IV techniques, odd ball tricks etc.

[iMac]

I regularly use a heat pack to raise viens on those with deep hidden veins, brings them up wonderfully, also on unresponsive patients or the extrememly obese when you absolutly have to have a line, the underside of the wrist works great.

I've only gotten one line there and it was in the middle of a code. Nurse tried 3 times to get it and I happily came in and got it on the inside of the wrist. I've never heard of keeping the bevel down.

[firedoc5]

I've never heard of bevel down. But I won't knock it. If it works, it works. Most of the time you learn the basics of starting an IV, then you sort of develop your own technique. Whatever works best for you.

I don't think the nurse should have started the "discussion" in front of the patient. But sometimes they don't stop and think about that. But next time, if it happens, ask the nurse to step out with you to another room or at least out of earshot of the patient. And if you do, don't start talking loud enough for the patient to hear you. Just some words of wisdom from someone who learned that a long, long time ago.

[toutdoors]

Never heard the bevel down technique, but have heard of and used the very lightly applied tourniquet or just using the opposite hand to occlude the vein. On dark skinned folks, have had a medic show me the old, penlight on the arm method, and that was a new one for me. Just hold the penlight at a 90 degree to the arm, and the veins should show up, normally.

As for the nail item, blunt the end of the nail with one tap of the hammer and it works like a charm, also slicking it up a little helps at times too.

[FormerEMSLT297]

Never heard of bevel down,,, one thing you might want to try is this:

Take a butterfly needle 22-25g, and attach a saline syringe to it, flush the butterfly needle, and put on a VCB, as distal as you can see the vein, insert the butterfly, and then GENTLY push a few cc's of saline, this will distend the vein, and then you can start a line with a 18-22 g angio....

We used this quite a bit in NYC on nursing home patients and others with frail veins, always worked pretty well....

Good luck, happy sticking.

[jsadin]

I've never used the bevel down technique, but I have heard of it. I generally go with a very loose tourniquet on older folks and that has helped immensely.

[letmesleep]

Lets see, I have used the heat pack trick.....works good, also the loose tourniquet...........works good, no tourniquet.......does the job.

I have heard of nitro paste being lightly rubbed on the site prior to cleaning.......wouldn't suggest it, It's a very old trick, and can get your a** in a sling real quick.....bad idea all around!!!!

My favorite is humming, don't ask, It's my thing, and it works for me. Pts ask me all the time what I am singing, I just tell them that the veins enjoy the entertainment......ok, it is a weird habit, but it's my cross to bare.......

[Indymedic99003]

I've heard of that method but also lowering the extremity to use gravity. They both usually work

[itku2er]

Me I pray that works.

[firedoc5]

I had one partner that had to stick his tongue out the side of his mouth. He also had shaky hands, but he was probably above average on first sticks.

[letmesleep]

Hey Doc, did he play for the "BULLS" as well?

sorry had too.