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I V
S T A R T S
COMFORTABLY NUMB
Lidocaine injections blunt
the pain of IV starts.
Forearm veins and veins on
the back of the hand are
excellent alternatives. On
obese patients, often the
only visible veins are located
on the inner aspect of the
wrist, so an IV cannula can
be placed there. If you're
unsuccessful in locating a
Jason Meehan
vein in either arm, look for
options in the foot and ankle
region.
3
used. (For attempts in the foot or
ankle, place the tourniquet just proximal to the target vein.) Examine the
Grow the vein
Stimulate the skin over the target vein by tapping your forefin-
ger at the site. This local stimulation
arm carefully for the best vein. Do
this by both inspection and palpation.
makes veins grow, perhaps by releas-
The cord of the vein can sometimes
ing a regional venodilator or by block-
be felt, even when it cannot be
seen. Be patient. Rather than
sticking the patient's arm in multiple places, don't start the IV until
you've found the optimal location.
The antecubital vein is often the
most prominent. Although this
vein is at the crook of the elbow
surgical patients because they're
immobile, with their arms straight
ON TAP Stimulate the skin at the target site to make veins
more visible.
and extended during surgery.
1 4
SUPPLEMENT
TO
O U T PAT I E N T S U R G E R Y M A G A Z I N E | J U LY 2013
Jason Meehan
joint, the location isn't an issue in
