IV start technique

[leviathan]

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I was reading an anesthesiology book and they had a different method for IV starts than I've been using. When I get blood flashback, I usually pop the needle and catheter in another 2 mm or so, then I thread the catheter forward until it's fully in the vein and finally withdraw the needle out.

The book says to advance the 2 mm, then withdraw the needle while keeping the catheter in place, then push both catheter AND needle forward together into the vein.

Does anyone do it the latter way, and if so, what are the benefits to this? It seems like you'd risk going through and through with the needle.

 

[dhb]

I was reading an anesthesiology book and they had a different method for IV starts than I've been using. When I get blood flashback, I usually pop the needle and catheter in another 2 mm or so, then I thread the catheter forward until it's fully in the vein and finally withdraw the needle out.

The book says to advance the 2 mm, then withdraw the needle while keeping the catheter in place, then push both catheter AND needle forward together into the vein.

Does anyone do it the latter way, and if so, what are the benefits to this? It seems like you'd risk going through and through with the needle.

Not much difference between both techniques per your description. I withdraw the needle slightly and advance the catheter with the needle this way you keep some rigidity that helps you advance the catheter.

 

[MRW]

My feeling is to put a few hundred IVs in and decide what works best for you.

 

[Mman]

I was reading an anesthesiology book and they had a different method for IV starts than I've been using. When I get blood flashback, I usually pop the needle and catheter in another 2 mm or so, then I thread the catheter forward until it's fully in the vein and finally withdraw the needle out.

The book says to advance the 2 mm, then withdraw the needle while keeping the catheter in place, then push both catheter AND needle forward together into the vein.

Does anyone do it the latter way, and if so, what are the benefits to this? It seems like you'd risk going through and through with the needle.

It doesn't really matter which way you use. Both are acceptable. If you thread the catheter off a little and then advance both the catheter and needle, the end of the catheter is flimsy and tends to follow the vein regardless. The needle shouldn't go through the vein's backwall because it's still within the catheter.

Do whatever works best for you.

 

[ssmallz]

the technique you described works better for the smaller IVs (22g and 24g) b/c the catheters are so small that they bend easily when you apply some pressure. by advancing with the needle, you get extra stability. With the bigger ones it doesn't seem to matter b/c the catheters are stronger

 

[IlDestriero]

I use both techniques. Most of the time the catheter threads off easily. Sometimes with "thick skinned" folks or with a 24g the catheter "sticks" in the dermis so I use the "advance the needle" technique.

 

[QbanDoc]

👍

My feeling is to put a few hundred IVs in and decide what works best for you.

There is the answer to this thread...🙂

 

[fabfive5]

👍
There is the answer to this thread...🙂

Just like so many things in medicine...experience is way better than a textbook. I would caution the textbook method in renal failure patients, who's veins are very fragile. Also, neonates and chronic steroid users...same reason.