# passed my IV test



## alright35 (Nov 5, 2009)

well got certified to start sticking pt. in the ED, so i guess you could say i passed. i stuck the fake arm like a thousand times over the past two days and stuck my first real person today. def seems like it will require a lot more practice on my part...those fake arms suck for giving you the feel of a real person. anyway just felt like bragging a little...first major thing i have done since medic school started, only 2 months in


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## Shishkabob (Nov 5, 2009)

Congrats!



Just wait till your nurse tells you to start an IV on an attempted suicide pt with no veins after years of heroin use, scars all over, and actively vomiting.  It's fun.


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## alright35 (Nov 5, 2009)

*fishing?*

yea, some of the already IV certified students were talking about all of the difficult people they have had to stick, i have my next rotation next week so we shall see. hey, do any of you guys make a normal routine of "fishing" for a vein, obviously our instructor said we can't but other students tell me that it's not the case in real life.


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## Shishkabob (Nov 5, 2009)

Define "fishing for the vein"?  Do you mean poking where you think there might be a vein, or poking where you know there is a vein and moving the cath around to get flash?

The former is bad, the latter is commonly practiced, good or bad.  Sure, it's uncomfortable to have something moving around your arm, but if they get the flash, it sure as heck beats having another poke.



I've had times where I got the flash, pulled out the needle and had no blood flow.  Pretty much have to jiggle the cath as you might be on a valve or it might be a positional site.


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## alright35 (Nov 5, 2009)

the latter, and i would be inclined to agree even i would prefer a little fishing when you know a vein is there just may be a little deeper. but again for some reason our instructor says no fishing, so i was just curious how common it was


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## Shishkabob (Nov 5, 2009)

Sometimes you just go too shallow or too deep for a vein and need to adjust.  Apologize to your pt and move on.



Do what I do, and tell yourself the temporary pain of an IV is offset by the good that the IV will do medical wise.


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## StreetPharmacist (Nov 5, 2009)

We had to do 10 sticks in class on each other not the fake arms, that was fun learning on each other to due sticks, cruel yes but effective teaches what its like to be the pt and feel what your doing to someone else and as far as fishing goes I wouldnt let anyone in class fish for my veins, I wouldnt let someone do it to me and Im not doing it to a patient it is unprofessional. What would you do if a peice of the cath broke off from fishing? Are you prepared to tell someone you caused a plastic embolism because you were to lazy to do your job?


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## HotelCo (Nov 5, 2009)

We didn't have to practice on any real people for class. I definitely wouldn't have my classmates practicing on me.


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## cm4short (Nov 5, 2009)

HotelCo said:


> We didn't have to practice on any real people for class. I definitely wouldn't have my classmates practicing on me.



I still have a scar from when a classmate practiced on me. He missed and I HAVE ROPES. I mean, you could see them trough a long sleeve shirt.


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## atropine (Nov 6, 2009)

Why do you need an IV cert as a basic?, just curious


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## Shishkabob (Nov 6, 2009)

atropine said:


> Why do you need an IV cert as a basic?, just curious




....





alright35 said:


> first major thing i have done since *medic school* started


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## RyanMidd (Nov 6, 2009)

Our class schedule was 4-on, 4-off, and the 4th day of every rotation was dedicated 100% to skills, all day, all practical.

That meant 2 hours of dedicated IV practice at the end of each "skills day".

Over that 6 months, our arms/hands/feet/ankles accrued many poke marks.

All seem to have disappeared, but try explaining at a blood donor clinic why you have 5 band-aids on hypodermic needle marks on each arm.


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## EMSLaw (Nov 6, 2009)

RyanMidd said:


> Over that 6 months, our arms/hands/feet/ankles accrued many poke marks.
> 
> All seem to have disappeared, but try explaining at a blood donor clinic why you have 5 band-aids on hypodermic needle marks on each arm.



"Hey, man, I just got out of rehab.  Don't judge me!"


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## Griff (Nov 6, 2009)

HotelCo said:


> We didn't have to practice on any real people for class. I definitely wouldn't have my classmates practicing on me.



Same here, they didn't let us practice on each other in the class.


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## Shishkabob (Nov 6, 2009)

We practiced on eachother, but only if you wanted someone to.  

Not only did it make the learning experience better because nothing replaces the real thing, but it also opened your eyes to the type of pain you'll be putting your patients through.


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## HotelCo (Nov 7, 2009)

Linuss said:


> Not only did it make the learning experience better because nothing replaces the real thing, but it also opened your eyes to the type of pain you'll be putting your patients through.



There should be little to no pain if done correctly. Speaking as a person who has had plenty of IVs in their lifetime, it's all about technique. It doesn't have to be a painful experience for the patient. What I found that made it less painful when they did it to me was when they pushed through the skin fast, instead of going really slow.

edit: 900th post.


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## Shishkabob (Nov 7, 2009)

I don't care what you say, having a sharp piece of metal thrust through your skin isn't going to feel good 




Well.. unless you're a masochist.


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## HotelCo (Nov 8, 2009)

Linuss said:


> I don't care what you say, having a sharp piece of metal thrust through your skin isn't going to feel good
> 
> 
> 
> ...



You're right, but it also doesn't need to be overly-painful due to poor technique.


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## rhan101277 (Nov 8, 2009)

Missed all of my IV's at clinicals today.  I had 3 patients, one was a diabetic and had tough skin, nurse took 2 tries.  The other had big veins, the nurse thinks I hit a valve, it took her 2 tries.  The other was a 84 y/o that was really dehydrated and even my instructor couldn't get it, he had to have a EJ done.

Anyhow I am a bit bummed about it, but I have had some successes, maybe today was just a bad day.


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## denverfiremedic (Nov 9, 2009)

rhan101277 said:


> Missed all of my IV's at clinicals today.  I had 3 patients, one was a diabetic and had tough skin, nurse took 2 tries.  The other had big veins, the nurse thinks I hit a valve, it took her 2 tries.  The other was a 84 y/o that was really dehydrated and even my instructor couldn't get it, he had to have a EJ done.
> 
> Anyhow I am a bit bummed about it, but I have had some successes, maybe today was just a bad day.



your a paramedic student and your just now getting Iv cert? thats odd


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## Shishkabob (Nov 9, 2009)

denverfiremedic said:


> your a paramedic student and your just now getting Iv cert? thats odd



He's not in Colorado like you.  Most states don't let their Basics get certed for IVs for field use.


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## denverfiremedic (Nov 9, 2009)

thats weird, here a basic can do IV, ECG with interpretation, certain Intubations and use a few intervenes drugs with the proper state certified training. I see why people are kinda harsh on basics in other states.


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## EMT_TIFFANY (Nov 9, 2009)

Congratulations! I as well just got certified in IV last week. My first round of clinicals is this week. In lab we had to practice on our classmates with a butterfly.


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## rhan101277 (Nov 9, 2009)

We were not allowed to practice on classmates.  We just had the mannequin arm.


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## rhan101277 (Nov 11, 2009)

denverfiremedic said:


> thats weird, here a basic can do IV, ECG with interpretation, certain Intubations and use a few intervenes drugs with the proper state certified training. I see why people are kinda harsh on basics in other states.



I think one reason people are harsh is that the basics do not have the education level that is required by paramedics, A&P I and II are important.  Also medic student get tons more lab and clinical time to practice these skills.


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## Dominion (Nov 11, 2009)

We used a combo of fake arm and each other.  The rule was if I stuck you, you got to stick me, so you had to try not to torture them because they're turn is coming.  So far I've been about 80% success rate in clinicals and almost all of my failures have been on crappy veins.  

I missed one guys hand the other day, couldn't thread the catheter.  I did get a 16ga in the OR last week and got to attempt an IV by landmark in the OR.


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## EMT1 (Nov 15, 2009)

*Iv*

We had 75 sticks on the manikin arm and hand. Then we did a saline lock on each other before we started our clinical rotations. The first nurse I worked with would not let me stick veins I could see, had to feel for the veins and all were done in the AC.


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## Dominion (Nov 15, 2009)

EMT1 said:


> We had 75 sticks on the manikin arm and hand. Then we did a saline lock on each other before we started our clinical rotations. The first nurse I worked with would not let me stick veins I could see, had to feel for the veins and all were done in the AC.



When I first started I couldn't stick a vein by feel for crap.  Now I'm getting better about it.  I'm still at about an 80% success rate.


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## JeffDHMC (Jan 3, 2010)

denverfiremedic said:


> thats weird, here a basic can do IV, ECG with interpretation, certain Intubations and use a few intervenes drugs with the proper state certified training. I see why people are kinda harsh on basics in other states.



Super nope.

No ECG w/ interpretation, no intubation unless you expand the definition to mean King tube placement (which basics cannot do in the City and County), IV drugs are limited to reversal agents (D-50/narcan) and ACLS drugs during an arrest under the supervision of a paramedic only.


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## alright35 (Jan 3, 2010)

boy this thread had the he double hockey sticks bumped out of it...
haha it's all good though


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## masquedxangel (Jan 8, 2010)

JeffDHMC said:


> Super nope.
> 
> No ECG w/ interpretation, no intubation unless you expand the definition to mean King tube placement (which basics cannot do in the City and County), IV drugs are limited to reversal agents (D-50/narcan) and ACLS drugs during an arrest under the supervision of a paramedic only.



Whew, glad someone said so before I had to. We never even touched on ECG when I was a basic, we just started it halfway through my Intermediate. NO intubation, only combi- and king- tubes. Can only start an IV once you get certified, post-EMT-B certification and as a B only a very few drugs.

Yay, necro thread.

I still have a scar on my arm from our certification class in which a guy just jammed it in and wriggled it around. It tore the skin and owowow. I'm a big baby about needles so I cried for all the times I had to be stuck but when I got to stick I was all gung-ho about it. Oh, irony.

I'm sort of surprised that some people aren't made to stick their classmates/be stuck. I HATED it, but it was wonderful to feel that yes the little pop the fake arms offer really DOES happen. That first stick is terrifying and I like poked him and then backed off all scared and then I STABBED HIM. I'm so glad he had a high pain tolerance and didn't care. I felt bad. But damn it once I backed out and corrected I got flash. win. IV cert is a huge step in my opinion, sticking people with needles is intimidating!


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## EMT_TIFFANY (Feb 27, 2010)

We intubate in Ohio as Basics


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## TransportJockey (Feb 27, 2010)

HotelCo said:


> We didn't have to practice on any real people for class. I definitely wouldn't have my classmates practicing on me.



For Adv Trauma (PHTLS class) and medic school we had to stick each other in class. I was usually considered the final for everyone since me and one other were incredibly hard sticks.


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## rhan101277 (Mar 7, 2010)

Linuss said:


> We practiced on eachother, but only if you wanted someone to.
> 
> Not only did it make the learning experience better because nothing replaces the real thing, but it also opened your eyes to the type of pain you'll be putting your patients through.



Not allowed to practice on each other here.  I still remember my first IV attempt back in October, I got it.  You miss some though.  I just have one more hospital clinical then its on the the ambulance.  I gotta pass cardiology and pharmacology finals next week though, which I feel like I can.

Today I got 6 IV's and missed two, pushed a bunch of drugs.  Did some vitals on a 9 year old that shot self in head with a BB gun.  Seizure pt. all kinds of stuff.


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