IV Certification - Clinical on Friday

[Boomerthedog]

Hi - I'm new to the EMT world as I just finished my EMT certification a few weeks ago. I also just finished up my IV Therapy course and need to get six sticks in a hospital setting this Friday to be certified. I am fairly nervous about this particular clinical since I only have four sticks and they were in a controlled classroom setting. My problem isn't so much locating the best vein and successfully threading the catheter (although I still get nervous on this part); what seems to be the most difficult for me is everything that comes after insertion - remembering to release the tourniquet, keeping the catheter steady, applying the tagaderm/tape cleanly, etc. I always seem to run into some silly issue like getting the tape stuck to my glove, wrinkling the tagaderm, etc.

If there is ANY advice anyone can give me about my first sticks on live patients, I would really appreciate it. The last thing I want to do is scare the life out of an already anxious patient because I'm fumbling around while he's got a tiny tube stuck in his vein.

Thank you!

 

[NYMedic828]

Most places will fail you if you take you let go of the catheter hub at any time prior to it being secured to the skin.

Take the tourniquet off as soon as the catheter is successful in the vein. You will look moronic if you go to flush the lock without removing the tourniquet.

I can understand your never with only 4 sticks. My class I did 300 by the time of state testing. But in the end there is really nothing more to it then properly going through the motions and putting a small hose into a bigger hose.

 

[ZootownMedic]

Its muscle memory man....and its a skill. You aren't gonna be good(or even decent) after 10 sticks. Just do the best you can and UNDERSTAND that you will miss some. The best paramedics, nurses, doctors or whoever miss skills sometimes. That is why it is called PRACTICING medicine. And as NYMedic said...don't let go of the hub. I have had instructors rip my IV out when I let go of it in training and real life! Take some deep breathes and don't let the patient see how nervous you are. Don't be scared....you will make mistakes, LEARN from them. Don't be the guy that never gets better because you are scared to start IV's. Everyone has felt like you. Anytime you have a chance to get an IV then take it!

Also, when you are in the ER alot of times the IV's you start will need blood drawn off them for labs and such. In many cases it is best to leave the tourniquet on until you get your tubes of blood, then release it.

Another piece of advice: PREP your stuff! Tear your tape, have your alcohol prep, saline lock/tubing, catheter, flush, tourniquet all set up before you begin. Sometimes I will set up half of it and throw the tourniquet on and set up the other half as the veins begin to engorge. Find your rhythm. Your goal right now is not to be fast but to develop good technique. Speed will come with time and is rarely important. Use a shallow angle and don't hesitate. Go all in or not at all and don't be that guy shaking like a leaf and then SLOWLY jabbing the needle into the patient and then pulling it out and all that. Best advice that got me through Paramedic school though....sometimes....YOU JUST GOTTA WING IT