A P R I L 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 1 3 3
Size matters
Don't use a bigger IV catheter than is
necessary. It's easier to put a small
catheter into a vein as opposed to a larger
catheter, says Dr. Gravenstein. Plus, a
small catheter pinches less going in. Keep
in mind that some nurses are against using
smaller catheters because they're shorter
and easier to dislodge.
"In an ambulatory environment, you
have an IV in order to give medication
and to potentially give resuscitation drugs if needed," says Dr.
Gravenstein. "The volume of those is only a few milliliters, so it
doesn't require a larger catheter."
Warm to the task
To help visualize veins, you can place blankets or warming
packs on the area where you want to start the IV. That not only
warms the area and helps dilate the veins making them easier to
access, it also helps relieve some anxiety for the patient, says Dr.
Soriano.
Skin-tight technique
When teaching new nurses a technique for painless IV starts,
stress that they should pull the skin tight away from the patient and
then don't let up on that skin until they are done advancing the
catheter, says Mr. Lippert.
What that does, he says, is pull the vein so it stays straight when
you're trying to advance the catheter into it. In addition, it makes the
skin taut so there's less resistance to the needle.
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"Once I use the
lidocaine, I'm willing
to say that 75% of the
people that I stick
tell me that they
did not feel the IV
catheter go in."
— Chris Lippert, RN, CAPA,
Avera Queen of Peace
Hospital in Mitchell, S.D.
