Tips on IV's

VinBin

VinBin

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So we are learning how to start IV's in class and it seems like everyone has certain things that they do to make it easier to get one started...

I was just wondering if you guys had some tips/unusual habits or something you did to make it easier or less painful to start IV's...
 
VinBin said:
So we are learning how to start IV's in class and it seems like everyone has certain things that they do to make it easier to get one started...

I was just wondering if you guys had some tips/unusual habits or something you did to make it easier or less painful to start IV's...
Click to expand...

If you mean less painful on the patient...........Get through the skin "quick". The longer a person takes to get through the skin, the more it hurts. I know, I used to let students start them on me.

Somethingthat works well for me is to go for the one I see. I don't spend a long time looking for a better site, I see it, I go for it. I also like starting 90% of my IV's on the inner side of the forearm. It is a self splinting spot, and it doesn't become positional like a hand or AC space can do.

Just my .02
 
Ask others for suggestions... more you start more you will come up on your own. I agree with DT4 EMS .. slow advance is very painful, hard on the vein.

The other hint is I believe IV's are 80% mental and 10% skills, & 10% luck.
Knowing that you establish is just as essential.
Other hints is not always using a tourniquet.. the only reason to use one is "increase and locate the vein".. avoid nodules of veins (usually are valves) and with introduction of cath's causes a back pressure.
Some other suggestions .. don't go in with a sharp angle, like some text recomend, you will puncture through the vein. Pull taughtness on the skin to help prevent the veins from being displaced "rolling"...
Also, asj the patient as well especially if they have the procedure multiple times. Yes, most really do know where they have been sucessfully occured.

Good luck,
R/R 911
 
I, too, go for the ones I see. I prefer the veins that jump up and say "hey", but unfortunately not all people have those kind. Sometimes I just can't see the veins, and then I go for the ones I can feel. I have very sensitive fingertips, and can feel better sometimes than I can see them.

I agree, alot of people do know what sites work for them and what sites aren't so good.

I usually ask, and if they tell me that the nurses or the lab people never get them in a certain spot on the first try, I'll avoid that one if I can unless I see a huge python vein looking at me.
 
Thanks for the tips...

Another question though, I heard that "traction" on the vein helps keep it from rolling...Is it better to hold the vein above or below the site where you are putting the IV, or does it matter?
 
I prefer below and cannot remember witnessing anyone try traction above. Keeping the patient relaxed is another good tip. If a pt is afraid of needles and tenses up, you are less likely to accomplish your task.
 
Heh, yea I guess that would be a bit dangerous...

Any really good ways to find veins in those with darker skin? Just feel for them?
 
i find using a BP cuff helps, which is usually being used anyways...

Letting it fall bettween systolic and dyastolic plumps up viens quite well

oh and, i think jelco's are crap, i refuse to use them

~S~
 
TTLWHKR said:
Num-Bee.....
Click to expand...

??

Stevo, I didnt know what Jelco was either but I googled it and found it was some type of "improved" iv starter...granted I only read their promotional site, but whats wrong with it?
 
well VinBin

first, you have to follow the mindset that not everything 'hospital' fits into our 'prehospital' enviroment.

the jelco's are the stilletto catheters in vouge now. as i had been using the normal ones for a decade before their introduction i guestioned the stats supposively validating their usage.

as such, where to the majority of needlesticks (live ones) occiur prehospital vs hospital ? i don't know if some of that info is still around, but i found at the time that the whole jelco deal was just a marketing ploy by manufacturers to sell more $$$ sticks under the guise of safety

the jelco's slow me down, and as they are not mandated i keep a stock of the old sticks around ....(my boss loves me)

so i guess if you want to berrate me for being a dinosaur, have at it...

~S~
 
Oh...well seeing I have started about 3 IV's, Im not one to tell anyone what to do...just wondering if those things had any real advantage...

In class we used some with a little spring loaded technique that pulled the needle back, I didnt like those too much caus they kinda took some control away...

When you say "old sticks" is it those that dont have the retractable needle?
 
VinBin said:
??

Stevo, I didnt know what Jelco was either but I googled it and found it was some type of "improved" iv starter...granted I only read their promotional site, but whats wrong with it?
Click to expand...

I have used three differant types of IV caths through the years. I started with Johnson & Johnsons Jelcos. I loved them, I still do. They are an unprotected cath. Now, we use BD Insyte Autoguard and I hate these caths. They are about 2.5 times longer than the Jelcos, which makes them hard to manuver around tight spots. The one advantage to these BD caths. is the actual cath. is very flexible so they are almost imposible to kink. The disadvantages is they are hard to thread into the lumen of the vien if you just barely puncture the vien. The other problem is the needle retracts by pushing a small button and it is very easy to hit this button when you do not mean to. I personally like the Johnson & Johnson Protect IV caths. They have a tab that actually help you to thread the cath into the vien. They are about the same length as the Jelcos. All of that being said I am glad most agencies and hospitals are going to protected IV caths. They are a Godsent on a code blue scene when you get an IV and the sharps container is across the crowded room.
 
i've seen the new spring types, they just get bigger all the time....ungainly to use , as well as warrant some patient anxiety when one swings such a gaft at them

it all started not too long after the aids scare really, before that ppe wasn't anywhere near as prevalant, now we seem to buy into anything that is handed on down

are there cdc stats that actually define the live stick incidents excluisively in ems, or are they all encompassing inclusive of all health care and every form of stick?

i had better info a decade ago....

seems the major prehospital incidents were trying to fill blood tubes with a 10cc stick, you know, holding that dime sized blood tube bettween your fingers while going over frost heaves?

and hey, those 10cc, 3cc, 1cc sticks are still around, inasmuch as they do have a retractable style out there i haven't seen one in our district yet.

simply drawing bloods with a vaccutainer/T-tap should have been the taught method over the 10cc method. People say it will collapse viens, which is can, yet you can slow the flow with the t-tap lock

i guess i'm just stubborn, i like my old sticks, go ahead and tape a biohaz container to my a** if it makes it better

~S~
 
When i start IVs for some reason, I have better luck going for the ones that I can feel, not the ones that I can see.... must most people are the opposite.
 
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