IV Vaso-Vagal HELP

[John Gonzalez]

I work with a plasma center as a nurse and honestly don't get to stick or use my IV skills period unless an adverse event. I recently had to try and attempt an IV using a butterfly needle with a line and the needle was a 23g. However the patient had a loss of consciousness and was profusely sweating and pale as well. I attempted to try and stick said patient with no results. Even though I saw a suitable vein my best guess would be that I was unable to get this patient due to having a vaso/vagal episode. Mind you this patient being over 200lbs. Does anyone have any advice on how to stick using a 23g butterfly needle when instances like this occur?

[IVRUS, BSN, RN]

Please remember that Vasovagal reaction is manifested by VASOCONSTRICTION. Your entire peripheral system shunts blood to the vital organs, as you are likely to faint. When vessels constrict, short of time and warm compresses, US will help greatly getting to those deeper vessels for cannulation.

[John Gonzalez]

5 minutes ago, IVRUS said:

Please remember that Vasovagal reaction is manifested by VASOCONSTRICTION. Your entire peripheral system shunts blood to the vital organs, as you are likely to faint. When vessels constrict, short of time and warm compresses, US will help greatly getting to those deeper vessels for cannulation.

This I know is usually a great help in any other setting, however with plasma centers this is not something we're too do as it is not in the centers SOP. Really we can only apply cold compresses fan the donor elevate lower extremities give an emesis bag and discontinue the process. In emergency situations say for allergies we can give epi pen injection. So other than warm compresses and pretty much time can I do anything else to get a successful stick with a butterfly needle?

[brownbook]

Who starts the IVs at the plasma center? Or am I confused about what a plasma center is?

If you rarely start IVs then starting one under stressful circumstances is not going to work. Experts would have a hard time on a vasoconstricted patient.

If you're almost 100% certain it's just a vaso vagal reaction there is little chance you need an IV. If the patient has a pulse and is breathing keep them in a safe comfortable position and monitor them.

It's actually a written policy that you can't use a warm compress?

If you need tips on starting IVs there are hundreds of them on Allnurses. Put how to start IVs in the search area of Allnurses.

[John Gonzalez]

22 minutes ago, brownbook said:

Who starts the IVs at the plasma center? Or am I confused about what a plasma center is?

If you rarely start IVs then starting one under stressful circumstances is not going to work. Experts would have a hard time on a vasoconstricted patient.

If you're almost 100% certain it's just a vaso vagal reaction there is little chance you need an IV. If the patient has a pulse and is breathing keep them in a safe comfortable position and monitor them.

It's actually a written policy that you can't use a warm compress?

If you need tips on starting IVs there are hundreds of them on Allnurses. Put how to start IVs in the search area of Allnurses.

At the plasma centers it's the phlebs who are doing the venipunctures for the donations. The nurse or if there's a hired paramedic are really only there to determine suitability of donors. And yes i'm sure it was a vasovagal episode with an loc of 5seconds and well its not written in the policy that we can't use warm compresses but it's a policy if its not in the SOP of the company you cannot do it.

[brownbook]

8 hours ago, John Gonzalez said:

At the plasma centers it's the phlebs who are doing the venipunctures for the donations. The nurse or if there's a hired paramedic are really only there to determine suitability of donors. And yes i'm sure it was a vasovagal episode with an loc of 5seconds and well its not written in the policy that we can't use warm compresses but it's a policy if its not in the SOP of the company you cannot do it.

Thanks, that explains a lot.

If the patient is so compromised they really need an IV it would be tough, even for an expert. Check out out to start IV's on Allnurses. In an emergency, to heck with policy, I'd have the phlebs start the IV.

Could you occasionally start the venipunctures for the donations, that is about 100% the same technique as starting an IV. I know, against policy ?.

[ClaraRedheart, BSN, RN]

I do the sonogram IV's on our unit... I might have seen something like this once maybe? Sometimes veins actually disappear, but if the person is actually in distress, you really shouldn't be sticking them again. Wait for them to calm down, give them some juice and send them on their way. Now, if they actually needed an IV in a hospital, I'd suggest something PO for anxiety and then try again.

["nursy", RN]

One thing that is important is to make sure the arm you're using is lower than the heart, as low as possible so that blood flows down into into. Sometimes the arms get propped up on an arm rest or a pillow, and the blood just drains out of the arm.