is it necessary to have blood backflow after inserting a IV?

EricaAngela90 · Sep 22, 2015

Did you get a flash of blood at all? With the young ones in picu I don't always get this great flow of blood when I put it in as you would with patients who have juicy veins and a good amount of time especially with a 24 I get no blood return when pulling back. However, if it flushes perfectly without any issues and it's on a hard stick patient, I'm going to keep it.

San Diego RN BSN · Sep 22, 2015

I got a flash after insertion then advanced it gently... I felt the same way... Very hard stick elderly lady... I flushed it 2-3 times to be sure... I also seen a comment that smaller veins don't have backflow...

AcuteHD · Sep 23, 2015

IV's and HD fistulas may be too different to compare, but there are some pts that have great fistulas but never get a flashback. Great flow, but just no initial flashback, not even a hint. Very disconcerting.

RainMom · Sep 23, 2015

Sometimes if I'm unsure (especially with someone who immediately bruises & I think I may have blown the vein) I'll feel just above the insertion site & can feel the fluid as it flushes thru the vein.

Oh'Ello, BSN, RN · Sep 23, 2015

Where I work we cannot give vesicant drugs through any IV access that does not have blood return. Non vessies... whatever. Maybe your co-worker had the patient's future drugs in mind?

iluvivt, BSN, RN · Sep 23, 2015

It does not happen very often but yes I have started IVs that I did not initially get a flashback or ever get a flashback. It is prudent to make certain it is a good IV . Hook up a flush and see how it flushes and make certain it is not infiltrating. If it flushes,now attempt to pull back a bit and see if you get a blood return as a venous spasm may have occurred and now the vein has had a bit of time to relax you may now see a blood return. I can place several fingers gently along the course of the vein and can actually feel the flush along the course of the vein!

You may have an IV in the ACF area that flushes and is NOT in the vein so you must be careful in this region. So I do prefer to see some blood in the flashback chamber and if you feel that your are in the vein just wait a bit before you you shield your needle or pull it out . sometimes the vein will spasm when the needle punctures it and it needs to relax before blood will fill the flashback chamber.

How strong can that spasm be: strong enough to hold onto a PICC line so you cannot advance it into the vein!