Could I get some quick tips on IV starts?

I've had marginal success with starting IV's, but lately it has been quite a dry spell. I think I may be overshooting the veins on some.

Do you guys and gals have techniques for starting them? At what angle do you insert the needle? How far?

And how do you get invisible veins to pop up?

All sage advice welcome!

Sent from my iPhone using allnurses.com
I think the best thing to do I'd watch your fellow nurses who have a lot of experience. Watching what they did taught me a lot. I think it's hard to describe in writing when so much of it is based on actually seeing and touching the patient.

You can find alot of IV start/ nursing info on Pinterest.

1. I spend no more than 1 minute searching for a suitable vein.2. Rub the area with an alcohol prep pad.3. Let the extremity dangle downward for a couple of minutes so the veins fill with blood.4. Apply the tourniquet (not always necessary for a very elderly patient with tiny veins that blow easily).5. Imagine that the vein is a mini waterhose. Quickly jab the catheter into the vein at a 10 to 15 degree angle (almost level with the skin).6. Once I receive blood return, I keep inserting for another 0.5 centimeters before loosening the tourniquet and removing the needle. 7. As I pull the needle out, I gently push the rest of the catheter into the vein.

Quote from hope3456You can find alot of IV start/ nursing info on Pinterest.

Quote from TheCommuter1. I spend no more than 1 minute searching for a suitable vein.2. Rub the area with an alcohol prep pad.3. Let the extremity dangle downward for a couple of minutes so the veins fill with blood.4. Apply the tourniquet (not always necessary for a very elderly patient with tiny veins that blow easily).5. Imagine that the vein is a mini waterhose. Quickly jab the catheter into the vein at a 10 to 15 degree angle (almost level with the skin).6. Once I receive blood return, I keep inserting for another 0.5 centimeters before loosening the tourniquet and removing the needle.7. As I pull the needle out, I gently push the rest of the catheter into the vein.

Quote from j_tay1981And how do you get invisible veins to pop up?

My dad was an anesthesiologist (started IVs all day, every day) and his advice to me when I was in school was, you can start an IV on anyone if you can get the tourniquet tight enough (except for little old people, as already noted). Practice and get good at tying a nice, tight tourniquet.

As long as you can feel a vein , doesn't matter if you can't see it. And don't forget anatomy you learned, gives you a place to start .

Quote from TheCommuter1. I spend no more than 1 minute searching for a suitable vein.2. Rub the area with an alcohol prep pad.3. Let the extremity dangle downward for a couple of minutes so the veins fill with blood.4. Apply the tourniquet (not always necessary for a very elderly patient with tiny veins that blow easily).5. Imagine that the vein is a mini waterhose. Quickly jab the catheter into the vein at a 10 to 15 degree angle (almost level with the skin).6. Once I receive blood return, I keep inserting for another 0.5 centimeters before loosening the tourniquet and removing the needle. 7. As I pull the needle out, I gently push the rest of the catheter into the vein.

Quote from veggie530I pull down on the skin to tighten it when I insert the catheter the rest of the way, too. Keeps the catheter from binding

practice practice practice.Don't shy away from hard starts.

It is all in the feel. A vein--that you may not even be able to see--is bouncy like a rubber band. Extremity down. Agitate the skin with the alcohol pad. Sometimes you reall have to feel for a vein, even if deep.On elderly people, their skin can be paper thin, therefore, veins that seem like you could get a 14 gauge in them from 50 feet away is not always the case. Their veins will be the ones that most often roll. If you take your non-dominant hand, secure the extremity with it, keep the skin somewhat taut with that hand, and dominant hand sticks and advances. The angle needs to be closer to the skin--not going in like you would for a straight stick blood draw, or when you advance, you will blow the vein at that angle. As a previous poster mentioned, don't shy away from the tough sticks. Really press and feel for the veins. Once you get good at feeling for where your options are, it will get better.