One of the important skills you’ll be doing as a nursing student or new nurse is starting IVs. A lot of nursing students are very nervous when they insert their first IV, because finding veins can be difficult. If you don’t find the vein properly, you can miss it completely, causing frustration and pain to your patient.
In this article (and video), I’m going to tell you some tips on how to find veins when starting an IV on your patients.
Differences in Veins Among Patients
In my experience, males tend to have veins that are much easier to access than females. Most men’s veins are superficial and large. In contrast, most women have more subcutaneous fat, and unless they are an athlete or engage in a lot of cardio exercise, it is often harder to see their veins visibly. This isn’t true in all cases, but as a general rule I’ve found it to be true.
In addition, people who are overweight tend to have a layer of fat over their veins, and this can make it more challenging to find them. You also need to consider that most of your patients will be experiencing health problems, and things like dehydration or illness can also make their veins constrict, making them harder to find.
Lastly, temperature can also cause a lot of variation in the veins of your patients. In a very cold room or climate, patient’s veins will constrict. In a hot and muggy climate, their veins will become much more visible due to dilation.
Best Vein Areas to Start an IV
Where you start your IV will greatly depend on the patient, as well as you personal preference. I prefer to start IVs in the A.C. region (anti cubital). This is the area on the inner fold of the arm. Nurses may also start an IV in the veins on the forearm, back of the arm, or on the hand.
Veins in the A.C. region are often larger, so it can be a preferred area when using a larger IV needle.
I like to start by feeling around for the vein. This tells me if it rolls around. It will also help me locate the vein if it isn’t visible on the skin’s surface. Veins tend to have a very rubbery or springy feel, so I can almost always identify them.
If you are not yet familiar with the feel of veins, I recommend you put on a tourniquet and practice on yourself or a friend.
Rolling Veins when Starting an IV
Once you find a vein, the next challenge will be to stick it without missing. One of the biggest reasons you can miss the vein is due to “rolling.” A rolling vein is a vein that moves easily as you insert the IV.
To prevent rolling vein, I recommend nurses do two things:
- First, have the patient stiffen the area you plan to stick. If it is their AC region, have them extend their arm firmly. If it is on their hand, have them make a fist.
- Next, spread out the skin around the vein with your other hand.
These to techniques above can help to increase your chances of success on your first IV stick.
Video of How to Find Veins
In the YouTube video below, I demonstrate how to find veins, as well as give some basic tips on handling veins.