On patients who have difficult veins, locating the appropriate tar-
get is the key. If you start with the wrong vein, you're not going to
have much success, so spend more time looking before you start
sticking. Once you find the right target, have these 5 things in hand
before you begin: an IV catheter; a tourniquet; an alcohol pad; 3
pieces of tape for securing the IV; and a small syringe of lidocaine
to inject for patient comfort. With these at the ready, you should be
able to get the IV started in about a minute or so. It's a small invest-
ment of time that serves as a bond between the anesthesiologist
and the patient. Doing so with confidence will put the patient at
ease and set the tone for the rest of the surgery.
Rick Novak, MD
Waverley Surgery Center
Palo Alto, Calif.
rjnov@yahoo.com
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