Lots of blood... starting IV's HELP!

[Epona]

Hi all! Been a LONG day.....

Hey... I wanted to ask those experienced RN's out there... when putting in an IV, how do you keep it from bleeding all over the place?? I am told that is normal, BUT I don't think it is. I remember getting an IV before and there was no blood all over the place... I mean it was running down the pt's arm, on the floor, on the bed, etc.

I can get the vein on the first try and I am in, BUT when I disconnect the plunger (not exactly sure what the name is) and try and connect the connector, blood is literally gushing out of the vein through the opening. I try to apply pressure on the catheter, but it still comes out everywhere.

What am I doing wrong, or what can I do to prevent the blood from flowing out once I remove the plunger that has pushed the catheter in??? Once I connect the connector, it's fine and it stops, but in the meantime, it's a river!! HELP!

[LR59]

First always wear gloves, I put a towel below the arm to keep things clean have your flushed pigtail ready pullback and put it on You can put pressure on skin behind Iv catheter But most of just takes practice practice practice Good Luck

[ANH_RN]

Just press down on the arm a little harder next time. I normally have to put a lot of pressure on the arm above the catheter insertion site to keep it from gushing out. Usually it works long enough for me to wipe it with an alcohol pad or a gauze around the opening then I connect the ... connector thingy!

[barbyann]

tourniquet is off, right?

[jamesy7]

Apply more pressure above the insertion! But, yeah I always have a towel underneath, just in case!

[elthia]

Are you using Insytes? If so, then you need to hold pressure on the catheter and vein after you withdraw the needle, to occlude the vein as you put the saline lock on, preferably you already have the flush attached to the saline lock. Then release pressure flush the IV, clamp and secure. I often put a towel or a chuck under the pt's arm when I start and IV to prevent a messy situation.

[All4NursingRN]

if you're not drawing blood take the turniquet off after you see flashback in your angiocath and before you lock in the tubing.

[JulieCVICURN, BSN, RN]

I'm not trying to be an ass here, but honestly it's not "normal" to get a gusher. You can improve that technique. Unless I'm using a large guage cath, I rarely get more than a drip or two escaping from me! Don't be afraid to use pressure above the catheter - it doesn't do much good to be right on top of it because while you'll compress the vein, you probably won't compress the catheter itself. And yes, yes, yes, make sure the tourniquet comes off as soon as you see the flash.

And I don't mean to be Captain Obvious, but you do have your saline lock pigtail all set up and flushed first, right?

Don't worry - you'll get better at it. Just the fact that you asked for help here tells me that it won't be long before you're much better at it than those who told you it was normal to have a river of blood every time!

[MKS8806]

Well I'd say you're in the right place then! lol

Like others have said, I would make sure and have everything set up and flushed before you start. I ALWAYS put a towel or chux under my patient's arm before I start an IV.

[Murse901, MSN, RN]

As others have said, lots of pressure above the site. It will take some time to find the "sweet spot" to hold pressure. It also took me some time to get used to doing it with the tourniquet on as I came from an EMS and Med/Surg background and didn't do the labs-while-starting-IV thing until I hit the ED. I had soaked more than my fair share of towels before I learned the right way to hold pressure. Good luck.

[hiddencatRN, BSN, RN]

I'm almost always getting blood when an IV is started, and I am new enough at it that the river of blood is reassuring I work in peds so there is often a second set of hands helping to hold but sometimes with a squirming baby the bigger concern is getting the line secured ASAP. I find it helps to make sure my supplies are close and the cap on the t connector loose or off. Having a chuck under the arm as insurance too.

[xtxrn, ASN, RN]

epona said:

hi all! been a long day.....

hey... I wanted to ask those experienced RN's out there... when putting in an iv, how do you keep it from bleeding all over the place?? I am told that is normal, but I don't think it is. I remember getting an iv before and there was no blood all over the place... I mean it was running down the pt's arm, on the floor, on the bed, etc.

I can get the vein on the first try and I am in, but when I disconnect the plunger (not exactly sure what the name is) and try and connect the connector, blood is literally gushing out of the vein through the opening. I try to apply pressure on the catheter, but it still comes out everywhere.

what am I doing wrong, or what can I do to prevent the blood from flowing out once I remove the plunger that has pushed the catheter in??? once I connect the connector, it's fine and it stops, but in the meantime, it's a river!! help!

was it a stream about the width of the end of the hub, or splattering on the floor like a crime scene from halloween? dripping blood has to go somewhere- it's not always exsanguination.

gushing...like old faithful, or just more than you'd hope to have to clean up?

you just put a spigot into a vein- blood will come out. "everywhere"- means anything from needing hip waders to get out of the room to being just enough to have to change the sheet... ? ?

do what the pp.'s have suggested- and it's just blood. ? if you put in an iv and get an organ falling out- then you're in trouble