we could undo that. So I had to stand up and start the IV that way.Sorry for the scare!!8)

longjourneydream · Aug 19, 2007

You guys are making me laugh!!!

Thats funny!

You know, now that that I'm thinking of that, and I don't belive that I'm not mistaken, I remember (and I will not tell you where I saw this)

Jugular stick in opposite direction (tward the feet) and it did not work???

now somebody tell me...

Oh No. It was going in direction of the heart but is arm was flex( hand toward the head) and no way we could undo that. So I had to stand up and start the IV that way.Sorry for the scare!!8)

ERRNTraveler, RN · Aug 19, 2007

Oh No. It was going in direction of the heart but is arm was flex( hand toward the head) and no way we could undo that. So I had to stand up and start the IV that way.Sorry for the scare!!8)

Whew! Thanks for clarifying!

vampireslayer · Aug 21, 2007

Read all the tips in the threads that were posted above. I went through this very same thing, could NOT get an IV when I first started. I got so frustrated, kept thinking "jeez louise, this is not brain surgery!" but I just couldn't do it! At first, even the easy ones, the big ACs, I could get in but couldn't advance!

What I found helped me, for one, with the ones that won't advance, try to figure out the angle of the vein before you ever start sticking. You need to know which direction that thing's going, sometimes it's not obvious until you feel (with your eyes closed, that really does help).

Make sure the thumb on your other hand is holding the skin taut so the vein and the skin don't move once you insert the catheter.

Sometimes using an alcohol wipe, or your hibiclens prep or whatever, to wet the skin, makes the veins more easily seen.

Make sure you look up along the vein further than just the insertion site, look for bumps that indicate valves, bifurcations, twists and turns (which you can often straighten with some pressure from your thumb), because you have to make sure the entire catheter, once fully advanced, has a nice straight shot.

Look at upper arms more often. Lots of people stop looking once they get up to the AC, but I've had lots of luck with upper arms and shoulders. Same with the inside of the wrist. There's more nerves in this area and can be painful, but if you're very careful, don't go too deep, and MAKE SURE you aren't aiming at a tendon! I've seen someone do that, boy that's painful!

Feet are options too, if they aren't diabetic. Not ideal, but it works.

I hate to say this, because I heard it a million times when I was where you are now...it just takes practice and time. It really does. I started an IV last week, first try, after 3 other nurses had stuck the same patient a total of 6 times!

And for me, I'm not afraid to go down to a 22 gauge, if I have to. I know lots of people won't even consider that, they want a 20 or 18, and keep sticking and sticking. From my experience, a well placed #22 will give me a nice fast flow of IV fluids, will flush just fine, and I've had CT use my #22's for IV contrast with no problem, even though they usually "insist" that they need an #18 in the AC, and my #22 was in the wrist! That might depend on the policy of your department and your CT people though. And for some reason, I always get the #22's, especially the ones in the upper arm/shoulder area.

Good luck!

VS