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I V
S T A R T S
PRE-OP PROBLEM
STARTING LINE Anesthesia providers who start
IVs have opportunities to connect with patients.
Who Should Start IVs?
A
t many facilities,
RNs start IVs. If the
RN has difficulty
and fails after 2 attempts, a
more experienced clinician,
often an anesthesia provider,
is consulted.
We do things a little differently at our
utes with patients to personally start IVs is
surgery center and in our anesthesia prac-
beneficial for a couple reasons: It ensures
tice: Each anesthesiologist starts IVs on his
a high likelihood of success, and it
patients. Anesthesiologists spend only 5 to
strengthens the provider-patient bond
10 minutes with patients when they're con-
when patients are understandably nervous
scious. This time is for reviewing medical
about surgery. Anesthetists appreciate the
records, completing assessments, explain-
opportunity to showcase their skills while
ing the anesthetic options and obtaining
comforting patients.
— Richard Novak, MD
informed consents. Spending 2 extra min-
5
Anchor the skin
simple and safe method to blunt the
Always anchor the skin over
pain of an IV start. The lidocaine can
the vein by pulling distally with
be injected with a 30-gauge needle,
your non-dominant thumb, while
which makes the injection of the anes-
inserting the IV catheter with your
thetic almost painless.
dominant hand. This anchoring and
During starts, blood begins to flow
stretching of the skin prevents the
into the hub of the IV catheter when
vein from rolling or moving during
you first hit the vein. Upon seeing the
your insertion attempt.
blood, you must advance the catheter
6
1 8
Numb and enter
an additional 1mm to 3mm before
A local anesthetic skin wheal
attempting to move it over the needle
injection of 1% lidocaine is a
and into the vein. When the needle tip
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
