# My pt. has no veins!



## BloodNGlory02 (Apr 13, 2005)

How do you go about finding/obtaining a vein in the patient that seems to have none? I've had 3 pt.s this week that I couldnt palpate, visualize or poke and hope. and were in desperate need of an IV. Usually my skills are ok, but im getting really discouraged with all these no veined people.

I've tried the 2 tourniquet method, hanging their arm off the side of the cot, having them squeeze their hand, nothing makes even the tiniest thing pop up. I give up


----------



## ma2va92 (Apr 14, 2005)

my list

hands  forearms  AC.. warm cloth{heat pack} rub the hell out of the area .. something will show... then the best you get is a 22 or 24 .. well it's a start to get somethig flowing


----------



## CodeSurfer (Apr 14, 2005)

Slap 'em real hard... then even if a vein doesnt show, you have gotten your frustration out. B)


----------



## TTLWHKR (Apr 14, 2005)

I hate it! People are always grabbing my arms asking if they can practice on my big veins. NO... I'm not a pin cushion. I'm irish, so I completely white, that makes my veins more obvious. Damn genes.


----------



## TTLWHKR (Apr 14, 2005)

I forgot...

Nitro stat... Just a little, spray it on where u want the vein, and it sort of makes it more obvious. Then, don't tell anyone u did it, especially if the patients BP bottoms out.  :blink:


----------



## BloodNGlory02 (Apr 14, 2005)

> *I forgot...
> 
> Nitro stat... Just a little, spray it on where u want the vein, and it sort of makes it more obvious. Then, don't tell anyone u did it, especially if the patients BP bottoms out.*



oh man then I BETTER get a line in!


----------



## MMiz (Apr 14, 2005)

I've heard good things about the Venoscope (http://www.venoscope.com/).  I've never seen one used, but another forum I frequent has talked about them as a tool for finding the hard-to-find vein.  At $150 it's a big investment though  B)


----------



## rescuecpt (Apr 14, 2005)

Take a penlight and have someone hold it up to their skin, to the side of where you think the vein should be - sometimes it makes it easier to see where it is/how deep it is/etc.

I have pipes and CC students are constantly looking at my hands and arms -  I have let a couple of the cocky ones try because my pipes roll and then they fell like dorks for missing.


----------



## Jon (Apr 15, 2005)

> _Originally posted by rescuecpt_@Apr 14 2005, 08:59 AM
> * Take a penlight and have someone hold it up to their skin, to the side of where you think the vein should be - sometimes it makes it easier to see where it is/how deep it is/etc.
> 
> I have pipes and CC students are constantly looking at my hands and arms -  I have let a couple of the cocky ones try because my pipes roll and then they fell like dorks for missing.   *


 This works GREAT in peds. Had a NICU nurse show me how their trans-illuminator worked (same way).

Tighter tournequet works, sometimes.

Put the pt. in tredelenburg if their pressure is even a LITTLE low.

EJ's are a great thing...if only I could do one or two in the ED (Darn residents  )

Otherwise, just stick them and turn them into a pincusion Doesn't always work, ut sometimes you get lucky.


Jon


----------



## Tigs_9 (Apr 15, 2005)

Not that i no what im talkin about or anything but my veins dont like to b played with. I give blood all the time and the nurse always puts something very cold on my arm and makes me clench my fist a couple of times..... Works for him and me   Mind u ur pt wud have to be fairly concious!!!  But like i said not that i no anything about it!!!


----------



## flmedic (Apr 15, 2005)

Always remember to look in the less obvious places like the leg or foot...depending on the severity of needing a line. I have had your situation happen to me more times than I care to remember thats where remembering anatomy comes into play there are certain areas that everyone has veins...wether you feel them or see them or not. I don't know your protocols but an EJ has saved me more than once.


----------



## BloodNGlory02 (Apr 15, 2005)

EJ's and IO's are a I-99 thing only. And the way they're itchin to get them, im sure as a lowely IV Tech I wouldnt get many anyways. *sigh* why cant everyone have a vein that says POKE ME! POKE ME!


----------



## TTLWHKR (Apr 15, 2005)

Go fer' the jug'! Just keep probin' around until blood starts squirtin!

Worst thing that happens is the guy dies. It's all gravy.


----------



## medic03 (Apr 16, 2005)

EJ baby.......


----------



## PArescueEMT (Apr 16, 2005)

nobody mentioned the interns vein... lateral forearm. always there and ready for an 18.


----------



## Jon (Apr 16, 2005)

> _Originally posted by TTLWHKR_@Apr 15 2005, 05:58 PM
> * Go fer' the jug'! *


 careful to who and how you say that....


Jon


----------



## Wingnut (Apr 16, 2005)

WhoooooooooohOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO!



 




*puts down the jug*


----------



## TTLWHKR (Apr 16, 2005)

> _Originally posted by MedicStudentJon+Apr 16 2005, 05:54 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MedicStudentJon @ Apr 16 2005, 05:54 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TTLWHKR_@Apr 15 2005, 05:58 PM
> * Go fer' the jug'! *


careful to who and how you say that....


Jon [/b][/quote]
 Jugular


----------



## PArescueEMT (Apr 17, 2005)

he knows... he just has his mind in the gutter.


----------



## MedicPrincess (Apr 17, 2005)

> _Originally posted by TTLWHKR_@Apr 15 2005, 05:58 PM
> * Go fer' the jug'! Just keep probin' around until blood starts squirtin!
> 
> *


 GOODNESS!!!   

You probe around the jugs until she bleeds!!!

WOW!! I think you revealed a lot about yourself.      B)


----------



## CodeSurfer (Apr 17, 2005)

> _Originally posted by MedicStudentJon+Apr 16 2005, 05:54 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (MedicStudentJon @ Apr 16 2005, 05:54 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TTLWHKR_@Apr 15 2005, 05:58 PM
> * Go fer' the jug'! *


careful to who and how you say that....


Jon [/b][/quote]
 *fears ambulance ride with jug poker*


----------



## Margaritaville (Apr 23, 2005)

If they need a line that bad - EJ or IO if its in your protocols! If only P's can do it than get some help!


----------



## TTLWHKR (Apr 23, 2005)

> _Originally posted by PArescueEMT_@Apr 17 2005, 09:42 AM
> * he knows... he just has his mind in the gutter. *


  :huh:  ya don't say..


----------



## rescuecpt (Apr 23, 2005)

> _Originally posted by TTLWHKR+Apr 23 2005, 10:45 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (TTLWHKR @ Apr 23 2005, 10:45 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-PArescueEMT_@Apr 17 2005, 09:42 AM
> * he knows... he just has his mind in the gutter. *


:huh:  ya don't say.. [/b][/quote]
 That's what happens when you're a young single whacker...


----------



## TTLWHKR (Apr 23, 2005)

> _Originally posted by rescuecpt+Apr 23 2005, 02:02 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>*QUOTE* (rescuecpt @ Apr 23 2005, 02:02 PM)</td></tr><tr><td id='QUOTE'>
> 
> 
> 
> ...


That's what happens when you're a young single whacker... [/b][/quote]
 He can have my wife.


----------



## ffemt8978 (Apr 24, 2005)

TTLWHKR,

Cool avatar


----------



## rescuejew (May 7, 2005)

we just got released for sternal IOs for unresponsive pts with no peripheral access.  They work REALLY well...

 Intermediates, once released, can do EJs


----------



## Luno (May 7, 2005)

Uh, nobody has mentioned the sub-clavian, one of the easiest sticks, if you have the protocols, of course.  h34r:


----------



## Jon (May 7, 2005)

> _Originally posted by Luno_@May 7 2005, 07:53 PM
> * Uh, nobody has mentioned the sub-clavian, one of the easiest sticks, if you have the protocols, of course.  h34r: *


 Or in your case, a lack of a system to scream at you....

Jon


----------



## ffemt8978 (May 7, 2005)

Or, if you can hyperextend your patient's arm, the AC's jump right out at you.  We managed to get an IV on a combative patient while he was still fighting us using this method.


----------



## Luno (May 8, 2005)

Yeah, but not killing the right people is a responsibility unto itself, Attaboy if they don't die, WTF medic, find a new team if they do.


----------

