So Thursday night was our first "IV Night" in class. Admittedly, it did not go stellar for me. First was the guilt of not having to get stuck because my veins are apparently nonexistent (the instructors even found it hard to find them,) but that's besides the point. Basically, both of the guys that I ended up sticking, with over the needle catheters by the way, had veins like railroad tracks and could be seen across the room, but somehow, I still managed to miss one completely, and only after digging around in the second was I able to finally get it. So basically, I'm here fishing for some comments, tips, advice, whatever, that might help me with getting my sticks. Considering how important volume replacement is in the pre-hospital setting, you can imagine that I'm more than a little anxious to get better at this particular skill. Thanks in advance for the help.
IV Therapy Help
- Thread starter Mad Max
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I actually don't have to replace a whole lot of volume in the field... :unsure:
It will get better with practice. Everybody develops their own preferred technique, has their own feel, go-to veins, etc.
What you can see > what you can just feel > anatomically fishing.
When all else fails, you have a drill for a reason
Get used to the catheter-over-needle style. I've never seen anything else in an ambulance.
Don't get sucked into the "Everybody needs the biggest catheter I can fit" crap. Address your patient, not your ego. Personally, unless I think the patient is going to be getting blood, I'm perfectly content with a 20g.
Once you get flash, advance maybe 1mm more so that the catheter is in the vein as well. Then thread.
Watch your angle. If you go in at a high angle, don't keep it long.
If you cant see the vein, try finding an anatomical marker on the vein you want to hit (freckle maybe), and don't lose that spot.
I'm tired, so I'm done for now. Someone else will chime in with more I'm sure
It will get better with practice. Everybody develops their own preferred technique, has their own feel, go-to veins, etc.
What you can see > what you can just feel > anatomically fishing.
When all else fails, you have a drill for a reason
Get used to the catheter-over-needle style. I've never seen anything else in an ambulance.
Don't get sucked into the "Everybody needs the biggest catheter I can fit" crap. Address your patient, not your ego. Personally, unless I think the patient is going to be getting blood, I'm perfectly content with a 20g.
Once you get flash, advance maybe 1mm more so that the catheter is in the vein as well. Then thread.
Watch your angle. If you go in at a high angle, don't keep it long.
If you cant see the vein, try finding an anatomical marker on the vein you want to hit (freckle maybe), and don't lose that spot.
I'm tired, so I'm done for now. Someone else will chime in with more I'm sure
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EFDUnit823
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Watch out for valves and if you tear the finger tip off the glove, you get a much better feel.
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If you go by look and not feel you will miss a lot. It gets better with experience.
Just to build on the other advice, try starting slightly distal to where the vein becomes prominent (by feel, not by sight). As you advance the catheter at a shallow angle (almost no angle at all), you'll meet the vein while it's still stabilized by surrounding tissue.