Starting IV's

[bsunbeam]

Is it acceptable for RN's to use local anesthetic to start an IV or do you have to be certified in such?

[lovablelvn]

Seems kinda silly to me. I have had IV's before and its really not that painful.

Remember, pain (or really anything) is what the patient says it is. Because it's not painful to you really doesn't mean it isn't for your patient.

Lido is always an option for our patients. Never had any problems starting an IV after giving lido.

[ERNP]

I have used lido and not used lido to start IVs in the past. The lido does displace tissue and sometimes can cause a temporary change in how the vein is perceived by the starter. This seems to be more true with the tiny little veins. But if you give it a few minutes, this will disappear and the vein will again become as you first noticed it. Give it 5 minutes if you are going to try it.

When time is of the essence, just stick what looks good and move on.

[GatorRN]

I've been on the other side as the pt many times. I don't mind sticking ppl all day, but I HATE to be stuck!! I personally don't see the point in using Lido first, a stick is a stick no matter how you look at it. I'd much rather just be stuck only once to start the IV.

[CuttingEdgeRN]

Here's a lengthy thread on this subject. Please note that it is in an advanced practice forum (CRNA) so a lot of "policies and rules" would not apply to most of the posters.

https://allnurses.com/forums/f16/lidocaine-prior-iv-start-152733.html?highlight=lidocaine+starts

[meownsmile, BSN, RN]

I can see using some Emla or other topical creme, but i dont see a benefit in sticking 2 times for a procedure that if carried out skillfully should only take 1 stick.

[PurrRN]

As a new student I've not had the experience of starting IV's just yet, so clinically I don't have a qualified opinion either way. However, as a patient, I've had IV's started both with and without the "extra step" of lidocaine. Maybe I'm a baby where pain is concerned, but the nurse who took the extra time to take that "extra step" is my hero. I know perception of pain is subjective but I'd rather experience a tiny prick to the big stick. When I found out that there was a way to decrease my pain while recieving an IV, I was more than a little PO'd at all the nurses who'd never done that for me before. Anyway, just one experience out of many that are out there.

[Kurt-crna wnabe]

i have started a thousand ++ i.v.s and i have used a topical spray maybe ten times. in the er you do not have the time for everyone to wait for a local to take effect. you usually have a huge back log of patients to treat and if someone is whining for a "numbing agent" they probally don't need to be in the er to begin with. maybe it is different in other inpatient settings or the or but someone who is skilled and doesn't have to "dig" frequently to get their line won't need a local.

my second point is you don't get a local when you are in the outpatient getting blood drawn....the pain is the same and they draw where ever they can find a vein,...whether or not you place an iv- you've broken the skin....and yes it stings.