Tiny vein tips for IVs

When I'm doing an IV on an elderly patient or a child I usually wrap the limb in a warm blanket or towel and hang the limb off the bed.

Hppy

When you say "missed" do you mean you didn't get in, back-walled it or it blew?

If the vein is visible try no tourniquet and drop the angle of approach to nearly flat. 

JKL33 said:

 If I'm asked to start an IV or draw blood on a challenging patient, finding the vein I'm going to use is by far the longest part of the process. 

Agreed. Success at IV placement is 50% skill and 50% vein selection. You can have all the mad IV skills in the world but if you pick a crap vein your chance at success drops dramatically and visa versa.

toomuchbaloney said:

You are so old school and I love it.  Great advice.  If the patient has tiny veins slow down. Try to make them less anxious.  Warm the extremity and place it in a dependent position. Flatten the angle of attack.  Hand draw the specimen rather than use a vacutainer. 

My spouse is a phlebotomy nightmare and my oldest child is worse.  

 

MY son was born premature and was having seizures. He had to have weekly blood draws after he came home. I learned a lot talking to the tech who usually did his draws. Thankfully the seizure D/O resolved and he is now 23 and graduating from college in March 2025.

An anesthesiologist told me, many years ago, that sometimes you just have to "go for the blue line" rather than try to feel a plumped vein from use of tourniquet.  Slowly, millimeter by millimeter, advance the needle till you obtain access.  Just another tip.

On attempts for ppl who are VERY frightened of needles, or on attempts where the vein is in a particularly sensitive area, I would inject a little wheal of 1% lidocaine with a TB needle -- inject right where I needed to go in with the IV needle.  If the patient can't feel my cautious attempt, there is less movement, reduced anxiety, and I had more success.   Check with your facility's policy about this, first.