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IV's and dehydration - 10/29/2011 11:11:31 AM

defiantbadgirl

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I know being well hydrated makes vein sticks easier, but what are surgery patients supposed to do that can't drink anything after midnight? When I had surgery, IV insertion took a long time (repeated sticks and moving the needle around underneath my skin). I was supposed to have two IV's but only ended up with one because the IV nurse blew my veins in one hand. I know IV's can't be placed where blood is drawn because the patient would be unable to bend their arms, but is there a better place than hands for IV insertion where they can actually get the needle in with the first or second stick?

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RE: IV's and dehydration - 10/29/2011 11:29:47 AM

Aylee

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The foot.

Really. . . ask your doctor if you can still drink water after midnight. I have never been told that I cannot have water. And start working on your hydration NOW instead of waiting for a few hours before.

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RE: IV's and dehydration - 10/29/2011 11:31:56 AM

Aylee

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They can also put IVs in your scalp.

Do you mind having part of your head shaved?

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RE: IV's and dehydration - 10/29/2011 11:42:15 AM

defiantbadgirl

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They don't allow fluids before surgery due to risk of aspiration. The foot? Yikes. What about the lower arm, above the wrist and below where the arm bends? Does anyone know if that's possible?

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RE: IV's and dehydration - 10/29/2011 11:43:44 AM

TheFireWithinMe

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quote:

ORIGINAL: defiantbadgirl

I know being well hydrated makes vein sticks easier, but what are surgery patients supposed to do that can't drink anything after midnight? When I had surgery, IV insertion took a long time (repeated sticks and moving the needle around underneath my skin). I was supposed to have two IV's but only ended up with one because the IV nurse blew my veins in one hand. I know IV's can't be placed where blood is drawn because the patient would be unable to bend their arms, but is there a better place than hands for IV insertion where they can actually get the needle in with the first or second stick?

If you need surgery again insist that an anesthesia guy put in the iv. They tend to be better at it AND they can freeze the area and then just go for it. My last two surgeries I had no idea he was putting in an iv, didn't feel a thing and it was MUCH easier.

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RE: IV's and dehydration - 10/29/2011 11:55:55 AM

Aylee

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quote:

ORIGINAL: defiantbadgirl

They don't allow fluids before surgery due to risk of aspiration. The foot? Yikes. What about the lower arm, above the wrist and below where the arm bends? Does anyone know if that's possible?

It is possible where ever there is a vein. Just ask any preemie.

Really, really, you should direct your questions to a professional in the field.

Why did you not ask when you were given your surgery instructions?

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RE: IV's and dehydration - 10/29/2011 11:57:39 AM

LafayetteLady

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quote:

ORIGINAL: TheFireWithinMe

quote:

ORIGINAL: defiantbadgirl

I know being well hydrated makes vein sticks easier, but what are surgery patients supposed to do that can't drink anything after midnight? When I had surgery, IV insertion took a long time (repeated sticks and moving the needle around underneath my skin). I was supposed to have two IV's but only ended up with one because the IV nurse blew my veins in one hand. I know IV's can't be placed where blood is drawn because the patient would be unable to bend their arms, but is there a better place than hands for IV insertion where they can actually get the needle in with the first or second stick?

If you need surgery again insist that an anesthesia guy put in the iv. They tend to be better at it AND they can freeze the area and then just go for it. My last two surgeries I had no idea he was putting in an iv, didn't feel a thing and it was MUCH easier.

I agree. IV sticks can tend to cause anxiety attacks for me that escalate beyond manageable control. After years of dealing with this, I have figured out exactly how it needs to be done to minimize that risk. The most important part? If the nurse can't do it with one stick, she doesn't get a second chance, she gets someone else. If they are moving the needle/canula around too much, they stop. Immediately. And get someone else.

I suspect she wasn't an "IV nurse." She was simply the one available at that time. NEVER feel you can't be assertive about your medical care. You were there for a procedure, NOT to be a pin cushion. Learn which veins on your body are likely to work best and instruct them to use those. Also ask them to use a smaller canula. They can't use a butterfly (used on infants) for an adult IV, but there are smaller ones they can use that your veins might be able to accomodate better.

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RE: IV's and dehydration - 10/29/2011 12:00:48 PM

TheFireWithinMe

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I have a friend at work who is an anesthetist, he gave me the advice I just passed on. My last surgery, I turned away for a second to say hi to my surgeon, turned back and the iv was in. It was really THAT simple.

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RE: IV's and dehydration - 10/29/2011 12:07:44 PM

LafayetteLady

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quote:

ORIGINAL: TheFireWithinMe

I have a friend at work who is an anesthetist, he gave me the advice I just passed on. My last surgery, I turned away for a second to say hi to my surgeon, turned back and the iv was in. It was really THAT simple.

Yea, that's great for surgery, but typically when I have gone into the hospital the anesthetist isn't doing the IV, it is a nurse and I have it long before surgery. I've had nurses who are really good, and one who was an x-ray tech (x-rays with idodine for thyroid) and she was beyond great. I told her I wanted to just keep her in my pocket to pull out every time I needed an IV, lol.

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RE: IV's and dehydration - 10/29/2011 12:12:13 PM

TheFireWithinMe

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quote:

ORIGINAL: LafayetteLady

quote:

ORIGINAL: TheFireWithinMe

I have a friend at work who is an anesthetist, he gave me the advice I just passed on. My last surgery, I turned away for a second to say hi to my surgeon, turned back and the iv was in. It was really THAT simple.

Yea, that's great for surgery, but typically when I have gone into the hospital the anesthetist isn't doing the IV, it is a nurse and I have it long before surgery. I've had nurses who are really good, and one who was an x-ray tech (x-rays with idodine for thyroid) and she was beyond great. I told her I wanted to just keep her in my pocket to pull out every time I needed an IV, lol.

He also told me that the patient can request/insist on having an anesthetist do it. Trouble is that people don't know that and of course noone tells them. They and xray techs do it all day long so they tend to be better.

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RE: IV's and dehydration - 10/29/2011 9:26:37 PM

bemyslut

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I have placed peripheral IVs (and central lines) in just about every location possible. The best person to place an IV is the one who does it on a daily basis. Our facility allows a nurse to make 2 attempts; if the nurses fails within her alotted attempts, a second person has to be called. What can you do to facilitate the process? Super-hydrate yourself the day prior to surgery. Your body requires about 100-150 ml/hr as a basal rate. If you stop drinking at midnight and have a 7am surgery, you are easily 700ml behind (1 ounce equals roughly 30 mL)....so drink it up!!!
If you have a phobia in regards to needles (and you wouldnt be the first patient), ask the dr who is prescribing the lab tests/blood draws for a prescription of EMLA cream. this has to be applied to the skin approximately 45 minutes before a needle stick, but it effectively renders the skin "numb" so there is very little discomfort from needle sticks

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RE: IV's and dehydration - 10/30/2011 10:30:40 AM

wandersalone

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I always let the staff know long before my surgery or blood test that my veins are notoriously difficult (apparently they wriggle about ha ha)and they either arrange for a phlebotomist who is very skilled if I am going to a path lab, or in some cases, get an ER doctor or an anaethsetist to put in the canula when I ma in hospital.

I have sometimes been asked to place both hands in a sink of water, I think it was warm water, and to press down on the bottom of the basin for about 10 seconds, before they tried again.

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RE: IV's and dehydration - 10/30/2011 5:34:17 PM

MstrDennynSlave

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IV's can be put into a vein on top of the forearm and also on the underside of it. Also along the wrist area.

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RE: IV's and dehydration - 10/30/2011 9:05:14 PM

LafayetteLady

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quote:

ORIGINAL: bemyslut

I have placed peripheral IVs (and central lines) in just about every location possible. The best person to place an IV is the one who does it on a daily basis. Our facility allows a nurse to make 2 attempts; if the nurses fails within her alotted attempts, a second person has to be called. What can you do to facilitate the process? Super-hydrate yourself the day prior to surgery. Your body requires about 100-150 ml/hr as a basal rate. If you stop drinking at midnight and have a 7am surgery, you are easily 700ml behind (1 ounce equals roughly 30 mL)....so drink it up!!!
If you have a phobia in regards to needles (and you wouldnt be the first patient), ask the dr who is prescribing the lab tests/blood draws for a prescription of EMLA cream. this has to be applied to the skin approximately 45 minutes before a needle stick, but it effectively renders the skin "numb" so there is very little discomfort from needle sticks

I need to have IVs' and or blood draws frequently. It isn't that my veins are not good, it is more a matter of the staff not listening. I personally only allow 2 attempts at a stick, and even then only if I think the nurse has a chance of making the second attempt. In other words, if they spend an inordinate amount of time twisting the canula around, they aren't allowed a second try.

I can only imagine the looks on the faces of ER staff if I asked them to have an anethetist, plebotomist or even x-ray tech do the stick, lol, but I probably will mention it the next time I need an IV.

I've never heard of this cream, but I did have a doctor who used to use something we called "freezy spray." I don't know the real name of the stuff, but it did serve to numb the area enough.

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RE: IV's and dehydration - 10/31/2011 12:09:22 AM

avena

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I've had IVs on the back of my hand, along the back of my thumb at the base, on the underside of my wrist, and on the underside of my forearm. As others have said, anywhere they can find a vein, they can insert an IV.

I'm also a huge wuss when it comes to needles. I tell them they have one chance to get the IV in. And that doesn not include digging around for it. At that point they usually go away and someone else comes in a few minutes later, inserts the IV with no problems, and away we go. I'm assuming that the person they send for is someone along the lines of the plebotomist or anesthetist or whomever...because they always get it in quickly with no fuss, so they must have a lot of practice doing it.

Not once has the nurse or doctor argued with me about wanting someone who really knew what they were doing insert the IV. Well...there was the student nurse who tried to convince me to let her try...and I do feel bad for making her cry...but really!! We're talking about letting someone PRACTICE inserting IVs on me...no FREAKING WAY!!

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RE: IV's and dehydration - 10/31/2011 4:29:37 AM

TheFireWithinMe

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quote:

I'm also a huge wuss when it comes to needles. I tell them they have one chance to get the IV in. And that doesn not include digging around for it. At that point they usually go away and someone else comes in a few minutes later, inserts the IV with no problems, and away we go. I'm assuming that the person they send for is someone along the lines of the plebotomist or anesthetist or whomever...because they always get it in quickly with no fuss, so they must have a lot of practice doing it.

My guess is yes. The good thing about an anesthetist (not sure about a phlebotomist) is that they can freeze you then just go for it.

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RE: IV's and dehydration - 10/31/2011 10:15:35 AM

windchymes

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After 23 years of being a medical lab tech, which includes a lot of up close and personal with veins, this thread is making me crazy, lol.

Hydration is good, but the best way to get your little veins plumped up is to take a brisk walk around the block or around the parking lot right before coming in. Get your heart pumping, your blood pressure up, your blood flowing through the veins. You will make everyone's job so much easier if you just do that. Most people show up for blood draws or surgery early in the morning when they're sleepy and cold, the heart rate is slower and the blood pressure is lower. Just take a walk, get yourself warmed up, get your blood moving, it makes an amazing difference.

The worst thing you can do is sit down and announce "You only get ONE CHANCE!" Great, thanks a lot for the extra pressure that I didn't need, now that I have to wear non-latex gloves to even try to find your veins, meaning I might as well have oven mitts on, and now I get ONE CHANCE, god forbid I miss, then I have to go pull someone else away from what they're trying to do to get ONE CHANCE, and god really forbid they miss..... You're not the only patient here today, and chances are your veins are nowhere near the worst ones we're going to have today, and the word is already going around that you're going to be a prima donna pain-in-the-ass. What you could do is say, nicely, that your veins are small, could you please have someone experienced? Work with us, encourage us, don't jinx us from the get-go, and hostility will get you nowhere.

A little secret....we probably feel worse when we miss than you do. Shoving things into veins isn't always easy because we work "blind", mostly by touch and feel, and sometimes by gut feeling. And now we have to try to feel with gloves on. Despite the "vampire" label given to us by so many, we really don't like causing pain. Being new and inexperienced at doing it can be terrifying. Having your confidence blown by mean or condescending patients (who, in all fairness, are also frightened) can pretty much guarantee them missing the vein and having to call someone else to try, who is also going to be mean and condescending to them for not getting the job done. Ugh, brings back traumatic memories, lol.

Oh, you're "deathly afraid of needles". *yawn*, you and everyone else. We're still not impressed, but if everyone who said that over the years would give us a dollar, combined with the dollars from each one who called us "vampires", we could be retired on an island by now.

I have never heard of calling an anesthetist or anesthesiologist away from their duties to come and start a routine IV, unless they absolutely had nothing else to do and it was in the immediate pre-op area on pre-surgical patients. Hospitals I've worked in would highly frown on it. If I'm about to be under his/her care as an unconscious surgical patient, I'd kinda like to know that I had their undivided attention and that they were not distracted by someone who's afraid of getting stuck. Let's face it, IV's hurt like hell going in, but only for a few seconds. Unlike phlebotomy needles, the angiocaths are big and they're dull, they don't slip right in like the super-sharp needles do. It fucking hurts. Numbing cream is great if you can get it, but sometimes, you just have to suck it up, grit your teeth, and tough it out.

And just for the record, phlebotomists usually don't start IV's, they're not trained for that, they draw blood for testing. Usually it's the nursing staff, the IV team, which is nursing staff, diagnostic imaging techs, and doctors who do it. And possibly some others I didn't think of, but probably not any phlebotomists.

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RE: IV's and dehydration - 10/31/2011 2:48:50 PM

tazzygirl

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quote:

ORIGINAL: defiantbadgirl

They don't allow fluids before surgery due to risk of aspiration. The foot? Yikes. What about the lower arm, above the wrist and below where the arm bends? Does anyone know if that's possible?

Yes, lower arm, and there is no pain with bending the fingers or gripping things.

quote:

If you need surgery again insist that an anesthesia guy put in the iv. They tend to be better at it AND they can freeze the area and then just go for it. My last two surgeries I had no idea he was putting in an iv, didn't feel a thing and it was MUCH easier.

Great suggestion!

quote:

It is possible where ever there is a vein. Just ask any preemie.

Really, really, you should direct your questions to a professional in the field.

Why did you not ask when you were given your surgery instructions?

For preemies, the foot is the best because those are larger veins... as well as the scalp. There is even an interosseous stick they can do... straight into the bone.

Back to the OP

You can request anything.... that doesnt mean the staff will be available to grant that request. Inform them you are a difficult stick. Veins roll, they also "hide". Nurses are used to that. When faced with a difficult stick, they will usually be grateful you mentioned it and try only once, or go see if the best person to place IV's is available. Keep in mind, ER and OR nurses and very good at these as a rule. But even they can have bad stick days.

I would get called from L&D to stick patients on the floors, ER, ICU... because I had that reputation of getting them on the first try. But even I had bad days. My own rule was never to stick more than once, nor did I "dig" for a vein. The longer someone takes to look for a vein, the better the outcome. If you have someone who is checking both hands, then unwraps to check your arms.... you got one of the best... and you are a difficult stick. A warm towel, dangling you arm/hand, can help too. But its really all about patience.

I have three spots where its easier to stick me at... and I point them out. Just dont rush them. And when they hit it... lots of praise goes a long way to boosting their egos. It is a blind stick... its hard to hit something when you can only feel it.. and harder when you cant even feel them.

< Message edited by tazzygirl -- 10/31/2011 2:50:09 PM >

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RE: IV's and dehydration - 10/31/2011 4:11:54 PM

avena

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quote:

the best way to get your little veins plumped up is to take a brisk walk around the block or around the parking lot right before coming in. Get your heart pumping, your blood pressure up, your blood flowing through the veins. You will make everyone's job so much easier if you just do that. Most people show up for blood draws or surgery early in the morning when they're sleepy and cold, the heart rate is slower and the blood pressure is lower. Just take a walk, get yourself warmed up, get your blood moving, it makes an amazing difference.

This is the first time I've heard this advice, but thank you!! It makes absolute sense now that I think about it, and I wish someone had suggested it to me in the past.

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RE: IV's and dehydration - 10/31/2011 6:04:10 PM

hausboy

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thanks Windchymes! Great advice!

I know that I've had butterflies used on me--(we don't use them on my unit or in our clinics) and they were a lot easier. I've had IV's in both AC spaces (inside elbow) without any issues--as well as on the back of both hands. (I also have really big veins and don't mind needles so maybe that helped too) Typically before surgery, I avoid caffeine and alcohol and make sure I hydrate well...I know the first thing I'm going to want post-op is water! Personally I don't have to take a brisk walk to get my blood flowing--usually the nervousness of going into surgery (white coat syndrome!) gets my blood pressure higher than usual!

OP--hope your procedure goes well.

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Post #: 20

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