My pt. has no veins!

[BloodNGlory02]

How do you go about finding/obtaining a vein in the patient that seems to have none? I've had 3 pt.s this week that I couldnt palpate, visualize or poke and hope. and were in desperate need of an IV. Usually my skills are ok, but im getting really discouraged with all these no veined people.

I've tried the 2 tourniquet method, hanging their arm off the side of the cot, having them squeeze their hand, nothing makes even the tiniest thing pop up. I give up :(

[ma2va92]

my list

hands forearms AC.. warm cloth{heat pack} rub the hell out of the area .. something will show... then the best you get is a 22 or 24 .. well it's a start to get somethig flowing

[CodeSurfer]

Slap 'em real hard... then even if a vein doesnt show, you have gotten your frustration out. B)

[TTLWHKR]

I hate it! People are always grabbing my arms asking if they can practice on my big veins. NO... I'm not a pin cushion. I'm irish, so I completely white, that makes my veins more obvious. Damn genes.

[TTLWHKR]

I forgot...

Nitro stat... Just a little, spray it on where u want the vein, and it sort of makes it more obvious. Then, don't tell anyone u did it, especially if the patients BP bottoms out. :blink: :P

[BloodNGlory02]

I forgot...

Nitro stat... Just a little, spray it on where u want the vein, and it sort of makes it more obvious. Then, don't tell anyone u did it, especially if the patients BP bottoms out.

oh man then I BETTER get a line in!

[MMiz]

I've heard good things about the Venoscope (http://www.venoscope.com/). I've never seen one used, but another forum I frequent has talked about them as a tool for finding the hard-to-find vein. At $150 it's a big investment though B)

[rescuecpt]

Take a penlight and have someone hold it up to their skin, to the side of where you think the vein should be - sometimes it makes it easier to see where it is/how deep it is/etc.

I have pipes and CC students are constantly looking at my hands and arms - I have let a couple of the cocky ones try because my pipes roll and then they fell like dorks for missing. :)

[Jon]

Originally posted by rescuecpt@Apr 14 2005, 08:59 AM
Take a penlight and have someone hold it up to their skin, to the side of where you think the vein should be - sometimes it makes it easier to see where it is/how deep it is/etc.

I have pipes and CC students are constantly looking at my hands and arms - I have let a couple of the cocky ones try because my pipes roll and then they fell like dorks for missing. :)
This works GREAT in peds. Had a NICU nurse show me how their trans-illuminator worked (same way).

Tighter tournequet works, sometimes.

Put the pt. in tredelenburg if their pressure is even a LITTLE low.

EJ's are a great thing...if only I could do one or two in the ED (Darn residents :rolleyes: )

Otherwise, just stick them and turn them into a pincusion Doesn't always work, ut sometimes you get lucky.


Jon

[Tigs_9]

Not that i no what im talkin about or anything but my veins dont like to b played with. I give blood all the time and the nurse always puts something very cold on my arm and makes me clench my fist a couple of times..... Works for him and me :D Mind u ur pt wud have to be fairly concious!!! But like i said not that i no anything about it!!! :rolleyes:

[flmedic]

Always remember to look in the less obvious places like the leg or foot...depending on the severity of needing a line. I have had your situation happen to me more times than I care to remember thats where remembering anatomy comes into play there are certain areas that everyone has veins...wether you feel them or see them or not. I don't know your protocols but an EJ has saved me more than once.

[BloodNGlory02]

EJ's and IO's are a I-99 thing only. And the way they're itchin to get them, im sure as a lowely IV Tech I wouldnt get many anyways. *sigh* why cant everyone have a vein that says POKE ME! POKE ME!

[TTLWHKR]

Go fer' the jug'! Just keep probin' around until blood starts squirtin!

Worst thing that happens is the guy dies. It's all gravy. ;)

[medic03]

EJ baby.......

[PArescueEMT]

nobody mentioned the interns vein... lateral forearm. always there and ready for an 18.

[Jon]

Originally posted by TTLWHKR@Apr 15 2005, 05:58 PM
Go fer' the jug'!
careful to who and how you say that....


Jon

[Wingnut]

WhoooooooooohOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO!



:o




*puts down the jug*

[TTLWHKR]

Originally posted by MedicStudentJon+Apr 16 2005, 05:54 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Apr 16 2005, 05:54 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TTLWHKR@Apr 15 2005, 05:58 PM
Go fer' the jug'!
careful to who and how you say that....


Jon [/b][/quote]
Jugular

[PArescueEMT]

he knows... he just has his mind in the gutter.

[MedicPrincess]

Originally posted by TTLWHKR@Apr 15 2005, 05:58 PM
Go fer' the jug'! Just keep probin' around until blood starts squirtin!

;)
GOODNESS!!! :o

You probe around the jugs until she bleeds!!!

WOW!! I think you revealed a lot about yourself. :P :D B)

[CodeSurfer]

Originally posted by MedicStudentJon+Apr 16 2005, 05:54 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (MedicStudentJon @ Apr 16 2005, 05:54 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-TTLWHKR@Apr 15 2005, 05:58 PM
Go fer' the jug'!
careful to who and how you say that....


Jon [/b][/quote]
*fears ambulance ride with jug poker*

[Margaritaville]

If they need a line that bad - EJ or IO if its in your protocols! If only P's can do it than get some help!

[TTLWHKR]

Originally posted by PArescueEMT@Apr 17 2005, 09:42 AM
he knows... he just has his mind in the gutter.
:huh: ya don't say..

[rescuecpt]

Originally posted by TTLWHKR+Apr 23 2005, 10:45 AM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (TTLWHKR @ Apr 23 2005, 10:45 AM)</td></tr><tr><td id='QUOTE'> <!--QuoteBegin-PArescueEMT@Apr 17 2005, 09:42 AM
he knows... he just has his mind in the gutter.
:huh: ya don't say.. [/b][/quote]
That's what happens when you're a young single whacker...

[TTLWHKR]

Originally posted by rescuecpt+Apr 23 2005, 02:02 PM--></div><table border='0' align='center' width='95%' cellpadding='3' cellspacing='1'><tr><td>QUOTE (rescuecpt @ Apr 23 2005, 02:02 PM)</td></tr><tr><td id='QUOTE'> Originally posted by TTLWHKR@Apr 23 2005, 10:45 AM
<!--QuoteBegin-PArescueEMT@Apr 17 2005, 09:42 AM
he knows... he just has his mind in the gutter.
:huh: ya don't say..
That's what happens when you're a young single whacker... [/b][/quote]
He can have my wife.

[ffemt8978]

TTLWHKR,

Cool avatar

[rescuejew]

we just got released for sternal IOs for unresponsive pts with no peripheral access. They work REALLY well...

Intermediates, once released, can do EJs

[Luno]

Uh, nobody has mentioned the sub-clavian, one of the easiest sticks, if you have the protocols, of course. :ph34r:

[Jon]

Originally posted by Luno@May 7 2005, 07:53 PM
Uh, nobody has mentioned the sub-clavian, one of the easiest sticks, if you have the protocols, of course. :ph34r:
Or in your case, a lack of a system to scream at you....

Jon

[ffemt8978]

Or, if you can hyperextend your patient's arm, the AC's jump right out at you. We managed to get an IV on a combative patient while he was still fighting us using this method.

[Luno]

Yeah, but not killing the right people is a responsibility unto itself, Attaboy if they don't die, WTF medic, find a new team if they do.