IV difficulty?

[So. IL Medic]

After a call that left me frustrated because I couldn't get an IV, I had a nurse with 20+ years of experience once tell me that getting an IV was "20% skill and 80% blind-*** luck."

You will have days of not being able to get the stick even if you used a smart cath with laser guided telemetry and you will have days that you could sink a 16 guage from across the room...blindfolded. With experience, the bad days get fewer.

 

[So. IL Medic]

Agreed. Palpate palpate palpate. Get fresh with the pt and feel 'em up.

 

[Hastings]

With experience, the bad days get fewer.

Up to that 20% cap.

It true though. I don't care how skilled you are at it. There are going to be days that it's just not going to happen. IVs are a strange skill that way. Frustrating, too.

 

[LucidResq]

This thread is reassuring - I just got back from an IV clinical in the ER that was pretty harsh. There were 3 that I did with ease... fast, graceful... I wanted to take a bow after I was done. There were many more that I totally messed up.

IV's are a lot like intubations. It's a skill that is easy to learn, but hard to master. It takes time... a lot of time... as in years.

Now although I'm not experienced at all in this field, this is one thing that I keep hearing over and over again and keep seeing in almost every aspect in EMS.

So I'm starting to realize that in this long, long learning process, it's best to not let things phase me, ask for guidance, jump on any learning experience I can grab, and take constructive criticism and suggestions to heart.

 

[EMT-P633]

missing a few IV's on your first medic hosp clinical rotation, dont sweat it. If your medic program was like mine, then you will end up with hundreds of attempts. and or actual sticks, My program required a minimum of like 40 or 50 successfull IV's. I think I ended up with close to or just over 200.

 

[Nephemera]

I never have trouble finding a vein or getting a flash, but I almost always end up messing it up when I try to advance the catheter. :sad: Any advice on what I might be doing wrong? None of my coworkers have been particularly helpful.

I think it would've helped a lot if I'd taken an actual IV therapy class, but due to monetary issues and the lack of classes available around here, I just ended up studying on my own and getting my sticks on actual calls. Currently going through I/99 class, with IV and drug administration stuff coming up this weekend...and I'm pretty embarrassed that I'm still so lousy at IVs.

 

[KEVD18]

I never have trouble finding a vein or getting a flash, but I almost always end up messing it up when I try to advance the catheter. :sad: Any advice on what I might be doing wrong? None of my coworkers have been particularly helpful.

I think it would've helped a lot if I'd taken an actual IV therapy class, but due to monetary issues and the lack of classes available around here, I just ended up studying on my own and getting my sticks on actual calls. Currently going through I/99 class, with IV and drug administration stuff coming up this weekend...and I'm pretty embarrassed that I'm still so lousy at IVs.

well, you shouldnt be embarassed that you cant start and iv without formal training.

then again, you shouldnt be starting iv's without being trained in them, so its sort of a circular argument.

to be perfectly honest with you, if we worked together i wouldnt be particularly helpful to you either, as i fundamentally disagree with your approach. maybe thats the problem you're facing at work....

get the proper education and you'll be fine.

oh and welcome to the looney bin.

 

[Nephemera]

well, you shouldnt be embarassed that you cant start and iv without formal training.

then again, you shouldnt be starting iv's without being trained in them, so its sort of a circular argument.

I wouldn't say I wasn't trained at all, just...rather informal one-on-one training from our training director. He sent me home with the book, tested me on it, had another medic sit down with me for maybe an hour and show me how to do things...and since then I've done practice sticks on coworkers and family members down at the office, and patients while we're on calls. But yeah, I would've preferred an actual class.

And thanks for the welcome.

 

[KEVD18]

informal training and reading through the material doesnt constitute training.

what are the requirements for basics starting lines in your state? does a 1/4asssed "training program" allow you to be initiating ivs on patients? if not, id be concerned about the legal liability of blowing a line....

 

[Nephemera]

informal training and reading through the material doesnt constitute training.

what are the requirements for basics starting lines in your state? does a 1/4asssed "training program" allow you to be initiating ivs on patients? if not, id be concerned about the legal liability of blowing a line....

Colorado Basics can start lines as long as they're IV certified or being trained and have ALS supervision. Our training director is authorized to be teaching IV classes, but yeah, I wouldn't call what I've done a class. Technically I'm still in training, trying to get all my practice sticks in with paramedic supervision.

 

[VentMedic]

Colorado Basics can start lines as long as they're IV certified or being trained and have ALS supervision. Our training director is authorized to be teaching IV classes, but yeah, I wouldn't call what I've done a class. Technically I'm still in training, trying to get all my practice sticks in with paramedic supervision.

So who does the QA/QC for the Basics on this skill? What documentation can you show for training in case of an adverse event?

 

[Sasha]

Like Vent stated, learn how to FEEL the veins. I have seen to many students or new medics that feel for a vein in the hand or AC and end up sticking a tendon!!!

This is very painful for the pt and can cause major problems down the line. You need to learn what a vein feels like and not just stick the big bulging thing!!

I have been on both the giving and recieving end of a tendon stick. OW!!!

Even so much as get close enough to poke the tendon and good luck getting your patient to let you try attempt number 2!!

 

[41 Duck]

We're starting this module in a couple of weeks. It's really the first one I've been looking forward to, as I'll actually be learning something totally new, rather than taking what I already know and adding a step or two, or a bit of extra information.

I'm sure I'll revisit this thread again after bombing a bunch of 'em.

Later!

--Coop

 

[Zippo1969]

hey there - don't feel bad, just practice....

I've been doing this for 12 years, and 3 years of that was spent on helicopters only...probably 90% of the time peripheral IVs were started prior to our contact with the patient, and the ones I did get to start (outside of clinicals) were big ol' honkin' external jugular veins in the air -

then i went back to ground units as a 2nd job and felt like I was Stevie Wonder trying to stick 'normal' veins for a couple shifts...

good luck on the rest of your clinicals :>)