This video demonstrates the technique to start an IV in the antecubital fossa. See our other videos for starting an IV on the dorsum of the hand or other great medical videos!
Watching this for my exposure therapy for my phobia. Well, I made a lot Of weird sounds whilst watching that! Like cries. Ermmmm. Very relieved once it’s over. But now I have to keep watching it until I’m okay with the video. Wish me luck.
Once you get a flash, take off the touniquet BEFORE removing the needle. The Flush should be attached to the extension set, then attach the set to the Hub and flush catheter.
I said the same above because that is absolutely true, EXCEPT when you need to draw some blood at the same time, then it can be helpful to leave it on because the pressure in the veins would be too low in patients with bad veins, circulation problems et cetera, so filling your bloodtubes would take too much time, sometimes won't even be possible when removing the tourniquet. :-)
Again... People! The purpose was to demonstrate how to accurately occlude the vein so that when the tourniquet is removed not a drop of blood is lost. This was executed perfectly!
Hope it went well for you. I like to watch videos and learn about things in afraid of too, so the fear loses its power. It's an awesome way to overcome your fears.
Other tips. Dont occlude the catheter with your thumb. Use your ring finger so you can hold the end of the cath with your index and thumb. Easier to apply your J loop or syringe that way. Also pull back on a syringe to check if the IV is patent. Blood flowing into syringe means you hit your mark.
Even with a flash of blood, after removing the needle, and connecting the syringe, I would consider one of two options. 1. let some blood fall onto a gauze pad placed under the catheter to remove all air and then place the syringe or tubing. 2. connect the syringe to the catheter and draw back a small amount of blood into the syringe to be certain that the catheter is in the vein. great video!
Hey Derek- that amount of air is clinically insignificant and will quickly be dissolved in the bloodstream. A much larger amount of air is necessary to cause a clinically significant embolus. Thanks for watching!
@@MedSchoolMadeEasy is shooting into legs (either illicit or medication- I only ever intend to administer antibiotics or pain meds amidst an emergency if say a war broke out etc....) but is shooting in legs bad or dangerous? I once shot in my leg and a water blister showed up days later and then it looked like a hole, known as ulceration or ulceritis or something of that sort? Blood clots? I'm very concerned as it seems i have terrible veins but hopefully excersize brings them back.... but yeah- is IV administration in legs bad? Or the hip/just above your groin area
@@joenevico7742 yea that's not good, you're not supposed to use femoral veins for IV injections, they're too risky. Too many risk factors like developing ulcers and risk for DVTs (deep vein thrombosis) i.e. blood clots. Plus they really suck. Might be because things have to travel further, poor circulation in the lower extremities. You have to have a Doctor's order to inject into the legs/feet actually.
If I am mistaken, please correct me....but I think he put the tourniquet on the wrong way. The tourniquet is supposed to be in a position where the flappy/hanging part ( the extra part) is not hanging downwards. The flappy extra part of the tourniquet is supposed to be facing upwards. The reason for this is because it get in the way of IV insertion which happens a few inches under the tourniquet....
Awesome video, Thanks. I have a problem when i get flashback of blood..Two things happen with me, 1) I am not able to control needle and go on puncturing vein ahead resulting into failed cannula. 2) If i advance the cannula in after stopping the needle, Cannula kinks and doesnt allow to go further in?? What shd i do to improve? thanks
I know this is from a while ago but it seems like there are many knowledgeable people in the comments. I'm going to be put under for a minor surgery in the next few days. In my experience, every time I've been in hospital, the nurses always mess up IV placement in the back of my hand and lower on the forearm too. They can never see my veins but still try, then pierce through the other side, say it's fine and try put meds through it anyway (which does nothing but cause me loads of pain) or prick me many times until the veins blow. It's very frustrating, so my mother suggested asking them to use this placement as they do for her. However people seem to say that this placement isn't good. Would you say it would make sense to ask for this for my general anaesthesia? Thanks
Literally trying to get used to needles I am aiming to be a nurse and am used to seeing everything but the problem is that I'm scared of needles and hate seeing needles go inside the skin. Lol I know I'm too weird.
Are you now in the medical field? I had a bad experience with an IV recently and IVs seem to be making me feel uneasy now. Shots don't bother me, its just IVs. I want to know if you've gotten used to them. Thank you!
This is wonderful! I have a question if you guys don't mind. I was taught that as soon as you see flashback you pop the tourniquet or it would blow the vein, but you guys did not. Can you explain if this is true? Or only for some veins?
it's possible, but not necessarily true. in young healthy people like in the video, I wouldn't worry about it. It's a whole different ballgame when you're starting an iv on geriatrics or diabetics with very delicate veins. you want to relieve all the pressure inside the veins as soon as you can to avoid blowing the vein. And as always already make sure the constricting band is off before you flush it! Haha
+mightyme87 If you can perfect this skill, it would be good to do. Although in most people this is unnecessary, there are some people (i.e. older adults) who have veins that "blow" much easier- in these people, popping the tourniquet as soon as possible (or not using a tourniquet at all) is a good idea! great question
+mightyme87 That is a great point, we probably couldn't popped the tourney faster. However, blowing of veins usually isn't as big of a concern with younger, healthier patients as shown in the video. On the other end of the spectrum are the elderly with weaker veins, whom you sometimes don't even use a tourniquet on because the risk of blowing a vein is so high. Thanks for stopping by mightyme, you rock-
wow Best video ever... I have a question. What is the sensation like when the saline is being pushed in? does it hurt, burn? please let me know. Thanks
+aurore0225 Great question! When they were hooking the 10 ml syringe up to the cannula in my arm I was wondering the same thing- but actually, surprisingly I couldn't feel a thing. If I had closed my eyes, I wouldn't have even known it happened. Thanks for stopping by
If the saline enters the vein it will not hurt/burn, but if the vein has been given a hole elsewhere - like if the needle was pushed through the opposite wall of the vein - then the saline will enter into the surrounding tissue, causing a wheal/bulge, causing discomfort. A brand new IV will need to be started "above" the bad site (not toward the hand) or on a different limb.
The point of leaving the tourniquet on was to show that by proximally applying pressure appropriately will stop the flow. If you don't have adequate pressure even when the tourniquet is removed blood will leak.
If you have the time do this with other sites for BD antibiotics. Ie., good veins on arms back of the hand etcetera. So people can move without tissuing them. This site even in bed patient is going to work for very short period of time.
That site is manly for venepunture. I dubbed this the vein for dummies, since it is relatively easy to find. Typically for patients who are mobile and can bend their arms, its best not to inject this area as it runs the risk of bending and potentially breaking the cannula. Do IV on the forearm as much as possible but its harder.
I can make incisions with a scalpel but can't stand phlebotomies or start an IV. Why? Because the damn thing is awake when you're starting an IV. Give me a central line any day. Have to get used to this...
+Tsundrul Palmo depends on how deep the vein is- you go in as far as you need to go until you see flashback. Obviously you shouldn't have to dig more than a centimeter in most cases though- withdraw and try again. I'm not sure what you're talking about with the "cap." Thanks-
sometimes it can be a cooling sensation. if you're injecting a drug, that can also cause temporary sensations. but typically no, you won't notice a saline flush going in
IV bedroom oxygen for the day I am a little tired with this feeling Mai thao October 1 2019 from the hospital cough long time and happy to see in office want to be an option but
Nice video, though I don't agree with your comment about not taking too long to look for a vein. Often, if you do take your time and look for a good vein you will be more successful, especially with those patients who have bad veins.
Hey guys, I'm a student in Austria studying in nursing school. We have just entered our first year practicals and I have a fear of needles. Tips on how to overcome?
Just know that the patient is just as nervous as you, probably even more as he/she is the one going to be stuck. Just take a deep breath and remember to follow the guideline in this video. Over time, you'll find you'll get used to it.
This video has a few errors shown; there are better videos to learn to start an IV. To answer your question I say "Because it has to be done." Just like the times when you'll have to clean up your patient's vomit or strong odor stool. "It has to be done." Do it and do it right.
I have done multiple IVs and received IV, both good and bad before. A good IV should feel like a normal, come and go kind of prick, similar to venepunture or when receiving vaccination. A bad IV..... has many types of pain. Especially mistakes like piercing through the other side of the vein, advancing the cannula with heavy resistance, push in pull out....... I leave it to you to experience XD
For starters, you start an i.v. by NOT choosing the ante-cubital fossa. This region is reserved for emergencies and blood draws ( done frequently by inexperienced staff ). For mobile regular patients the ante-cubital fossa is an absolute no-go.
@@dman5909 It depends, of course. Generally you work your way up from the hand, to the forearm, the AC is possible but reserved, when need be then there's the upper arm. To go straight for the AC is not professional.
It depends. I was always taught to work distal to proximal, but when I moved to the ED the ACF became the gold standard. Reasons being placement of an 18g or 20g was standard; any pt going for a CT with contrast is going to need a large IVC in a large vein anyway; of course your high risk pts may need rapid fluid resus; and IVCs are used for repeat bloods rather than repeat punctures with butterfly's. When I do the odd shift on a med/surg ward I go back to cannulating hands. My point is, yes you're right, but it also depends on your use case and policy
I usually don't inject all the way up to a small air bubble in my NS filled syringe when flushing IVs for that reason, it's almost virtually impossible to keep ALL of the air out of a syringe when working in real time and everything that can happen during an IV site, however that amount of air is of no concern, if it were an entire 10 mL/cc of nothing but air then yes, we would have major concern for an embolus. AC sites are pretty useless when we need an IV for continuous IV fluid therapy however, good site for an emergent situation since we usually don't have a lot of one to pick and choose and we would probably need a large bore catheter for fast IV fluid infusion.
People this is reality not Television. You would need an entire line of tubing filled with air before acquiring an emolism or pneumo. A few bubbles are not problematic in this inservice.
Not at all! Some people are very difficult iv sticks. If there is nothing visually, some of the veins may still be palpable. If not, a vein finder would be useful
We will try to make a new video in the new future to help explain this better. Thanks for your questions, hopefully we can answer it better with a new video!
IV's are major sources of sepsis and great care must be exercised in their placement and care. I'd start with triple prep, just like the OR. Stretch the tourniquet before tying it to lessen skin pinching. When inserting the catheter, the finger touched the Luer lock. This is very important because when IV tubing is attached, changed, etc. someone is going to contaminate the tubing tip by touching it to the Luer lock in an effort to find the hole. Happens ALL the time. Put some Betadine ointment on the puncture site. Don't rely of Tegoderm.
can you provide peer-reviewed literature to support any of the claims you just made? I would love to read an meta-analysis about PIVs being a 'major source of sepsis'
I had an IV yesterday but I have a concern. The person who did the prepatation got it wrong 3 times. After taking the bandages off, I noticed that I had a red splotch where she had inserted the needle incorrectly.
It could be hematoma, meaning your veins that was punctured by IV is internally bleeding slightly. Minimize the chances of this happening by compressing bandage tightly for a while.
I was in the er this Monday night and the nurse was very nice and got me in one stick I've heard many bad things about the hospital but I was treated very nicely
+Mackenzie Shackleton To be clear, diabetic injections should never be into peripheral venous systems (like the video)- rather they're most likely subcutaneous injections that should be done into abdomen or upper thing (not pictured in this video). Thanks for stopping by!
