Question

Your older patient needs a peripheral iv started Although her veins was difficult to stabilize you attempted to insert the cannula you were unsuccessfull what can you do to ensure the best chance of success with the next attempt

Answer 1

The following steps can be taken:

1. If the vein is palpable and visible avoid using a tourniquet. Tourniquet increases the pressure in the vein and increases the risk of vein tear.
2. Use a blood pressure cuff and inflate it to 30 - 40 mmHg ( as a substitute for tourniquet)
3. Using the fingers of the non-dominant hand apply traction on the vein. This will prevent side ways movement of the vein.
4. Insert the i.v. line on the top of the vein. In other words, the site of insertion of the needle into the vein has to be from the top of the vein. If you insert the needle from the sides it will push the vein sideways.
5. The needle should be inserted slowly into the vein. Don't rush it in
6. Once inserted, secure it in place with hypoallergenic tape.
7. Stabilize the i.v. access with proper dressing.