IV Endorsement

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MTEMTB

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Got a 2 day class coming up next week.
Protocol has been changed (again) and we are going to learn to not only set up the IV, but to do the vein puncture.

Any tips?

I also volunteered to be stuck. I have some good veins on my hands.
 
Get sticks on the hard people in your class.
 
MTEMTB said:
Got a 2 day class coming up next week.
Protocol has been changed (again) and we are going to learn to not only set up the IV, but to do the vein puncture.

Any tips?.
Click to expand...


Pointy end goes into the other person :rolleyes:
 
Dont confuse a tendon for a vein.

Youll regret it.
 
If you're going for a hand vein and you can't get it, digging the needle in at a 90 degree angle will not help. If you for some reason feel the need to put a needle in to someones hand at 90 degrees, please do not let them see it.

I was the lucky stickee, and I don't know who looked more terrified once they saw what was going on.... me or the instructor.
 
- Slow is smooth, smooth is fast. It's not a race, the person isn't dying yet.

- Apply the tournequet, lower the arm at a slight angle, maybe have them squeeze their fist a couple times. Start low at the hand and work your way up. Look at the back of the hand, but DONT go for the first thing you see, check out all your options.

Look at your own hand. Look at your thumb. See that little "dip" at the bottom of your thumb near the wrist? Now rotate your wrist outward (ulnar deviation, if you care. lol), you should see a small vein appear. That tends to be palpable, and a good vein to go for. It can be positional, however, and CAN be tricky on some people.

Check the top of the forearm, some thinner people have huge veins just proximal to the wrist. Finally, work your way up to the AC. If you aren't 100% on the AC, start at the wrist. If you start at the AC, anything lower is a no-go.

- For gods sake, don't leave the tournequet on for 20 minutes while you look at veins. lol

- Before you poke with your needle hand, use your other hand to slightly pull the skin around the vein taunt. This can keep it from rolling on you. Do NOT make that cause your hand to be in the way of the needle, its a good way to stab yourself in the back of the rig.

- Finally, when you poke into the vein and get a flash, advance the CATHETER forward, not the entire goddamn needle. It goes completely through the vein into the muscle, causes lots of pain, and makes the other person want to punch you. Man, was I pissed at my buddy when he did that. lol
 
Did the first class last night. Alot more people showed up then were expected.

We got to stick our partner twice and they stuck us twice. I got mine in first try. My poor partner blew mine. My hand still aches this morning.

Thank you to everyone who replied it was a great help.

yes I was sweating bullets and nervous that I would hit a tendon or blow the vein.
 
I blew a vein on someone last night. No big deal, apologize and move on.
 
I couldn't get a line for love or money the other day. But none of my preceptors could either, so I felt a bit better.
 
EMSLaw said:
I couldn't get a line for love or money the other day. But none of my preceptors could either, so I felt a bit better.
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that always makes me feel better when that happens. hahahaha.

i love starting IVs. i have a couple tips:

1.TRACTION TRACTION TRACTION! but be careful with old people, you can really hurt them if you pull too hard.

2. tighten the screwable parts on the stopcock if you decide to use one. mr. murphy rears his head all the time with stopcocks. for me at least.

3. don't toss the needle till you milk it for a dex stick reading. ((thumb up))
 
Took me 6 tries to get the IV in last night.
my partner stopped after 3 tries.
No one got one in me.

Dumbest thing. I would get the needle into the vein, but would not advance it enough for the cath to go in.
The instructor caught it and got me going correctly again.

Now we were told to slap the vein by one instructor and to not slap it by the other.
Any thoughts on this?

Got to also do the IO. We used chicken legs.

We were told to check the blood sugar when setting an IV line.
The ones we have you can not get the blood out of it it is completely enclosed. We would have to get it from the cath before we hook up the fluid.
 
MTEMTB said:
We were told to check the blood sugar when setting an IV line.
The ones we have you can not get the blood out of it it is completely enclosed. We would have to get it from the cath before we hook up the fluid.
Click to expand...
sounds complicated. i guess the equipment we have here in hawaii is a little old school, cuz there's a couple of ways to "milk the needle" to get a blood sample with the equipment we have.

and i've seen a lot of people slap the veins, and i've tried it and it hasn't really worked, so i stopped doing it. maybe my technique sucks.

but as i think about it more, if you're slapping a vein to get it to engorge, you're probably better off looking for another site.

i try to let gravity do a lot of the work.
 
I work as a phlebotomist at the hospital so I get plenty of practice with hard stick patients. I still find starting I.Vs a lot harder. I would always want to hold the needle at an angle and go straight in. Not a good thing with I.Vs.
 
MTEMTB said:
Now we were told to slap the vein by one instructor and to not slap it by the other.
Any thoughts on this?

We were told to check the blood sugar when setting an IV line.
The ones we have you can not get the blood out of it it is completely enclosed. We would have to get it from the cath before we hook up the fluid.
Click to expand...



Slapping the vein really doesn't do anything at all, but hey, it's your technique.



As far as getting blood out of a safety cath when the needle is fully retracted, just push a pen in to the opposite end and it will slightly pusht he needle out to where you can get blood on to a BGL strip....

As far as it being a good way to get a BGL reading, that's another thing entirely.
 
I heard that checking the blood sugar with venous blood can give you inacurate readings. I don't know for sure. I have had a chance to research it.
 
Miss EMT said:
I heard that checking the blood sugar with venous blood can give you inacurate readings. I don't know for sure. I have had a chance to research it.
Click to expand...

It all depends. Some meters are only calibrated for cap. blood, while some can do capillary and venous. Some of the newer meters can be within 1% difference between cap and venous samples, you just need to check with your protocols.
 
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