Getting the hard IV's.

I too like to kneel beside the cot and will rest their arm on my knee or the bench seat to help steady. Only problem with that is I have a tendency to do a little blood letting every now and then and if their arm is on my knee I have to change before the next call.
 
marineman said:
I too like to kneel beside the cot and will rest their arm on my knee or the bench seat to help steady. Only problem with that is I have a tendency to do a little blood letting every now and then and if their arm is on my knee I have to change before the next call.
Click to expand...

Placing a 4x4 under the catheter before disconnecting the sharp and attaching the extension helps with that, if you can't occlude the vein.
 
marineman said:
I too like to kneel beside the cot and will rest their arm on my knee or the bench seat to help steady. Only problem with that is I have a tendency to do a little blood letting every now and then and if their arm is on my knee I have to change before the next call.
Click to expand...

And that is why I always try to remember to put a towell over my knee first. The more IVs I start, the less blood letting there is, but at first, I could be pretty bad at times.
 
The problem should not be in knowing if your in the vein or not (as that device lets you know). It won't be on the market long. Just aspirate or lower the IV bag, blood return should be seen.

Here is an old hint. Apply your tourniquet (constricting band) then "milk" the veins downward. This can be done by wrapping your hands or placing another constriction band a little looser and rolling it downward. It causes the blood to fill up the veins.

So many do not allow gravity to work as well. Allow the arm to dangle down while you prepare your equipment. Also heat packs to cold or those with poor circulation.

In regards to allow the arm to sit your lap, one should always have a towel under the arm for several reasons (mainly sanitary) also if they bleed it go onto the towel as well.

R/r 911
 
Yeah, you don't forget the towel after that first time that you really needed it.
 
Ridryder911 said:
The problem should not be in knowing if your in the vein or not (as that device lets you know). It won't be on the market long. Just aspirate or lower the IV bag, blood return should be seen.

Here is an old hint. Apply your tourniquet (constricting band) then "milk" the veins downward. This can be done by wrapping your hands or placing another constriction band a little looser and rolling it downward. It causes the blood to fill up the veins.

So many do not allow gravity to work as well. Allow the arm to dangle down while you prepare your equipment. Also heat packs to cold or those with poor circulation.

In regards to allow the arm to sit your lap, one should always have a towel under the arm for several reasons (mainly sanitary) also if they bleed it go onto the towel as well.

R/r 911
Click to expand...

That is exactly what I meant by being patient and allowing the vein to fill.
 
Ridryder911 said:
The problem should not be in knowing if your in the vein or not (as that device lets you know). It won't be on the market long. Just aspirate or lower the IV bag, blood return should be seen.

Here is an old hint. Apply your tourniquet (constricting band) then "milk" the veins downward. This can be done by wrapping your hands or placing another constriction band a little looser and rolling it downward. It causes the blood to fill up the veins.
So many do not allow gravity to work as well. Allow the arm to dangle down while you prepare your equipment. Also heat packs to cold or those with poor circulation.

In regards to allow the arm to sit your lap, one should always have a towel under the arm for several reasons (mainly sanitary) also if they bleed it go onto the towel as well.

R/r 911
Click to expand...

This product works very well. I cary one for hard to find veins. The only problem is it does not fit large arms. But, you can use it on the forearm and get a hand vein.
http://www.narescue.com/BOA-Constricting-Band-P79C197.aspx
 
jtpaintball70 said:
I think I might have to go get one. That is kinda cool. What is the exterior made of? Would Cavi-wipes hurt it?
Click to expand...

It is a vinyl type covering. I clean mine with Cavi-wipes after every pt. I buy a new one every couple months.
 
I only stick a patient twice and then I have someone else in my ER do it. I very rarely will go fishing. I've been fished in before and it's not fun.

I find that if you cannot see the vein but feel it is much more reliable than seeing vein but not feeling it.

As for elderly, I find that if you use a 22 or 24 ga if they don't need fluid replacement then that is the size I'll use.

spider veins are another story, 24 gauge is the way to go. The smaller the spider vein the harder the stick.

practice practice practice and more practice.
 
or only find the Pts with fire hoses for veins. Like me, they can draw me without a tourniquet. :P
 
Yeah...need a little help too

I'm finishing up my clinicals in the ER and am trying to "master :)" IV insertions before I'm done. Sometimes it goes great....... but the last couple pts I had I blew the vein. I'm at a 15-20 degree angle. Once you see the "flash" what does everybody else do? I'm just trying to find different techniques so I can find what works best for me......and my pts!

thanks!
 
awhiting said:
I'm finishing up my clinicals in the ER and am trying to "master :)" IV insertions before I'm done. Sometimes it goes great....... but the last couple pts I had I blew the vein. I'm at a 15-20 degree angle. Once you see the "flash" what does everybody else do? I'm just trying to find different techniques so I can find what works best for me......and my pts!

thanks!
Click to expand...

I've had a few problems in my clinicals with getting the flash, but when I advance the catheter I blow the vein. One of hte nurses showed me to advance the entire needle into the vein once you get flash, only a quarter inch or so, but then advance the cath. Seems to work great. You do have to level off once you see flash though
 
A couple of years back, all the best IV tips and techniques were put together in a guide called, "Uncovering Difficult IV's", which is available for free download at:

http://www.ems-safety.com/free.htm

It's good stuff. That one pearl of wisdom that you need to greatly increase your success may well be in there!
 
Almost all protocol within 100 miles of me states that after two attempts AC
the medic shall immediately switch to the I-O drill/gun.

And if they can't get it after all that.... they probably need an in-service. <_<
 
ILemt said:
Almost all protocol within 100 miles of me states that after two attempts AC
the medic shall immediately switch to the I-O drill/gun.

And if they can't get it after all that.... they probably need an in-service. <_<
Click to expand...

Ours says each medic tries twice then we transport without. No EZ-IO here yet so we don't have that option. The service just south of me does an EZ-IO after 2 failed perp. IV attempts and they go straight to the EZ-IO on all PNB's.
 
Protocols for both fire services I do rides with is two IVs and then an IO. Some medics I've talked to says they'll take a look and if the patient is critical not waste time with trying to establish IVs if they haven't got anything and go straight to IO.

I've recently got to use the EZIO drill. It's awesome!
 
I really like the IO myself. I think its just one of those things every service should have, having access is very important, I couldn't imagine transporting anybody to the hospital without access that needed it.
 
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