Starting an IV with Lidocaine or Not?

[hayest]

I recently had surgery. My physician actually started the IV without Lidocaine. He knew I wanted the area numbed before the IV was placed. I've heard the reason before from other nurses and now him..... Lidocaine can hide the vein to cause a 2nd stick. I was willing to risk it. I wanted him to use the Lidocaine and I thought he was. He found the vein, said "here's a stick", (i felt nothing -- thinking this is great), then he said "here's a stick" and OMG .. that hurt like hell. I was VERY upset with him. I haven't had the opportunity to ask him why he didn't use Lidocaine. I know he told the preop nurse that if he could not start it, he would have her do it. I knew he was nervous. Keep in mind, he starts IV's all the time, just not in front of a lot of people. I had everyone leave the room and it was just him and me. Not only do I want to know why he did not use Lidocaine, but why didn't he ask me again and why didn't he give me the chance to ell him that I would allow him to try a few times. He did bring up after starting it "now I know where I can start the IV - next time, we will put creme on your hand to numb it". My reply was "a little late in saying that". What is the consensus of using lidocaine to start IV's or not?

[Khaan]

It's just an IV, have you ever had one? I have and it hurts for a second...then it's fine. Most adults can handle it just fine. I stick a minimum of 15 people/day. Today 26...everyone was fine, they even thank me afterwards. You know women used to have to have babies without epidurals? People have become big babies, and giving lidocaine is silly for such a minor thing.

Yep. My fellow students put some in me. Even let them to do a 14 in my AC to get trauma practice. It hurts. Generally I can take it, but not everyone's pain tolerance is the same. Same people experience it differently, and that's why we ask the patient's perception of pain in our assessment, not what we think it is.

[Athanasia]

You think childbirth is less painful? My menstrual cramps are more painful than an IV lol.

[Athanasia]

I only use 20 or 22 gauges, in outpatient we start at 6am and it's very fast paced so there is simply no time for lidocaine or EMLA cream. We have 60-80 patients per day. I do agree that people have different pain thresholds but they will have to make the decision IV with sedation or no IV without sedation for their colonoscopies and endoscopies.