I've been performing Intravenous injections for a few years now and wanted to help anyone who may be struggling with I.V.'s.

Well before you can learn to "stick" you have to know a little something about the vascular system of the body.

So here's a quick review of the vascular system you need to know;

VASCULAR SYSTEM ALSO CALLED CIRCULATORY

MADE OF ARTERIES AND VEINS

ARTERIES CARRY OXYGEN-BLOOD AWAY FROM THE HEART TO BODY (BRIGHTER IN COLOR)

VEINS CARRY BLOOD FROM BODY TO HEART (DARKER IN COLOR)

CAPILLARIES SMALL VESSELS CONNECTS VEINS AND ARTERIES

Small review I know but I'm sure you already know the insight on the anatomy; so let's get started on the Intravenous part:

Confidence is the golden ticket, confidence brings an ease to the situation. So even if your not sure you'll be able to get it on the first try act like you've done this a million times.

Before the patient comes, make sure you have all required supplies. If it looks like your prepared, the patient and your team will look up to you for your preparedness.

SUPPLIES USUALLY USED:

CATHETER

• USE SMALL GAUGE CATHETER (OR ONE DESIGNED FOR PROCEDURE)
• USUALLY 22 GAUGE
• ALWAYS USE BEVEL UP
• CHECK THE CATHETER TO MAKE SURE IT OPERATABLE

GLOVES

• HAVE LATEX FREE IF POSSIBLE
• NEVER START AN IV WITHOUT GLOVES

TOURNIQUET

• APPLY ESTIMATED 2 INCHES ABOVE INJECTION SITE

GAUZE

• CONTROL ANY EXCESS BLEEDING
• HELPS POSSIBLE SPREAD OF BIO-CONTAMINATION

TAPE / ADHESIVE MATERIAL

• HELPS PLACE CATHETER AND TUBING IN PLACE

EXTENSION TUBE / IV TUBING

• HELPS WITH INFILTRATION AND BOLUS TO PATIENT
• CAN VISUALLY SEE BLOOD FLOW AND SALINE FLUSH

PRN / HEBLOCK / LURE LOCK

• THIS HELPS TO ENSURE CATHETER DOESN'T LEAK ANY BLOOD
• ACCESS FOR FLUSH OR DOSE

CHUCKS

• HELPS CONTAIN ANY BIO-CONTAMINATION

Okay now that you have your supplies, we can finally get started.

First find out with patient which arm is best or medically unable to assess. Sometimes patients have had certain operations that prevent access. Than when you know which extremity your going with visually inspect before applying the tourniquet. The higher you start on the arm is going to be usually less painful for the patient, since all the nerve receptors are more of abundant toward the hand. So the antecubital (elbow) vein is usually the prime choice.

Next apply the tourniquet about 2 or more inches above the injection site. Now a little trick that I do while I'm making sure everything is ready prior to the "stick" is I have the patient drop his/her arm to the side and pump the fist to allow the veins to dialate. Sometimes it can be tough to really see the vein, if you put your index finger and just tap the arm you may feel a littl pressure, the pressure is usually that of a vein; but unless your positive it's a vein don't go advancing any needle.

Now your ready to actually start your stick; grab your catheter (needle) and check it, make sure bevel is up and direct the catheter to the direction of the vein. Now when your holding the catheter make sure it's a comfortable position for your and that your have at least one finger free so you can use it to advance the catheter once you see flash (blood return in resovoir). When you start your "stick" make sure it's fast and steady; the angle of the catheter is important to. Do not have the needle facing at a steep angle facing the skin or a shallow angle parallel with the skin a 45 degree angle is usually sufficient with a regualr Intravenous injection. Different angles are used for different procedures or injections. Once you start to advance the catheter retract the needle has controlled and quick as possible.

Before you disconnect the needle from the catheter apply pressure the the site gently to stop the blood from flowing-out and make sure your tubing is ready to be connected. Connect the tubing and flush the site to make sure adequate flow is granted for dosing. It's important to to allow any air into the site for it can pose serious complications. Always flush the line to allow ease and to double check vein ability to with stand the bolus going to be given.

Once your satisfied with the site secure it with the tape and you are all done.

Now, sometimes if you no someone is coming for an appointment the next day, inform them to hydrate so the veins are nice and dialated.

So patients are on blood thinners and or take an Aspirin in the mornings, this may make it difficult to start an IV in the arm; So I recommend if you know know this ahead of time that you start straight in the hand. Not many people are confident in starting in the hand, the only tip I can give is: You have to be confident that you have the vein when your "stick" because you don't always see flash, and make sure you advance the needle farther then in the antecubital to help make sure the vein doesn't actually push it out. It has the tendency to fight the catheter and make it tough to advance once your in the vein. Another tip is if you hold the skin tight it'll help in keeping the vein from moving on you and missing it.

I hope this hub helped a little, take care.