Any tricks of the trade to starting IVs on diabetics?

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mbd410

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Does anyone know of any "tricks of the trade" for starting IVs on diabetics? Their veins are already crappy. Luckily the call I just went on wasn't in dire need of an IV. Getting IVs on diabetics is tough for me. I've only been an intermediate for 4 months. I don't really have any trouble getting IVs on other patients...just some really brittle diabetics. Right now, I am just really PO'd because I couldn't get IV access!!! HELP!!!
 
Well you can give this a try, allow arm you are trying to start an I.V. to hang down for a min. to try to get veins to pop up, or if time allows, get a couple of chemical hot packs, (put a pillow case against them so you don't burn the patient) and apply them to the part of the arm where you want to stick them.
The heat will help make the veins rise. Be careful to watch the hot pack areas so the patient does not get burned. Hope this helps! :)
 
mbd410 said:
Does anyone know of any "tricks of the trade" for starting IVs on diabetics? Their veins are already crappy. Luckily the call I just went on wasn't in dire need of an IV. Getting IVs on diabetics is tough for me. I've only been an intermediate for 4 months. I don't really have any trouble getting IVs on other patients...just some really brittle diabetics. Right now, I am just really PO'd because I couldn't get IV access!!! HELP!!!
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A lot of it will be in your mind. If you think on the outset you will have trouble on a particular type of patient...... you will always have trouble.

Realize with experience you will get better. I can remember going for around 6 months and not missing a single line. I got cocky and "bam" I hit a slump.

What I do is take a minute to look at both hands and arms of the patient. Then when I ee one, I always go for the "first good one" I see.

I have never had any real differences in daibetics vs. other types of patients.

Practice and gain cionfidenece. Nobody is 100% first shot IV folks. If you are in the 90's you are better than average. :)
 
DT4EMS is right, most of the time is 90% confidence.

Helpful hints I have found is placing some of those "heat packs' on the area and let the arm dangle as was described. Look at the chest wall, sometimes diabetics have poor peripheral circulation and more distal you get the poorer it becomes.

There is trick I have used called "milking the vein" where you place the constricting band high on the upper arm, and place both hands around the upper arm just below the band, and slightly compressing around the arm performing this and moving downward. This "pushes" blood supply into the distal area..

I did not see it mention, just a reminder... it is a rule of thumb to never start a line in the feet/legs of a diabetic.

R/r 91
 
wasn't there some sort of 'milking' band marketed for that in Jems Ryder?

my preference is to use a BP cuff, deflate just below the Systolic....works better than the starter kits rubber band anyways....

~S~
 
"nitro paste"- not exactly in protocol, but of course I never followed protocols anyway.
 
new one on me FedMedic

does it raise a vien well?

~S~
 
works very well....careful with documentation, though:D
 
They use to use it as the "Viagra" in the 80's... as well.

R/r 911
 
We use to have an older medic who use to swipe the nitro off the trucks, it took us a while to figure out why...:rolleyes:
 
know venous anatomy, especially in the AC area. Practice feeling for hidden veins, not just sticking the ones you see.
 
Stevo said:
wasn't there some sort of 'milking' band marketed for that in Jems Ryder?

I saw someone use one of those. They got the stick, but it looked like a ChiaPet when they were finished. I guess you could shave the whole arm though. :)
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jeepmedic said:
The spray works well also.;)
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Once I laid a "Nitro-stat tab" on a vein and waited and waited and waited...but nothing happened. :sad:
 
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