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Discussion

Tips for IV insertion

Hey Everyone,

I was wondering if new grads and/or experienced nurses could give some tips they found that work for IV insertions. This is one skill I feel like I CAN NOT master and I get sooo frustrated. :angryfire If I find a decent vein I try it and get blood return, then it blows. Its especially hard in older people or those with dark skin because you can't see or feel anything! If I don't see it, I usually won't go for it. I have a hard time picking out a good vein and half the time I feel like I don't know what to look for. I also feel like I go in at the wrong angle, or if I get blood return, when I keep advancing the catheter I go in at the wrong angle.

If anybody has any good tips or tricks I would appreciate it! ;)

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  • Experts

You know, AriRN, there are lots and lots of posts on that very topic interspersed here on allnurses. Run a quick search and you'll have more help than you would ever imagine!

Confidence. It's your best skill...

Take a deep breath and try to relax. Use gravity--hang the arm down and sit on a stool or chair--along with the tourniquet. Go in at not much of an angle--maybe 20%. Get enough of the needle in so that when you advance the catheter it will go more smoothly. Practice with a blanket for angle and hands (which hand goes where when). I did a lot of practice on blankets and it helped me a lot. Also important is to anchor the vein so it doesn't move.

Believe it or not it gets easier. Starting IVs is something I still hate to do. I've only been a nurse for 9 months and I started an IV on someone who was a renal patient and I only had one arm to work with. They stuck her several times the night before and no one could get her started. The patient begged me to start her because she wanted her morphine. I told her I was waiting for the IV team cause she's such a hard stick and has had TLC in the past. So after her asking me to start her I got in on the first try. I was so happy with myself. So it does get better and easier.

I think the big thing is to not rush and take your time. I have also found it works better if the patient is in bed supine and you raise that bed up and have lots of light. I've had my best successes doing that. It's true what they say - you just need to keep on sticking and getting the experience.

Kelly

hang the arm down and sit on a stool or chair

The NICU where I work is not really conducive to it, but when I'm working ER or EMS I've found this to be a very helpful trick. If you feel rushed, it's too easy to goof up. Sitting down, to me, has a calming effect if nothing else.

This was taught to me by an RN with 20+ years of experience. If the pt is elderly or if you can see and feel the vein, don't use the tourniquet. The pressure from the blood that can't get past the tourniquet is enough to cause the vein to blow.

This nurse will use the tourniquet to find a vein, but then undo it for all of her IV starts. If I could be half as good as she is, I would be happy.

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