other side, and
instead of entering
from above, go in
from the side that
moves it in the other
direction. In other
words, if the vein
rolls to the right,
come in from the
right. Now the vein
won't run away from
you.
Work the
angles
My angle of entry is
lower than what they
teach you in nursing school. In fact, instead of coming into the vein at
the traditional 30- to 45-degree angle, I like to come in at 5 to 15
degrees, almost parallel with the lumen. That way if I go too far, the
needle stays in the lumen instead of going right through the opposite
wall of the vein. Then, after the flash, lower the angle of the needle to
match that of the lumen before you advance the cannula.
Additionally, with veins that roll — especially those in the hand —
once you've just barely inserted the needle on a parallel trajectory, I
recommend pulling the needle upwards a tiny, tiny bit to lift the skin.
Then advance it. The lift opens the vein and makes sure you don't
compress it, and the needle goes right in. You'll get a large flash of
blood and will be able to quickly advance the cannula.
6 1
O C T O B E R 2 0 1 5 | O U T P A T I E N TS U R G E R Y. N E T
Holly
Wright,
RN,
BSN
z WELL TAUT Anchoring skin with your
thumb stops the upper layer from moving
while you try to stick.
