Intravenous catheter placement excuses when the vein is blown
We all miss IV’s occasionally, but the excuses which are offered for the missed IV can be very entertaining. I have heard all of the following excuses:
- “The vein rolled.”
- “The vein was too squiggly.”
- “The catheter hit a valve.”
- “The vein was too small.”
- “The vein had a curve in it.”
- “The vein was crooked.”
- “The IV needle wasn’t sharp.”
- “The needle was dull.”
- “The vein collapsed.”
- “The vein ballooned.”
- “The vein was too deep.”
- “The catheter just wouldn’t thread.”
- “The catheter was too stiff.”
- “The patient moved.”
- “We have a bad batch of catheters!”
- “The vein wouldn’t accept the catheter.”
- “I missed because Dr. Taylor was watching me.”
- “Dr. Taylor likes to come in and ‘show me up’ if I don’t get the IV started.”
- “Oh sure. You used that vein? I could have started it in THAT vein!”
- “The catheter was in the vein, but when I began the flow of IV fluid, the pressure blew the vein. The patient told me her veins tend to do that.”
- “The other nurse distracted me.”
- “I used a tourniquet and I shouldn’t have!”
- “This box of IV’s is old and out-of-date.”
- “The patient had a vasovagal reaction just as I entered the vein with the needle, and the vein literally exploded.”
Three keys to successful IV starting:
1) Vein stabilization
2) Angle of entry
3) One-handed threading of the catheter, while maintaining skin tension
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