Starting IV's...

bigwavedave · Apr 25, 2006

from my experience the big blue veins you can see are always easier. and it does make you feel better when you try unsuccessfully to start an iv and then the one with more iv experience cannot start it either. it's hard to describe exactly what veins feel like. as far as putting it in an artery- if you are feeling for a vein and you feel a pulse- don't put try sticking there. if for some reason you do get it in an artery it would bleed like crazy- more than usual and a brighter red than normal. take out the iv catheter and apply pressure until bleeding stops and then i would normally place a folded up 2 x 2 gauze secured with tape.

TazziRN, RN · Apr 25, 2006

If you feel something but you're not sure if it's a vein, keep your fingers on it and release the tourniquet. If it disappears, it was a vein. If you can still feel it, it's a ligament or something.

JMBM · Apr 25, 2006

If you will be called upon to start IVs regularly, you must learn to locate veins by feel. In fact, the largest, best anchored, easiest stuck veins are not visible. The best way to do this is to sit down with a friend and a tourniquet or BP cuff. Inflate the cuff to roughly diastolic pressure/tighten the tourniquet and let the arm hang down for a bit. Now hunt around by feel until you find what might be an "invisible" vein. The accessory vein just lateral of the AC is a good one. Not sure? Release the tourniquet/cuff while you are palpating the possible vein. If it "deflates", it was a vein. If not, it probably was a tendon. Do this a couple times; trace the vein up and down. Now, go do the same on a bunch of other friends. Use both hands/different fingers. Wear gloves. Pretty soon, you'll be picking out those hoses with no problem. Don't worry. You can teach somebody to do IVs in about 15 minutes. It takes years to get good at it.

mom23RN · Apr 25, 2006

I would suggest starting with someone with great veins and work your way down. :lol2: Feel around even on yourself (hmmmm... that didn't sound right) with your eyes closed and you should be able to feel them. I think they feel like a long balloon. Kind of squishy, but firm.

I agree you are goiing to have to learn how to feel them as sometimes you absolutely cannot see them.

IVs were my forte!! I loved when people tracked me down to get a hard stick for them!!!!!

Roy Fokker, BSN, RN · Apr 25, 2006

I learned how to stick IVs in school.

Then I "really" learned by watching this awesome nurse in the ER - she's been doing this for over 25 years. The other folks in the station - even the Docs - say that they are yet to see her fail!

She was the one who taught me how to get it by "feel". Sight is good, but "feel" is better. My greatest triumph was sticking a 83 year old severely dehydrated patient - I couldn't believe that I did it :)

I agree with TazziRN. and with JMBM :)

Practice! Practice! Practice!

And please remember to "secure" the IV as you go along.... there are few things more frustrating than getting a good stick in only to be careless while you are drawing blood/hanging fluids and losing the IV site! :banghead:

turquoise · Apr 25, 2006

This one piece of advice is what has helped me more than anything else. I asked one of the "never miss" nurses and she said to close my eyes and feel around. Things that were hard were most likely tendons or such and the "springy" things were probably veins. I don't have great feeling in my fingers but i've done much better when I wasn't trying to stick by sight. (I do open my eyes before i actually stick though.)

ICRN2008, BSN, RN · Apr 25, 2006

Veins feel very different from tendons and arteries. Try pressing your finger firmly in the skin and then moving it back and forth; the tendons will feel "stringy" or "ropelike". When you apply pressure and let up a few times, you will really notice the "bouncy" feeling of the veins. Arteries are easy because they are not as bouncy, and if you occlude them there will be blanching distal to the site.

I suggest familiarizing yourself with the major veins of the arms and where they lie (cephalic, basilic, etc.). When I studied phlebotomy in my previous program, we had to learn these well because sticking someone in the wrong place can cause nerve damage (and a lawsuit!).

P.S. I started my first IV yesterday- and got it on the first try! :)

Antikigirl, ASN, RN · Apr 26, 2006

I hope this will help, but I learned from paramedics/ER nurses/and RT's!

The veins you can see will roll on you fast...they are very superficial and are accustomed to moving if hit or rubbed. Makes sence really...the more towards the surface the more protection!

SO bummer...got to go by feel! And me...oh man...I was not comfy with that! But I practiced big time feeling my veins in the tub, or assessing my familys veins (of course no poke on either...just to feel them!

They are very rubbery feeling if you lightly touch...they have a bounce back with very very light one fingered tap (not a hard tap...just a light one with one finger). And if you feel something, especially in the AC...try again..sometimes that is a relaxed tendon....a tendon will feel more like grissle if tapped again!

Hot pack always...this will save a miss...I use to not...not anymore! In fact I like warm wet packs!

not only assess the vein itself..but where it is going! Don't hit anything that curves....really lightly feel where that vein is going! I close my eyes actually....that way I really FEEL! I will even rub my finger really well to get it sensitive!

I have seen some huge hoses so they say on folks...went in..and it rolled. Again it is use to moving since it is superfical enough to see....practice feeling for them!

ADN 2002 · Apr 26, 2006

It sounds nuts, but I sit sometimes when I'm watching TV or something (not looking at my arms) and palpate veins - I learned fairly fast how they feel and where they are and now I am a lot more confident in starting IVs.