Your Guide To Establishing IVs

In life, we all have our own set of skills. As a nurse, we are required to have a wide skill set. However, of course, we are going to be better at some of those things than others. Maybe your best skill is assessment, while another nurse might be the best at wound dressing. Regardless of your skills, we can all benefit from nursing tips and tricks. 

Establishing IVs is one of those nursing skills that seems very divided. Nurses are often really good at IVs or struggle with it. With so many body types and extenuating circumstances, it can be hard to nail the perfect IV every time. If you are a nurse that needs a couple of tips and tricks on establishing IVs, we’ve got your back. Let’s go over the ultimate guide to establishing IVs. 

Before we start, keep in mind that if you are in nursing school, you might not be able to take advantage of some of these tips depending on how your instructor wants you to complete the task. However, these are perfect for real-world applications.

IV Start Tips

• Relax: Our first tip is to relax. Naturally, when we get nervous, we start to make mistakes. Before you go to start your IV, relax and know that you’ve got this! 
• Prepare correctly: Make sure that you have all of the supplies you need plus some extra. There is nothing worse than getting midway through putting in an IV and realizing that you don’t have something that you need.  
• Finding the vein: Remember that your patient has the best information about their body. Ask where people typically stick them or what their experiences have been in the past. Try to go by feel as visual cues can be helpful, but are unreliable in many cases. Try to find a vein that is not in the antecubital space because AC IVs are uncomfortable for patients and occlude a lot. 
• Tight-fitting gloves: You should always wear gloves to protect yourself from blood-borne pathogens; however, the size of your gloves matters. Tight-fitting gloves will allow you to feel the veins better. If you really can’t feel anything through gloves, then feel the area before cleansing without gloves (unless in an isolation room). 
• Mark your site: If you have found your vein, you’ll want to mark it. There are a couple of ways to do it like using a pen or visually marking it. Both of these ways have flaws. If using a pen, the mark will likely be gone by the time you properly clean the site. If you visually mark it, you may lose the spot once you look away. We like to mark the spot by making a small indent in the skin with our nail, that way it doesn’t disappear and you know where to hit.
• Sizing: Keep in mind the sizing of your catheter and the size of the vein. Bigger is not always better. You will need to match the sizes to get a proper fit and ultimately get that stick. 
• Maintaining traction: Use gravity to your benefit. The more traction you have on the arm, the easier the stick will be. Of course, you don’t want to make your patients too uncomfortable, but feel free to stretch and hang the arm. Also to pull the skin and keep it taut at the IV site, use a couple of fingers on your non-dominant hand.
• Bevel up vs bevel down: We might have always been taught to go in bevel up, but if you are going to stick a shallow vein, bevel down might be the move so that you don’t blow the vein. 
• Advancing the catheter: It has been standard practice that we advance the catheter with our index finger. However, if you are not steady or have a hard time doing that, try using the index finger and thumb of your non-dominant hand to stabilize and advance the catheter.

Patience: Above all, have patience. Remember that practice makes perfect and that you might not get a flash right away. Give it a couple of seconds before pulling back out to make sure that you didn’t get it before assuming.

There you have it– some tips and tricks to establishing IVs. Try these out and see if you become one of those IV wizards.

Do you have any IV tips? Share them in the comments!