Troubleshooting Difficult IV
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- Опубликовано: 8 сен 2024
- We've all been there: a patient with challenging IV access is rushed to the operating room without a secured IV line. Picture this: you're in the OR, surgeons are eagerly waiting, OR techs are bustling with surgical trays, and there, amidst it all, is your patient, looking at you with hopeful eyes after multiple failed IV attempts. The pressure is on.
Sure, calling for an ultrasound seems like a viable option, but it comes with its own set of delays - waiting for the equipment, setting up a sterile field, and so on. In such moments, reverting to traditional methods can not only save time but also earn you significant respect for solving a problem that stumped others.
So, you apply the tourniquet, meticulously searching for a vein that could accommodate at least a 20G needle - the minimum gauge required for anesthesia in a patient undergoing exploratory laparotomy. Finally, you spot a vein that seems perfect. You cannulate with precision, only to discover that you can't fully insert the catheter. It's hitting a venous valve, hindering both the catheter's insertion and the IV flow. Watch the video to see how we troubleshot this case!
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Instead of obstructing the vein proximal to the catheter tip, the method I use is simply to raise the arm so the catheter is above the level of the heart, remove the tourniquet, and then remove the needle. Make sure to use that sequence. Usually zero blood flows out from the catheter, or a drop at most. Connect the fluid line, lower the arm, start the infusion. 9 out of 10 times, zero blood. Onlookers, initially perplexed at what I am doing, are amazed at the result, which they instantly then understand !
Your incredible comments and support are much appreciated! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is here to assist. Try it free for 7 days and give us your feedback. Let's master IV access together! www.nysora.com/iv-access-app/
Thank you for sharing your experience. In acase of possible valve obstruction to the cannula I attach a syringe containing saline to the back of it and advance it while injecting the fluid. It always works.
Great tip. Thank you for watching! And that is great feedback! Which IV video did you like the BEST so far? Greetings!
We appreciate your amazing comments and support! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is here to help. Enjoy a 7-day free trial and let us know your thoughts. Together, we'll become IV access experts! www.nysora.com/iv-access-app/
These videos are so helpful, I'm a urgent care nurse and usually wherever I go, the other nurses there give me the difficult IV patients. 👍
Thank you for watching! And that is great feedback! WHich video did you like the BEST so far? Greetings!
Thank you for all your fantastic comments and support! If you or your nurses or colleagues are struggling with IV access, be sure to check out the new NYSORA IV Access App. Try it free for 7 days and share your feedback! Let's master IV access together! www.nysora.com/iv-access-app/
Truly this is a very good technique. the part of the video that I didn't Expect was really keeping the tourniquet on will keep the valve closed. Even in flushing with IV fluids via the IV line. The trouble we can run into here, is, having now bent the introducer, and withdrawing it, the catheter had straightened out and the needle remains curved. We have to mindful of this part (trying to re-cannulate the catheter so as to push through past the valve. Great tip.
Thank you for watching! And that is great feedback! Which video do you like the BEST so far? Greetings!
Thanks for your awesome feedback and support! If you or your nurses or colleagues are facing tricky IV access, the new NYSORA IV Access App has you covered. Get a 7-day free trial and share your experience. Let's conquer IV access together! www.nysora.com/iv-access-app/
Good video. Very useful. A saline syringe can also work if injected past the vein gently.
Not every cannula can be rescued.
Great point!
Your wonderful comments and support mean a lot to us! If you or your nurses or colleagues are struggling with IV access, check out the new NYSORA IV Access App. Try it free for 7 days and give us your feedback. We'll master IV access together! www.nysora.com/iv-access-app/
thank you! You are a great anesthesiologist!!!🎉
Big thanks for your fantastic comments and support! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is here to help. Enjoy a 7-day free trial and tell us what you think. Together, we'll nail IV access like pros! www.nysora.com/iv-access-app/
Nice! I used to teach residents the same technique, without bending the needle. I ask teach them how to identify a valve.
Great tip. Thank you for watching! And that is great feedback! Which IV video did you like the BEST so far? Greetings!
Thank you for your amazing comments and support! If you or your nurses or colleagues are struggling with IV access, the new NYSORA IV Access App can make it easier. Enjoy a 7-day free trial and share your experience with us. Together, we'll become IV access pros! www.nysora.com/iv-access-app/
If you use an AccuVein you can wipe the vein and see valves so you can avoid them before sticking.
We appreciate all your fantastic comments and support! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is the answer. Try it free for 7 days and let us know what you think. Let's conquer IV access together! www.nysora.com/iv-access-app/
I find this very informative
Happy to hear that!
We’re excited to share that NYSORA’s Difficult IV Access App is now available on the Apple Store and Google Play. Written by anesthesiologists, it’s packed with countless tips and clinical videos on how to successfully access tough veins.
We warmly invite you to test drive the app for one week for free and let us know what you think. We believe this app will be immensely helpful to you and your colleagues. Download the app for free, share it with your colleagues, and let’s all improve our IV skills together www.nysora.com/iv-access-app/
thanks for your useful suggestions!
Glad you like them!
Thanks so much for your amazing support and comments! If you or your nurses or colleagues are facing tough IV access, the new NYSORA IV Access App has got your back. Try it free for 7 days and share your thoughts with us. Let's ace IV access together! www.nysora.com/iv-access-app/
Nice video, thanks doctor
Most welcome
We appreciate your amazing comments and support! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is here to help. Enjoy a 7-day free trial and let us know your thoughts. Together, we'll become IV access experts! www.nysora.com/iv-access-app/
Cool video!
Glad you enjoyed it!
Thank you for all your fantastic comments and support! If you or your nurses or colleagues are struggling with IV access, be sure to check out the new NYSORA IV Access App. Try it free for 7 days and share your feedback! Let's master IV access together! www.nysora.com/iv-access-app/
you're a true vein whisperer!
Alternatively we can introduce the introducer/stylet but without crossing the cannula tip and cannulate the IV. Of course there is chance of rupturing the valve.
Thanks for your awesome feedback and support! If you or your nurses or colleagues are facing tricky IV access, the new NYSORA IV Access App has you covered. Get a 7-day free trial and share your experience. Let's conquer IV access together! www.nysora.com/iv-access-app/
Bending the needle in the IV catheter can disable the safety mechanism before the IV catheter is even placed with some IV catheters
Thank you! Indeed - it may not applicable to certain safety catheter designs
Good point. The needles used do not have the mechanism you mention. Do you know of a video demonstrating the use of the needles you are using?
We truly appreciate your awesome comments and support! If you or your nurses or colleagues are struggling with IV access, the new NYSORA IV Access App can help. Enjoy a 7-day free trial and let us know how it goes. Together, we'll excel in IV access! www.nysora.com/iv-access-app/
Ole, ole y ole 🎉 .
i just happened to be doing this yesterday !! besides learning techniques and dissipating the myth of "hitting a valve" - this channel has been a great confidence builder somehow. A great theme would be how to address shrunken rubbery old chemo/carboplatin veins, sometimes too small to go sideways, so far the solution is to get a bigger iv for more piercing power but is that the right way to go ?
Great tip. Thank you for watching! And that is great feedback! Which IV video did you like the BEST so far? AND - we will get to that video as well!!! Greetings!
We appreciate all your fantastic comments and support! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is the answer. Try it free for 7 days and let us know what you think. Let's conquer IV access together! www.nysora.com/iv-access-app/
Using the longest 20 gauge catheter in the hospital is your problem 😅
Some medications require larger bore like a 20 G.
@@ally70520g refers to the diameter and you are correct, but this comment was talking about the length of the catheter, not the gauge or diameter.
If the length of the catheter had been shorter then it would never have hit the valve to begin with.
Your incredible comments and support are much appreciated! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is here to assist. Try it free for 7 days and give us your feedback. Let's master IV access together! www.nysora.com/iv-access-app/
👍👏😊
When is the book coming out?
Big thanks for your fantastic comments and support! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is here to help. Enjoy a 7-day free trial and tell us what you think. Together, we'll nail IV access like pros! www.nysora.com/iv-access-app/
when is the book coming out?
Thanks so much for your comments! If you or your nurses or colleagues are facing tough IV access, the new NYSORA IV Access App has got your back. Try it free for 7 days and share your thoughts with us. Let's ace IV access together! www.nysora.com/iv-access-app/
Also teach
We’re excited to share that NYSORA’s Difficult IV Access App is now available on the Apple Store and Google Play. Written by anesthesiologists, it’s packed with countless tips and clinical videos on how to successfully access tough veins.
We warmly invite you to test drive the app for one week for free and let us know what you think. We believe this app will be immensely helpful to you and your colleagues. Download the app for free, share it with your colleagues, and let’s all improve our IV skills together www.nysora.com/iv-access-app/
Why don’t you just flush it with a 10cc saline syringe that’s attached to a extension set? Much easier
Some of your practices are not approved by any professional organization. The bending of the needle might be a helpful hack, but it’s potentially dangerous. The same can be achieved by lifting the entire catheter up once piercing the skin then continue- same result. Over & over in your videos I’m seeing close-ups of a needle sliding in & out of the cannula-a disaster waiting to happen. I’ve been in the business 30 years so I’m not ‘overly cautious’ due to inexperience. I just follow professional guidelines.
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Can u explain in a way I can understand what happens that is bad if u bend the needle?
Thanks for your awesome feedback and support! If you or your nurses or colleagues are facing tricky IV access, the new NYSORA IV Access App has you covered. Get a 7-day free trial and share your experience. Let's conquer IV access together! www.nysora.com/iv-access-app/
Nurses love guidelines 😅
did you even read what they said lmao @@nysoravideo
In my opinion, the use of a long cannula in superficial veins is not a good idea because of what just happened initially., hitting the valve..and possibly, change of course and particularly, change of size of the vein
Big thanks for your fantastic comments and support! If you or your nurses or colleagues are having trouble with IV access, the new NYSORA IV Access App is here to help. Enjoy a 7-day free trial and tell us what you think. Together, we'll nail IV access like pros! www.nysora.com/iv-access-app/