Peripheral IV's

JRapha'sRN · Aug 17, 2005

Good job starting your first IVs!! :balloons: It is one of my favorite skills to do! Instant satisfaction (or disappointment...) The best thing I can recommend is to keep on trying. My first year as an RN I made it a point to let the other nurses on my med-surg unit know that I wanted IV experience. I got plenty of experience that year and now, several years later, I am the one other nurses come to when we have a tough stick. :)

To decrease the incidence of those disappearing veins make sure you don't do a hesitant stick--put that needle right through the skin, don't do it slowly! As your confidence and skills increase the veins won't disappear as often. There is no way to avoid it completely.

Good luck as you learn and have fun developing your skills!

letina · Aug 17, 2005

My pet peave with this experience was that a couple of times a vein that had previously been jumping out at me would disappear when I needed it to be visible.
I know that this is one of those things where practice is the only way to get good at it.
Anyone have any advice...you know...a secret technique that makes it work for you every time??

Here's what works for me when I see that nice big bouncy vein - stretch the skin over it, and 'anchor' it down with your thumb whilst smoothly inserting your needle :wink2:

Daytonite, BSN, RN · Aug 18, 2005

So, the vein just totally disappeared. Hum. That shouldn't happen. Now, don't get mad, but are you sure you were looking at a vein before the tourniquet went on?

One of the greatest skills you should learn to develop is the ability to "feel" for veins. Once you train your fingers to feel that bounce of an engorged vein when the tourniquet is on and are able to trace it's path by feel all you have to do is make sure you point the needle in the right direction and stick.

I was just thinking that if the vein is so fragile that it's disppearing with a tourniquet you could try accessing the vein without a tourniquet (you can do that, you know). My guess is that a vein that disappears like that is probably not a good one to use.

missnurse01, MSN, RN · Sep 15, 2005

i totally second what the above poster said! It is much more important to be able to feel a vein than see it in general. people always look at me like i am crazy when i am feeling around somewhere that they can't see anything. i also moved to a higher percentage of very dark skinned people in the population-so none of their veins are generally visible....unless u get that young guy with them sticking way out! another trick is to look at the area at a different angle, wipe with an alcohol or betadine, sometimes it shines from an angle. good luck, and u are off to a great start! even with the veins that u can see, really start feeling for those suckers.

pricklypear · Sep 15, 2005

Oh yes, they do disappear!!!! Had it happen lots of times. Yes, they were veins. I'm not sure where they went, but I think they were able to slip down or behind something. JRapha is totally correct, you have to jab those slippery viens quickly before they get away. That's when they seem to vanish, it you get into the skin without getting the vein in the same motion. Sometimes a side approach works if you can anchor it with a finger on the other side so it doesn't go sideways.

meownsmile, BSN, RN · Sep 16, 2005

You can wrap the arm with a warm blanket from the blanket warmer for about 10 min. to help dilate the veins,, and instead of using the tourniquet, try using the blood pressure cuff.

Sometimes adjusting the pressure can help make the veins show up a bit better by not occluding circulation completely.