IV Sticks - AEMT noob tips and tricks?

[Altered Mental Status]

I'm hit-or-miss.

So far, I've only practiced with 20g in a non-moving ER setting for clinicals.
I'm about 50-50. I don't know how the eff I'm gonna get good at this in the back of a moving truck.

I look to you, oh wise veterans to tell me where my *ss is and where my elbow. :unsure:

PLEEZ HALP.

 

[Shishkabob]

Practice. I know it's cliche, but that's really all it is. Some days you won't hit the best veins ever, and other days you'll hit veins no one else can.

Don't be afraid to poke away, and jump in on all the ones you can.

 

[Cup of Joe]

http://emtlife.com/showthread.php?t=25740

 

[Akulahawk]

Seriously, it just takes practice. Otherwise, just get a little zen and become the needle.

 

[foxfire]

When you look at the arm, picture in your mind where the Vein is and then go for it. I have totally sucked for a month during my training. could not hit the broadside of a barn. but after some medics watching me start a few, they where able to figure out what I wasdoing wrong.
like linuss said keep at, ya have your good days and bad ones.

 

[MSDeltaFlt]

I'm hit-or-miss.

So far, I've only practiced with 20g in a non-moving ER setting for clinicals.
I'm about 50-50. I don't know how the eff I'm gonna get good at this in the back of a moving truck.

I look to you, oh wise veterans to tell me where my *ss is and where my elbow. :unsure:

PLEEZ HALP.

If you can't feel it, don't stick it.

 

[Altered Mental Status]

Thanks, guys. I feel like having Paramedics standing over me is exactly what I need. Nurses at the hospital can't really instruct me. They say things like "It's just in and then advance the cath, see?"

Every time I try doing it by the book (45º then drop it to 15º), someone goes "Wait, you don't want to go so deep, she's got flat veins," or something like that.

It's getting so that I'm starting to feel like it's sort of random and unique each time...like there are no real rules.

I hope I get better at this.

 

[Altered Mental Status]

If you can't feel it, don't stick it.

What do you do when you have a hypotensive, dehydrated, skinny 80-year-old lady?

 

[Shishkabob]

Honestly, shoo off anyone that tries to tell you their specific way. It's medicine, it's an art. If it works, works for you, and is safe, do it.


You'll learn what works for you, what doesnt, and what works for certain patients.




You're GOING to miss IVs. Don't let it bug you... even if it makes a little kid scream bloody murder.

 

[tylerp1]

When I began my clinicals, my first few starts were in the ACs. It gave me a good idea as to what I was feeling for when I palpated hands, forearms, etc, as well as technique. Worked well when you do encounter those dehydrated 80 year olds.

Just remember that when you get to clinicals, you [should] have the proper equipment, good lighting, knowledgeable preceptors, etc etc. They are there for help; 'somebody to fall back on', if you will. They aren't trying to set you up for failure. Many times, other medics, nurses, and physicians would show me alternative ways to do what I had just performed successfully.

I simply wanted to learn how to do as much as I could in as many different ways as I could encounter. It allowed me to find my style and it'd be nice to know another technique for those times you're in an unfavorable situation.

 

[mikie]

slow down...

Take your time! No need to hurry and forget minute things or 'penetrate' too fast and end up missing/going though the vein. Ask for help.

 

[MSDeltaFlt]

What do you do when you have a hypotensive, dehydrated, skinny 80-year-old lady?

The veins are there. Start feeling for them. Learn to feel for them. Every pt contact you make start feeling for veins even if you're not even going to stick them. Feel for them anyway. They're there.

 

[Akulahawk]

The veins are there. Start feeling for them. Learn to feel for them. Every pt contact you make start feeling for veins even if you're not even going to stick them. Feel for them anyway. They're there.

This will most definitely help... especially when you're trying to get a line in a patient that you can't SEE a vein, but you need that line put in...

Also get to know the general anatomic locations of the veins. While there's always some variability, veins will be in the same general area from person to person.

 

[fast65]

It sounds like pretty much everything has been said already, but let me reiterate that you WILL miss IV's, don't let that discourage you, because we all miss them.

What my preceptor once told me was once you get flash, let the flash chamber fill completely, if it doesn't, advance a little more. The key is to find a technique that works for you, and the only way to do that is to practice, practice some more, and then practice some more after that. Take your time, be patient, and practice as much as possible.

 

[Handsome Robb]

Don't forget to pop the tourniquet before pulling the needle outta the cath Unless you like holding absurdly hard tamponade on your patients.

 

[fast65]

Don't forget to pop the tourniquet before pulling the needle outta the cath Unless you like holding absurdly hard tamponade on your patients.

Oh yeah, I almost forgot about that one

 

[Handsome Robb]

Oh yeah, I almost forgot about that one

I also know someone who *****ed and moaned and ended up starting another line in the opposite arm during a lab day in class cause their drip wouldn't flow, to only realize after starting the second drip the tourniquet was still on the original arm.

It wasn't me ... I swear! ... ... ok ... it was me :rofl:

 

[Chief Complaint]

^^^^this, be mindful of your TQ.

Be sure to have all of your supplies ready. Teg out of the package, tape torn, gauze handy, etc.

 

[Fish]

Personal pref.

I always start lower than a 45 degree angle because most peoples viens are very close to the surface, I always keep the skin taught. Once I get a flash, I insert the needle just a bit more than thread the cath. This works good for me, I am successful over 95% of the time if I had to guess.

Another tip, that alcohol prep is your friend. When you are doing your cleaning of the IV site prior to putting an IV in push down abit harder than you might think you should this helps irritate the vien causing it to stand up more and it causes less sensitivity in the area so you can insert your IV slower and increase your chance for success all the while causing less pain.

Try it on yourself, have someone start an IV normal way. Then the way I described you will find it hurts less and is easier.

 

[Altered Mental Status]

Personal pref.

I always start lower than a 45 degree angle because most peoples viens are very close to the surface, I always keep the skin taught. Once I get a flash, I insert the needle just a bit more than thread the cath. This works good for me, I am successful over 95% of the time if I had to guess.

Another tip, that alcohol prep is your friend. When you are doing your cleaning of the IV site prior to putting an IV in push down abit harder than you might think you should this helps irritate the vien causing it to stand up more and it causes less sensitivity in the area so you can insert your IV slower and increase your chance for success all the while causing less pain.

Try it on yourself, have someone start an IV normal way. Then the way I described you will find it hurts less and is easier.

This is brilliant. Thank you.