Pediatric PIV starts

[NewPICURN]

I have not had much success with them. I have been in the PICU a year now and I realize that sometimes, there are complicating factors, dehydrated or fluid overloaded, but I have a hard time just FINDING the veins sometimes. I have started a scalp PIV before, but just learned about finding a vein between bicep and tricep and someone told me that you can kind of blind stick between the knuckles. I know peds patients aren't the only hard sticks out there.

What did you do to improve your skills?

Any tips?

I have tried to observe as many other nurses as I can and somehow they just see/ hit veins that I can't.

[NotReady4PrimeTime, RN]

Moved to the Pediatric Nursing Forum for more attention.

The great saphenous is a good place to look for a large vein. It's closest to the surface right there between the medial malleolus and the extensor hallucis longus tendon. It's big, it's long, it's straight and it's sitting in a slot. There's also a good one that runs along the lateral edge of the foot, the lesser saphenous. It's also fairly large, fairly straight and near the surface.

Hand veins can be challenging on tiny hands, but not impossible. Instead of using a tourniquet, try flexing the child's wrist firmly, holding it down with your non-dominant thumb across the knuckles. You'll be able to see the veins better that way and they're secured by the stretched skin so they don't roll. It's also easier to see them through wet skin... lots of soluprep! Then there's the cephalic vein. It's another juicy, long, straight superficial one that sits in a slot between the extensor pollicis brevis and the extensor carpi radialis tendons.

Those are my go-tos.

[Lisa Jane RN]

For me, neonates are much easier than the older chubby babes. My first choice is usually the hands and wrists rather than the saphenous. But thats just a personal thing. Definitely helps to have lots of prep on and if you can get your hands on a transilluminator they are worth their weight in gold!!!I also spend more time looking than poking, unless it's an emergent situation I spend a lot of time searching, I try to take my time rather then rush. If I'm going to poke, I just want to do it once :)And heat! Heat helps too!!!Good luck!!!

[Lisa Jane RN]

I rarely blind stick. And like everything, it comes with experience.

[almacg]

I find that the easiest blind stick for a pedi patients are the ac sites it feels like a cherry stem and I agree chubby babies are harder to stick because the veins are just not as visible. Always warm up your potential sites too because the dilation of the veins really help.