Need advise on IV's

[Justhere, BSN, RN]

Only been in nursery for 5 months we do well & sick babies. Had a 35 weeker needing an IV. Got it 3 times but it blew every single time we began to flush it. Any advice on getting IV's going on these little ones. Tourniquets or no. Anything will be very well appreciated.:loveya:

[SteveNNP, MSN, NP]

I've found that one technique over another usually doesn't work for every situation. Using a rubber band as opposed to only a finger as a tourniquet is better sometimes, or sometimes makes them blow easier. I only stick what I can see, usually starting with the scalp or feet. Insert the needle slowly, and only advance it a hair more once you see return. Make sure you advance the catheter slowly, or you'll punch through the fragile vessel wall. My unit started using 10cc prefilled NS flushes, and I swear these make them blow even more often, so I usually draw up my own in a 3cc syringe. SOmetimes it's just luck! I had 10 "first try" tough sticks last week, as one night, 6 of our unit's babies PIV's went out within 30 min! But my luck ran out, and had a few days of unsuccessful sticks. So have someone else try if you can't get it after 2 sticks. Try searching for IV threads on this forum... there are dozens of them.

Stevern21

[PremieOne]

Starting IVs can be frustrating at times. It takes practice, skill, luck, a good IV catheter product (we are trialing 3 new types) and whether you can visulize the vein without transluminating. With some of the new types of IV catheters you do not get a good flashback and so you have a 50/50 change of getting the IV.

One thing to remember is securing the IV after insertion is very important. We use bio-oclusive to cover the IV, double back the tape, and place an armboard on the extremity we have IV in. We do not like doing scalp IVs. We usually go for PICC lines for the infants who keep losing their IV or have MEDs fo more than 5 days.

[Justhere, BSN, RN]

Thanks for your replies. We don't have a transluminator here, wish we did. Could see the veins real well, got a flash with all of them but once we tried to put fluid to them they would blow.

[Zippedodah]

Some kids are just like that....can't get a line in to save your life.

Why don't you like scalps? If we know we can get one in quicker than sticking hands and feet many times, we will. IMO, they last longer, usually, and are easier to maintain, esp if you have a big kid that needs a tight swaddle.