I have a question about starting IVs. First off I would like to say thank you for the video on how to find a vein. I actually found this site from YouTube and so glad I did. Sarah you are awesome! I am reviewing all of your video through your channel, especially the dosage and calculations and skills videos. They are a super big help!!!
Now regarding my question, I feel that my nursing program has not really prepared me for starting IVs or drawing blood. We just learn the basics and if we are given an opportunity in clinical to try to start an IV (which is not the often) we get a chance to try.
However, I have yet to successfully get one. My instructor says that the vein keeps rolling (not sure what that means). So what tips can you give me so I don’t “roll” a vein or miss it completely? Also, one time I got it in the vein but it messed up when I tried to put in the cannula. I am so frustrated. Thanks in advance for your help!
-Mallory
Update: this video about finding veins may help new nurses learning to start IVs:
Nick says
You must hold skin tight to stabilize vein. Veins “roll” when the clinician is not stabilizing vein at time of insertion.
S.L. Page says
Hey Mallory!
Very happy you found the site and thanks for your kind words about the videos. I am so happy they are helping you out. I had the same problem with starting IVs when I was a new nurse. I agree with you about nursing school not properly preparing us for the real world regarding IVs. Starting IVs is a very essential skill as a nurse and you must know how to do it. However, as with anything they take LOTS of practice. You really have to attempt them over and over before you get good at them. Very rarely does someone come out of nursing school as an IV pro. Here are some simple tips and tricks.
1.) Put the tourquinet on tight (of course not so tight it cuts off circulation but enough the patient doesn’t complain). This puts pressure on the vein and makes it “puff up” so you decrease your chances of missing it.
2.) After putting on the torquinet, have the patient dangle their arm down so the blood pools into the lower extremity…this also helps “puff up” the vein. The key to not missing a vein is having the vein nice and engorged.
3.) Before you stick the vein, touch it and see if it moves. I like to tell my students…if the vein moves like a worm under the skin (the vein moves side to side) when you touch it, it is a “rolling” vein and will need to be stabilized before you poke it with a needle.
4.) Hands veins like to roll so have the patient make a fist and this will keep the vein from moving when you poke it with a needle.
5.) After you get blood return from sticking the vein that means you are in the vein BUT you probably need to advance the needle just a bit more so it will completely go into the vein so you can advance the cannula. Many times after a person gets blood return they immediately try to advance to cannula causing the cannula to bend and “blow” the vein. This is because the needle is barely in the vein and needs to be advanced more into the vein so the plastic cannula can slide into it.
So there are my tips…those are things I have learn over the years of trial and error. I hope it helps and again thank you so much for your kind words 🙂
Sarah
Jennifer says
For older patients, try not using the tourniquet so you don’t blow the vien.
You can have them dangle there arm to help the veins pop out more.
When you anchor the view don’t hold it down above where you are going, try doing it below.
Mallory says
Thank you everyone for the great tips! I didn’t expect to get this many responses! Jennifer, most of my patients were older so I am going to avoid using the tourniquet and may be that will help. Also, thanks to Nick & Sarah for the idea of how to stabilize the vein.
Mallory