Need help with IV technique

[Firemedic7]

Hi All!

I figured that this was the group of nurses to come to with this, so maybe you can help me.

I am an RN student through Excelsior College and have been a paramedic for 15 years.I currently work for a Fire Department that does 5-10 medic runs a day. My problem is that I have never been very good at IV's. It is a no brainer for say the big AC that pops up or a big hand vein but when thay become a challenge like in a forearm I am not the guy to go to:(

I know that this may sound crazy but could the fact that I have some colorblindness make it harder for me to find those hidden veins? I will be searching and my partner on the medic will be like "Don't you see that one right there?" and I won't, it is becoming a concern for me because I want to work at a trauma center when I finish my RN.

I have scheduled myself for clinical time at our local ED and some of the nurses there said thay would try to help me out.

Any info would be appreciated.

Thanks

[ERheart, BSN, RN]

The key to IV starts is feeling. Take a hot shower, when you get out feel your arms. Feel where the veins are. Remember them. Many times when I set down to start an IV line. I close my eyes and feel the pts arm. 9 times out 10 I get a line.

Also listen to the pt. They know there body.

Hopefully that helps

[Larry77, RN]

Just wondering, why upside-down on the arm?

When I've used a BP cuff I placed it upside down so the tubes were out of the way.

[EricJRN, MSN, RN]

When I've used a BP cuff I placed it upside down so the tubes were out of the way.

Yes - that way it's easier to look/feel for veins and you don't contaminate your site.

[Jennifer, RN]

I also have had a hard time getting iv sites on pts. Hands are the worst for me. I'm getting better with practice, though. I like to use ac veins with abd pain and chest pain complaints in case of ct scans. Also, if veins are large and tortuous, don't use tourniquet.

[vamedic4, EMT-P]

Hi firemedic

I'm with you - when I first started out on the truck, I couldn't hit water if I fell off a boat. Luckily for my little patients, things have changed.

My best advice is a page from another above...learn to feel your way around to find veins. Your eyes can deceive you...well, mine can anyway.

It's not always ideal given your line of work to warm patients up prior to sticking, but if you can- do it. Hang the extremity dependent, tourniquet or b/p cuff to expose veins, enter smoothly and quickly to reduce pain for the patient and with some skill (and sometimes a bit of luck), you'll get that IV.

Don't lose confidence in yourself - there are times when you'll miss everything you aim at - be not afraid, it happens to EVERY ONE OF US. Just keep practicing and you'll be amazed how quickly things can change.

All the best,

vamedic4

[Firemedic7]

Thanks for all of the great advice!!!

I'll get working on feeling the veins and I am scheduled for clinicals next week.

God Bless

[rclink]

Thanks for askin!

One trick that I learned in the Army as a medic to differentiate a vein and other structures is to make a V with your fingers (like makin a peace sign..do they do that anymore?") and with the middle finger proximal and the index finger distal tap these fingers alternately while palpating the vein. If it is a non venous structure it will not "FLOW" between your fingers and will feel hard. If it is a vein it will slightly resonate between your fingers. It works well when your not sure what your feelin under there, and works well in a diminished light setting, so your vision is not quite an issue. I use it alot in the ER and it's great for fat arms, and kids as well!! Good luck with excelsior and If you wish to write me about the program, contact me via e mail at [email protected]

Kepp up the Great work everyone and thanks for caring!!!

[MAP1]

Practice is what is necessary - also flick the length of the vein to get it to

be more visible - and good luck