How to insert difficult IV or draw blood sample in patients with difficult veins: Best technique

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Intravenous access

There are several different methods to facilitate an IV line placement in patients with difficult peripheral IV access. Of course, you can use ultrasound to find and cannulate a vein in a difficult patient, but this requires a considerable amount of skill, equipment, and TIME. And frankly, you would not make the surgeons happy by wheeling in an ultrasound machine when the case is already delayed. In this video, Dr. Hadzic teaches his street-smart, a surprisingly little-known technique, that is much simple and faster than ultrasound.

4:04 Difficult veins: Case #1
5:52 Difficult veins: Case #2

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As an intern, to avoid difficult cannulation, apply three cotton balls with tape to both arms and get someone better to do it.

markraines
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I made my entire EMS department watch this video. Each and every Paramedic is thankful. Its standard in the field now for difficult sticks. Success has been 3 fold. Thank You!

svoceanghost
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I'm a recoverd 17 year I.V. heroin user. I've been hospitalized many times and I've taught a couple nurses how to hit difficult veins. I'm very good at it!

Rightwinger
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I used to work in pre-op holding. Started a lot of IVs. Used BP cuff, warm blankets & hung arm down for gravity assist when faced with a difficult start. Some veins are just difficult to access despite your best efforts.

lorismith
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I’m a paramedic, just went from the city of a tops 10 min transport to the county of at least an hour transport. I can definitely see myself taking out ace bandage and trying this once or twice. Great!

jamiethon
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As a Paramedic I want to add in that veins don't wiggle, roll, run away, etc. Can they spasm or be moved/pushed by a needle before it punctures the vein? Yes...
Is there anything we as providers can do about these issues? ABSOLUTELY!
Holding traction on a vein, preferably at 3 points (2 minimum, above & below the insertion point) and keeping that traction until the cannula has been fully inserted typically makes the difference between a successful attempt or having to stick a patient again.
Also, PRACTICE! In the beginning it doesn't even need to be practice sticking, but take your tourniquet home and practice finding/feeling the veins of anyone that will allow you to try! If you learn what veins feel like (that soft, sponge like, slightly bouncy feel - everyone explains it differently) plus learn to feel for valves, bifurcations, etc. You'll be much better prepared for whatever situations you may come across. Some of the best veins can be felt but are not particularly visible!
This video is great! While it's "low-tech" that's exactly the type of continued learning & teaching we should all be doing because it's accessible most anywhere at anytime!

amwelch
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I'm a former emergency nurse and now nurse anesthetist and I have a very high success rate with IV but sometimes I have to cheat with ultra sounds. I will try this very intersting technique as soon as possible! Thanks!

Tibosan
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I decided to watch this after a hospital visit to the VA hospital. The nurse was trying to draw blood and put an IV in me. She was unsuccessful in my left arm several times. It started to hurt after the 4rth unsuccessful poke and I told her to stop and just do the right arm. It took another unsuccessful poke and another nurse to get the job done. I wish the first nurse would watch this because she didn't even care about keeping the patient warm. I was shivering and maybe that could of helped her draw blood easier along with this method.

Jorge-
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I just shared this on my phone with a prep op nurse in between my cases. When I returned to retrieve my phone, I see that she is sharing the video with 3 other nurses. I am sure all the preop nurses in our hospital will know this technique . Thanks for sharing the great video and knowledge.

cnghiem
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This is the best IV technique I have ever seen. We have done the double tourniquet and BP cuff but not walked the blood down distally.

sana-cmoc
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I'll keep you posted after trying this technique in my cancer patients. 😍 Thank you

fatimaellyzzamae
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Bravo doktore, nema, sto Balkanac smisli ne može niko. Svaka čast 👍

zoranmudrinic
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I appreciate your video. I am someone who has terrible veins and always get nauseous from the digging. Now I can show your video which takes less time to watch then dig in my arms and hands for a vein.

greenpenns
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As someone who very much dislikes no is tormented by the thoughts of IV and any needles because I was on dialysis for almost 11 years. I was diagnosed with systemic lupus nephritis which completely ruined both of my kidneys and overall health. I had both arms destroyed by procedures in which they tried to get fistulas and or grafts. I remember when they did this green light to track my veins which made it a lot easier to find it and get an IV or draw blood. I have been poked by different people for years and I always tell them to please use a butterfly needle. I have had some less compassionate people one who told me that I should stop being scared and he poked me digging .I yelled at him to stop because he was hurting me. He called me a big baby and started laughing at me. I wish they would implement this every where especially for people who have trouble like myself. It would definitely help ease the anxiety of the over poking.

butterflybeautym
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We need more anesthesia providers with the willingness to speak truth to power. Thank you for “standardizing, ” the level of care given to the pt. presenting with hip fracture/advanced age. Mom fractured her right hip February 2020. Dad his left April 2020. Mom fractured her left hip August 2020, and died at home in November. Both received “spinal, ” for the first surgery and did very well. Mom received general/endotracheal for her second-she did not recover from the cognitive decline.

haroldmarks
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I am in paramedic school now and currently practicing IV's on a fake arm (the veins actually fill with fake blood, it's pretty cool). So far it has been pretty easy to locate a vein because it is basically Shaq's arm 😂
I want the real deal! An 80 y/o F with diabetes and edema. I'm glad this video delivered, and showed actual IV situations. TY

sambalam
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This is a technique that can be used even in the most resource limited settings. Nowadays there is too much reliance on technology but not everyone has access to ultrasound. Thank you for showing this useful technique.

And yes, anything that happens amiss is always blamed on the anesthesiologist. 😅

dannamadura
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I have really terrible veins and am on IVIG so I will definitely save this video in case we have trouble with my veins again in 2 weeks. I have had to cancel my treatments before becUse we couldn't hit a vein.

petraarkian
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As a surgeon- thank you for your service!

bowenyao
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I am a very difficult patient to start an IV. Thank you for educating me on ways to help nursing staff start my IV! Thank you!!!

myfriendoretheshepherd