Healthcare/Lab Bees – Doing IVs

posted 3 years ago in Career
Post # 2
Member
2114 posts
Buzzing bee
  • Wedding: July 2012

in nursing school we practiced on fake limbs and the. On our classmates. Once you are familiar with the equipment and the motions…oh and how to find a vein, etc…it’s just practice from there. But dehydrated people are difficult to work with, older people too. Sometimes you hit a valve and have to try again. General rule is you make two attempts and then get someone else. Very few hethvare workers have the gift of always hitting the mark. Most of us have good and bad days when it comes to inserting IV catheters. Anyway to answer your question, no. A one day class will not make you an expert. Experience will! 

Post # 3
Member
2163 posts
Buzzing bee
  • Wedding: June 2014

FI says it’s not hard, just stay relaxed and find the vein. Remember what you’re taught. And the tourniquet isn’t supposed to be on longer than a minute. He wants to know if you are doing IVs only in the arm, or in the hand…?

He says it depends on how much training you do because every patient is different and their veins are all different. Ok…I gotta stop. I’m terrified of blood so I just have to stop. Lol.

Post # 5
Member
42490 posts
Honey Beekeeper
  • Wedding: November 1999

AB Bride:  I am one of those nurses who can start an IV on almost anyone thanks to some great training by mentors.

Your instructor will teach you how to use the equipment. After that it’s the small things that make the difference.

It also depends on why they are having an IV. If they are likely to have long term IV therapy and are not having a central line, PIC line etc, you want to start low on their hand so you can move up. If it’s a one time thing, you can pick the best, easiest vein.

Take your time. There is no need to rush.  Pull up a chair to the side of the bed.

Look at their arm first so you get a sense of what kind of veins they have and where they are located.

Wet a towel with warm water. Squeeze out the excess and wrap it around their arm, then cover the wet towel with a waterproof pad and tape it together. Ask the patient to let their arm hang down over the side of the bed while you get set up, cut tape etc. The warmth and being dependent both cause the veins to distend.

Use a BP cuff instead of a tourniquet. It distributes the pressure much more evenly – especially works well with the elderly.

It’s not appropriate to go into detailed instructions about the actual poke, but if you take the time to do the prep you will be good at IV’s and  the more you do the better you will get.

One thing, never be afraid to ask for more training or help. There is nothing more irritating than a nurse or a student who says “I’ve already done that” when they clearly need more experience or assistance.  

Post # 7
Member
1040 posts
Bumble bee
  • Wedding: July 2014

The advice above is good. My advice is to take your time finding the best vein (youll learn the knack of feeling them with practice, there’s a sort of bouncy feeling you get with a good vein – feeling is much more important than what you see), make sure both you and the patient are comfortable, and put a pillow under the patients arm. The last part is actually really helpful, it makes the patient more comfortable and it helps stop them inadvertently pulling their arm away. 

 

Also make sure you have everything to hand before you start (nothing worse than having a successful iv -with blood coming out – and realising that you have no bung to seal it off), and if the patient is confused, ask for help before you start as they may move suddenly)

Post # 8
Member
1040 posts
Bumble bee
  • Wedding: July 2014

Also, and to be honest this probably applies to doctors (and I say that as one, I just know my colleagues are the worst offenders!) more than any other healthcare worker – make sure you clean up after yourself, especially sharps. 

  • This reply was modified 2 years, 8 months ago by  .
Post # 9
Member
1619 posts
Bumble bee

“shop till you drop” to find the best vein.  Do your patients the favor of considering the use of the IV – is a 22ga OK, or do you need an 18ga?  Duration – given a choice, putting one in an antecub or hand is not ideal if they have to stay in for several days, they’re more uncomfortable for pts as its irritating when they move as the joints bend. 

There are lots of tips and techniques to stabilize skin and veins.  Eventually you’ll find your own technique that works for you.  Good Luck.  I know others disagree, but think that using local on the skin helps.  It’s less uncomfortable for the patient, and you’re more likely to feel confident (confidence begets success) if the patient isn’t showing pain.  Others say it turns 1 stick into 2, but I’d much rather be stuck by a tb needle, have the skin numb, and then if you want to poke me with something larger – I’m OK with that. 

  • This reply was modified 2 years, 8 months ago by  .
Post # 11
Member
1040 posts
Bumble bee
  • Wedding: July 2014

Don’t worry about what you see – go with what you can feel. Practice feeling for that bounce that a good vein has (you can even try this on yourself to see what I mean). Being able to find a non visible vein through touch is a very useful skill, and it’s far more reliable (visible veins can be scarred or clotted if someone’s had a lot of IVs in the past, but you can tell which veins are viable by the feel)

Post # 13
Member
42490 posts
Honey Beekeeper
  • Wedding: November 1999

AB Bride:  Look at your own hand to see where the veins should be. After you dangle the arm, apply heat etc, apply the tourniquet and palpate the vein  lightly with your fingertip. It helps to get the sense of the placement in your brain. If you make it a habit to palpate the good veins, pretty soon you will also be able to palpate the veiins that aren’t so evident.

Look at the skin. Are there any freckles, small scars etc that you can use as markers for where to poke? If the veins  are decently visible on the patient, make your poke at the junction of where two or sometimes even three veins meet. It tends to be more stable and not roll around.

Use a shallow angle. You don’t need to dive bomb the vein. If you get a flashback of blood then can’t advance the needle easily, you probably went right through the vein and out the other side.

Remember to apply traction with the thumb of your non dominant hand (the one not holding the needle) about 2 inches distal to the site. Once you have made your poke and advanced the neeedle in the vein a bit, then you can let go of the traction and use two hands to finish advancing the catheter off the needle.

When you have the needle in the vein, advance it just a bit then hold the needle steady and push the catheter off the needle. Do not pull back on the needle or you will pull it out of the vein,

Where on earth are you learning to start IV’s where there is no BP cuff available? Pump it up to somewhere between the systolic and diastolic. That way you know you have occluded venous flow but left the arteries to flow freely and give good vein distension.

If you do have to use a tourniquet, don’t tie it too tightly. The blood needs to flow distally to the site, then be occluded fom flowing back up the arm.

Just take your time and remember that we all started somewhere. Remember to listen to the patient. If they say that one arm is better than the other, if possible start there.

Post # 15
Member
42490 posts
Honey Beekeeper
  • Wedding: November 1999

AB Bride:  You can buy a portable BP cuff from $10 and up. You don’t need a high quality product for this use.

You just tape the butterfly with one piece of tape across the wings, then deflate the cuff.

Where are you working and what are you injecting?

Leave a comment


Sent weekly. You may unsubscribe at any time.

Find Amazing Vendors