Starting IV's

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We're starting IV's on each other this week and i'd like to ask you guys for some tips. We practiced once on the dummies but I know it will be way different when we start it on each other. We need 3 successful tries before the second semester in January. Thanks a lot!:)

"I learned many years ago that tournaquet placement is very important...about 6 inches above your target site...... ( exception are the elderly with fragile veins)... "

hitowr, just had a question about this part of your post. So what do you do differently when you have elderly patients, what's the "exception"? What is your best advice? Also, the other type of pt I have always had a rougher time with are VERY obese pts, it's as if the veins have all retreated! Any pro tips would be appreciated! Thanks, SG

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you might try a blood pressure cuff I know a nurse who does that and it seems to work

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"I learned many years ago that tournaquet placement is very important...about 6 inches above your target site...... ( exception are the elderly with fragile veins)... "

hitowr, just had a question about this part of your post. So what do you do differently when you have elderly patients, what's the "exception"? What is your best advice? Also, the other type of pt I have always had a rougher time with are VERY obese pts, it's as if the veins have all retreated! Any pro tips would be appreciated! Thanks, SG

Their veins are usually so fragile that the pressure of the tourniquet will likely blow them... I put it on lightly.. or not at all...and that 's about the one time I DON'T use a local....with them, keeping the vein straight is also a problem... I like to have someone helping me ...another pair of hands..... as far as the obese or children who have very thick skin, you just have to know your anatomy and have an idea where the veins are.... again... it's so important to hang that arm over the rail for awhile and let the arm engorge....put the tournaquet on while it's hanging down.. then be patient for one to pop up enough to be able to feel it... you will probably never see it. On these later patients, some lidocaine will surely keep them from wanting to knock you off your stool as you may have to dig around a bit..and do that VERY slowly... you will get good at this.. as with all things.. proficiency just takes time. Good Luck..... hitowr

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Grr. one of my patients this past monday needed an iv restart, and she was a VERY hard stick. she had bruises up and down both of her arms from the nurses trying to get the first IV in, which i had to d/c. so i put the tourn on the opposite arm and start looking around for a good vein, grab my supplies and a 22 cath needle (that was what the other nurses finally had to resort to for her first IV) and the pts. nurse comes in, points to the vein I was bout to try, and states that I need to save that one for her in case my stick didn't work : / ( the patient said she'd only let me as a student try once.) none of the other veins were nearly as good, and the nurse points out this thin one and declares i need to try first on that one. as a student i felt stuck, bc i didn't want to argue with the nurse in front of the patient and look like a fool, but on the other hand i didn't want to choose that vein bc i was pretty sure it was going to blow. sure enough, got in, got the return, there goes the vein. then the nurse takes the big vein I was going to use originally and gets it in no problem, then looks at me and goes 'see, it's not so hard'. I left that room so frustrated : /

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Specializes in Float Pool, ICU/CCU, Med/Surg, Onc, Tele.

I saw an experienced RN start an IV on an elderly patient with very fragile veins... no tourniquet, let the arm dangle to distend, and she went in near the wrist. The thing she pointed out to me was that she went in right in the center of a Y where two veinlets branch off of one vein. Right... in the center... worked like a charm!

I had never seen that done before, and I was most impressed. You might give it a try sometime.

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Thank you all for your input. I survived my first stick....actually my second. The first one I tried wasn't successful because her vein rolled. My instructors tried so hard to help me by moving the tourniquet lower but it still didn't work so i had to withdraw. The second time I did it , on another classmate, I picked the inside of her wrist and had her put her arm down for a few seconds with the tourniquet on (had the tourniquet real tight). I went in fast and got flashback right away. She even said that she barely felt it compared to another classmate who did it and wasn't successful. Anyway, nobody wants to do it on me since they all know I'm a very hard stick:chuckle....anyway, I survived another skill and I agree with all of you that we can master any skill by practice. Thanks again!

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I know lots of nurses hate to see IVs in the AC, but when you'rs just learning, it's alot of times a "can't miss" spot that lets you get the feel of putting in IVs, builds your confidence to working up the the more difficult sticks. When I first started, an older nurse told me to just put a 20 in the AC in everyone- It worked, I was able to do this on most, so I became comfortable with my technique and then branched out to other veins.

Okay, I'm going to reveal my ignorance, but I've got to know --- what is AC?

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AC = antecubital fossa

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