I.V. Starts . . .improving your odds! by Tom Trimble, RN:"A calm start: Ensure the patient is comfortable and sufficiently warm to prevent vasoconstriction, allay his apprehension, have him understand the necessity of the procedure and how best he may help."
http://enw.org/IVStarts.htm

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Starting Intravenous Lines, MR Angiography Protocols:"Dynamic contrast-enhanced MRI and MRA is rapidly increasing in popularity and creating new skill requirements for MR technologists. For MR Angiography, as well as MR of the liver, breast, and other applications it is increasingly necessary to inject gadolinium contrast agents dynamically during scanning while the patient is inside the magnet. This requires starting an intravenous line and attaching a long length of tubing that reaches outside the magnet. It is important to point out that starting an iv is an art-form which is learned with experience accumulated after performing hundreds of iv’s. Some patients are easy but many are difficult."
http://www.mrprotocols.com/sset/iv.html

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Starting the I.V., Watts, H. David, The Literature, Arts, & Medicine Database:"This poem explores the act of inserting an intravenous line (I.V.) into a patient just prior to induction of general anesthesia. The physician-narrator is initially full of bravado, stating "I am good at this" and "I'm the best". The physicality of the act is detailed: the vein "lies stretched and succulent" and the needle "waits / like a mosquito attached / by its sucker." By the end of the second stanza, however, when the I.V. has been successfully inserted, the significance of this seemingly simple medical intervention is stated: "I am suddenly aware / I am connected to his brain."
Dr. Aull at 212-263-5401
http://litmed.med.nyu.edu/Annotation?action=view&annid=1119

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Tips for Tough IV Starts, RN Village, Nurseweek:"I'm compiling tips for nurses new to the world of IVs, and would welcome any not mentioned below. Share your expertise!"
http://nurseweek.com/rnvillage/Discussion.asp?forumid=210

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On the road to successful I.V. starts, Nursing2000:"If you work in a busy hospital, you can understand why. For an experienced practitioner, it's quicker and easier to perform venipuncture than to coach a less-experienced nurse through the procedure and give her feedback. So the less-experienced nurse never develops the skills to perform venipuncture confidently under all kinds of conditions. Poorly prepared, she's set up to fail—causing frustration for her and needless pain for her patients."
http://www.springnet.com/ce/p004a.htm

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Danger Points: How to prevent nerve injuries from venipuncture. SUE MASOORLI, RN, Nursing98 September 1998:"Complications related to venipuncture are a leading cause of malpractice actions against nurses. Follow this advice to protect your patients from debilitating nerve injuries—and yourself from legal entanglements. Peripheral venipuncture--whether for phlebotomy or for inserting a peripheral vascular access device--is a common procedure performed on patients. Not surprisingly, the injuries associated with venipuncture are also a common source of malpractice suits."
http://www.springnet.com/ce/p809a.htm

See also:

Arterial Blood Gas Sampling, Queens University School of Medicine:"The sampling of arterial blood for analysis of the respiratory and acid-base status of patients is a common practice in acute care medicine. In contrast to starting an IV, which requires considerable finesse, obtaining a sample of arterial blood from an arterial puncture is a relatively easy procedure. This module is made up of this workbook of reading material and a multi-media program that will take you step by step through the process of performing an arterial puncture for the purposes of sampling arterial blood."
School of Medicine, Queen's University
Kingston, Ontario, Canada K7L 3N6
613.533.2544
http://meds.queensu.ca/~pmsp/iv/ABGmod2.htm

Hypodermoclysis, IV Access Intravenous Access, Family Practice Notebook:"Indications Mild to moderate dehydration in adults Geriatric patients Palliative care Intravenous Access difficult or impractical Patient unable to take fluids orally Nausea or Vomiting Intestinal Obstruction Cerebrovascular Accident"
Scott Moses, MD, Family Practice Notebook, LLC
1162 Durango Point Lino Lakes, MN 55038 US (651) 407-5974, smoses@goldengate.net
http://www.fpnotebook.com/ER91.htm
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