Baby IV's!!

  1. Hello all!

    I am a novice NICU nurse and i was wondering if any of you have any tips on starting iv's on the little ones! I know practice is a big help, lol, but are there any tips anyone has inparticluar that i could attempt?
    I am just kind of discouraged, and would appreciate any input such as angle, how far away from the vein do you enter, if tourniquets are always necessary,(our staff doesnt seem to like to use them) if one area of the body is easier than another (head easier?) etc.
    Any suggestions as to anything else i could practice on? My family, God bless them, let me practice on them, ( )...but now adult veins are too easy! (-like comparing a hair strand to a pencil, lol.) At our hospital we have a "3 pokes per nurse" maximum, i would really love to not have to poke my poor angels more than once!

    Any input is greatly appreciated!!
    Thanks so much!!
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    About neonursey

    Joined: Jun '04; Posts: 24
    NICU nurse


  3. by   nursecheryl81
    Hello Neonurse, I am a new neonatal nurse as well! First to start a neonate IV you must insert the needle at about a 15-30 degree angle... One thing that helped me was using a transluminator (used to check for pneumothoraxs) to see the veins better.. You can see the veins, how long, and how straight they are as well.. You can put the transluminator light on the side, or on top or wherever helps you see the veins.. And one thing I am learning is that you must push the catheter in as you take out your needle, other wise you are pushing the needle head through your vein and causing the vein to "blow." I have done that a few times... Practice, Practice, Practice!!! Good Luck!!
  4. by   dawngloves
    I like to insert just to the right of a vein.Easier to hit the vein rather than trying to go in on top of it.
    Hands are the easiest to get, but I look in the feet first. Hate UE IVs.
    And I'm not a big fan of translumiinators. Awkward to use. Most nurses in my unit are dependant on it.I would try without it first and use it as a last resort.
  5. by   BittyBabyGrower
    We have never used transilluminators! Saphenous veins are great too and front scalp veins. You just have to practice, at least one stick!
  6. by   ayndim
    I remember one nurse here (sorry for the faulty memory -- but ask my anything about micro or a&p) said that she practiced on the veins in her ankle. I think it was on the l&d area. I will try to find the post for you.

    Okay here it is. It was a vein in the foot. And the post is from canoehead. It is on the 2nd page.
    Last edit by ayndim on Jan 9, '05
  7. by   dawngloves
    I don't know if I could bring myself to stick an IV in my foot. :uhoh21: And it's not as small as a baby foot anyway.
    I don't think I could reach my cervix either. :chuckle
  8. by   neonursey
    Thanks for your input everyone!!

    I'm gonna give the transilluminator a shot next time, i see there are mixed feelings about it! (guess i need to try it before i can knock it)
    ayndim, i gave it a shot on my own foot and got it!! go figure!! (thanks for finding me the thread, putting an IV in yourself isnt as bad as it sounds, lol). Dawngloves, i was skeptical at first, but surprisingly there are some tiny veins in the least its a little more difficult than fat adult hand veins! It's also not as painful when you're doing it to, i must sound like a wierdo! :chuckle )

    i think my biggest mistake was not threading the catheter while removing the needle, no wonder they blew (thanks nursecheryl81)!

    keep it comming with the input, i really appreciate it you guys!!

    Thanks so much!!!
  9. by   dawngloves
    I have big feet. :imbar
  10. by   ayndim
    I am not sure if I could give myself an IV. But am glad it worked for you. Actually, I probably could if it meant saving a baby from more than one go. But since I am a prenursing student still I have a ways to go until I even decide what specialty to work in.

  11. by   MsJessikia
    what a great topic. I am also a novie NICU nurse and i tend to get pretty discouraged if an IV isnt working for me. I was working on a 28 weeker the other day, poked her twice and felt terrible when I had to have another nurse take a poke. Thanks for all the great advice... my future patients will appreciate it very much!!
  12. by   nekhismom
    I find it easiest to stick in the hands and in the weird crooks of the feet where no one else can stick. BUt that's just me. I've never even attempted a saphenous vein, I'd be way too worried. ANd I totally suck at head IV's. I'm just not used to using those veins. I've never used a transilluminator either. But to each his own. You'll get it, just hang in there!
  13. by   Mimi2RN
    We all have different ideas about starting IV's. I like to use the saphenous, I always look at those first. Often I can feel them, not see them, and a heel warmer will bring them up nicely. There are often skinny little veins on the feet, which are better than you would expect, too.

    I do like to use a tourniquet, at least when I'm looking, not always for the stick. The hands and forearms are often used first, and I can usually get the AC even if I can't see it. We do try to preserve those, in the little ones. The term babies are harder, especially the sugar babies who need an IV ASAP.

    Scalp veins can be wonderful, we use a rubber band for the tourniquet, and keep the scissors handy to cut it off. We have Blenderm tape for the hair, and try to trim as little as possible. Veniguards add stability to the dressing. On this site I learned about baby oil for tape removal, it works very well.

    Good luck, practice as much as you can. Remember, we all have bad days!
  14. by   JVanRN
    Thanks for the replies on this thread...many useful tips...especially threading the catheter while withdrawing the needle...I've alrealy started a few more IV's sucessfully be trying that.