IV Insertion Tips – How to Find a Vein
In this video I will talk about how to look for veins for IV insertion. Being part of the code blue team at my hospital, it is my responsibility to gain IV access. IV access is important for giving lifesaving medications, so I have to be really good at it. In this video I will give some tips on how and what to look for when attempting to gain IV access.
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Firstly, in order to identify a vein, it is important to look at the vessels of a person’s arm.
Here are three pictures of the veins in a person’s arm. In the first picture you can see where the veins are located in persons arm. So when I go in to insert an IV, I always try to map which aim I am trying to get, I tell myself “okay I am going to try to go for a basilic vein or the cephalic vein”. These two veins are coincidentally are the ideal vein for IV access as it less likely to occlude the line if the patient bends their arm. It is also difficult for the patient to take out or dislodge the IV when it is located there. However, in codes, typically the largest vein is the one I go for which is in the antecubital fossa.
So as you can see each vein has a different size and therefore you need to account for this when choosing which IV catheter size you want to use. The larger the number the smaller the needle which would appropriate for a smaller vein. Seems like a simple concept but it is not uncommon for people to choose the wrong one. Another important factor is the depth of the vein. Veins that are deeper are going to be more difficult to hit. If someone is overweight or has a lot of adipose tissue in the arm, sometimes having these visualizations in your brain will guide where you want to attempt an IV start.
Next let’s talk about how a vein feels. An artery will have a pulse, so if you put your index finger and feel the vessel pulsating avoid that at all cost. Next try to visualize this picture in your head. Arteries are what we want to avoid when obtaining IV access. To feel for a vein, you want to feel and see if it bounces up softly. If it is really hard or doesn’t bounce when palpating it then it may not be a vein.
Here are some tips on how to make your veins be more palpable. First you can use a torniquete. Tie the torniquete tightly around the arm and have the patient make a fist with their hand. This will contract their muscles and promote blood flow which is slowed with the torniquete getting the vein to become full of blood and come to the surface. Next have the patient put their arm down towards the ground so that gravity works on the blood flow and get the veins plump making it easier to palpate. Last tip I have is to use a warm blanket or a warm damp wash cloth. The washcloth is preferred as it will clean the arm a bit and with good lighting, you will see the vein better. When the body is warm, blood flow increases, dilating the veins and making them easier to find.
The last thing that is worth mentioning is that veins have valves, and this means that you can put a catheter in but hit valves and won’t be able to flush through even though you are inside the vein properly. But what you can do is pull back a bit and see if you push fluids through without hitting the valve.
Anyways, I hope you enjoyed todays video. If you found this video helpful I would greatly appreciate if you hit the thumbs up button so this video can get promoted to others. Thank you for watching and see you in the next video!
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