The dreaded event has happened. After eight hours of successfully keeping your confused patient from pulling out her IV, she has finally done it. Somehow, she has ripped through all the gauze and wraps and a bloody, tape-covered catheter is laying in the floor. You begin to feel nauseous and your anxiety level rises at the thought of attempting this IV. Maybe no one realizes it, but your fear of IV insertion failure is real. Take a deep breath, and gather your supplies. These five tips can help you go from newbie to an IV starting pro.
1. Use Firm Traction.
All veins roll. Some roll worse than others, especially in older people with thin skin. Holding traction is a must. Otherwise, you will be digging and chasing that vein all over. Not only does this hurt the patient, but you also have a risk of stabbing through the vein. Hold firm traction at the top and bottom of your insertion site using your non-dominant hand before attempting the start.
2. Don’t just use your eyes, feel.
Sometimes, the juiciest veins are the one you can’t see. If you depend solely on your eyesight for IV starting, you will miss out on a lot of good options. Practice feeling veins that you CAN see, noting the difference between veins and muscle/flesh. Before long, you will be sticking with your eyes closed. Well, maybe don’t close your eyes. But you get the idea.
3. Use a Tourniquet, or Don’t.
Sometimes, using a tourniquet is a bad idea. If you can feel that it is a large vein, and can even see it, skip the tourniquet. Tying the tourniquet too tight can cause the vein to blow when it’s punctured. If you blow a vein using a tourniquet, try starting an access without it.
4. Use an Appropriate Sized Needle
I know we all want that big 18g access for our patients. But it’s not always appropriate. Using a needle that is too large can blow the vein. Use the biggest access that you can. But realize that, sometimes, a 22g may be all you can do.
5. Don’t Let Unsuccessful Attempts Haunt You.
We all miss veins. It happens. Whether it’s a faulty method or just a bad vein, no one is successful 100% of the time. Let the losses go. Be confident with the next attempt. If given the opportunity, attempt every IV you can. The more you try, the more skilled you will be.
I hope these tips will help you be successful with your next IV attempt! Good luck, nurses!