Anchor away
Anchoring the skin can make all the difference in your IV start.
Using your thumb, push against the skin a good distance away from the
insertion site. That will stop the upper layer of the skin from moving
when you're trying to do your stick.
Think one notch on a ruler
Inexperienced nurses sometimes stop too short once the needle's
in the vein, leaving the cannula in the wall of the vein and preventing
it from advancing. To make sure both the needle and the cannula are
in the lumen, once you see the flash, advance it a little farther and pic-
ture it going into the vein (parallel to the lumen). Then advance the
cannula.
Use a tripod
Stabilize your hand by resting your 3 available fingers (not the
thumb or index finger) on the patient's arm while you insert the nee-
dle.
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In nursing school, they teach you to start distal with the hand and move inwards. I
prefer to find a straight section between the elbow and the wrist, one that's not on a
bony surface or too close to the wrist or antecubital fossa (elbow pit), where flow
would stop if the patient bends the arm. If that's not an option, I use the median
cubital vein or any of the prominent antecubital fossa veins inside the elbow.
— Holly Wright, RN, BSN
ELBOW-WRIST
STRAIGHTAWAY
Where to Place the IV
