DIFFICULT IV: FIND MISTAKES!
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- čas přidán 18. 11. 2022
- Seemingly easy IV access turns into a nightmare and multiple failures when the operator hesitates and does not recognize that the veins are thick-walled. Take a part in voting what went wrong in this multi-attempt at IV cannulation.
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DIFFICULT IV: FIND MISTAKES!
Greetings! In this video, we're going to see some mistakes that are made during IV catheterization in patients who have well visible peripheral veins. but their veins have thick walls and I will point out some of the mistakes but some mistakes will be left to the community
to figure out. feel free to leave the comments with your suggestions. However, in a follow-up video, I will disclose all mistakes made and how to avoid them. so be sure to subscribe to the channel and not miss the video with the answers. Let's get started
First attempt-what happened, what is wrong with this one?
Second attempt-what is wrong here? Is the needle catheter system now in the vein? we clearly don't have a flashback and yet, the operator is trying to withdraw the needle to see whether he has passed through and through in order to get the flashback. What would you do?
Clearly we are having blood return in a catheter but also we can see the hematoma formation as well as the blood flow is not adequate. meaning the blood coming back into the needle catheter system is from the perianal hematoma and not from the intravenous catheter
placement.
Attempt number three
What is wrong with this technique?Is the catheter in the vein? Clearly this has been a failure but let's see now what we can do to fix that.
Here's a more experienced operator who then takes over and let's see what happens. Let's look at the stabilization of the vein and the speed at which the catheter is being introduced
and here we go.
All right, I hope you find this video useful and what made a difference between unsuccessful attempts and a successful placement of the IV catheter is-
Number one- lack of hesitation
Number two- greater speed of catheter insertion which was required for the veins with the thicker wall
And three- sufficiently deep insertions of the Catherine needle system into the Lumen of the vein before attempting to feed the catheter of the needle.
I would love to get some feedback from you on what mistakes were made during the first three unsuccessful attempts and be sure to subscribe to the channel so you don't miss the follow-up video with answers.
Until next time!
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Doc if I may ask you what causes resistance during canulation
Cuddos to the patient who allowed these attempts for our learning
Also with the more exexperienced person, after catheterization of the vessel, keep in mind the needle-catheter system was deliberately bent, when the flashback was achieved the curved needle was reintroduced. This can be a problem as the bent needle may not always follow its soft catheter and damage the sheath and vein
@@small-timegarden yes i dont like doing that either (especially if you are then holding with one hand to reach for lines, flushes, valves), i do it slightly when the vein is really shallow
Why bend ?
@@rodrigolantadilla to give it a flatter angle
Yes.. cuddos to the patient. Must be so painful 😣
MVP of the video: the patient who did the move a muscle with all those attempts and making this video possible.
Thankyou
Indeed! Thank you for commenting!
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/
The patient is a hero! Thank you for your patience!
We see what you did there ;) Greetings from NYSORA!
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/
Another great video. Just because vessels are large, doesn’t necessarily mean they are easy to cannulate. Good reminder to adjust techniques for patient conditions.
Hi Zach! We really appreciate your feedback! Thank you!
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/
As a Cardiac Telemetry Nurse, my greatest hobby and passion when I work is drawing blood and inserting IVs, especially very hard sticks. Your IV videos are most educative and stimulating Doc. Thank you.
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/
Number 1 problem in my opinion is choice of vein.
Take the time to let veins fill and go for the largest and most straight vein possible.
In patients where I anticipate the need for fluid resuscitation, I'd go for the *second* best vein so that I can place a large bore cannula in the best vein after induction of anesthesia.
To be fair the patient in the video is a premium one - young, thick skin with healthy connective tissue, large veins. The majority of patients you encounter in real life are old, have either very few and much smaller veins, or big veins under extremely thin skin with close to no connective tissue, hence rolling around like a dog in the snow ...
With many real-life patients the first two veins that were attempted in the video would be as good as it gets.
Ok noted
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/
I can not emphasize enough the need for 3 things:
1. Stretching the skin. It makes skin puncture easier and quicker and less painful for patient. Also stabilizes the vein which makes puncture easier and also, especially when still learning, easier to judge when the catheter is sufficiently deep in the lumen.
2. Avoid hesitation. Even in a failed attempt, it is less distressing with lesser chances of hematoma if the actions are rapid and smooth.
3. Stabilize the hand well
U just solved my biggest challenges
Slow is steady, steady is smooth, smooth is fast.
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/
Thank you for the video, keep them coming. I am learning so much here 🤩
More to come!
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/
Very interestingly you guys showed step by step the best techniques of iv canulation 👍
Hi Soumyajit! Thank you! Your comments are much appreciated!
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/
I like to clean the site and then plump and then clean and then dart it in but as soon as you get flashback I advance the catheter immediately. A mistake I’ve seen is that they don’t remove the tourniquet as soon as they get flash back, if you flush while the tourniquet is there, it will most likely blow. Or if you withdraw the catheter with the needle still in, while the tourniquet is on, it will also blow. Gotta keep the integrity of the vessel intact. Thank you for this video.
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/
actually puncturing slowly isnt a mistake in general. there are small and delicate ones, where you have to, in order not to miss the vessel. However great video, thank u very much :)
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/
I am an LPN graduate and this is the first time I have seen about bending the needle to insert it in a curve, I loved the tip.
Thanks for the class.
Glad it was helpful!
Was waiting for this video! Excellent demonstration but i would like to add on to this by assuming that the a dressing seen above the wrist was also a previous failed attempt. Then i would suggest we dont attempt another cannulation proximal to that because i had an instance where propofol extravasated through the prev failed site😬
Great comments. Can you elaborate on "was waiting for this video?" - it sounds interesting. Greetings!
@@DRBLUESNYC i had asked for an iv troubleshooting video to which u had replied 'good idea' so i was expecting this one😁
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Firstly I have definitely been there. And the microskills - depth, duration to wait/advance each iv size post flashback/ vibility of cannula in vein definitely different again in paediatrics. Agree optimise vein size, angled cannula, fast insertion, slightly steeper angle entry, then shallowed, wait, small 1mm (with 20g) advancement, withdraw needle partially, advance catheter/catheter and half inserted needle into vein. And yeh i dont go downstream for things i cant avoid tissuing ... Tiva/dilute norad etc. Practice practice and it will become second nature just time. Frustratingly you cant always identify what has changed in your technique once you're getting v.high success
@@nowayitsjordan Once you're sure to be in, withdraw the needle to avoid puncturing again the vein''s wall.
What do you mean by ", I don't go downstream for things I can't avoid tissuing"
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The other mistake not waiting for a flash after entering the skin. When using a smaller catheter 20g through 24 you should wait 2-3 seconds for a flashback. You might actually be in the vein if you advance the catheter, you will probably go through the vein.
Story of my life
what are symptoms of someone going through the vein?
@@KBradAdams sometimes you get an immediate hematoma, when you try and advance the catheter it will not advance. When you try to flush the catheter there will be immediate swelling.
@@medic13601 Should I worry or just wait and see if it all improves? It has been 5 weeks now...
@@KBradAdams You might have what it is called phlebitis an irritated vein. You should have it checked just to make sure and nothing else is going on.
Specifically for that Cephalic, the speed of insertion is key when ur dealing with such healthy elastic skin + wide vein. It'll just roll if u go slow.
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/
When is the follow-up video to this? Really want to see it. Thanks as always NYSORA
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/
Excellent video. Additional observations.
1st attempt: not enough tension - skin too loose, insertion site is past the bifurcation, needle visibly outside the vein, lengthwise hematoma - possibly sliced the vein with the lateral repositioning.
2nd attempt: again not enough tension on skin, IV catheter needs to be bent prior to insertion - can see the catheter deforming as the clinician is trying to get the correct angle, stopped advancing needle on the distal side of a valve - needle removed - and tried to advance the catheter (can sometimes float the catheter through the valve but doesn't always work.
100%! Thank you for the feedback!
@@DRBLUESNYC Tank you, Dr. Hadzic. Your analysis was spot on. 🙂
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/
Thanks
There is a lot of subtle tactile information at your fingertips when insering an IV. Experience will tell you when when you are in the vein far enough to slide the cannula in. Choice of vein is extremely important. I tell residents it's like real estate - location, location, location. Stabilising the vein and arm/hand well is very important.
Dear Frank! Indeed! we really appreciate your feedback.
interesting metaphor 😂but its true ! the cephalic vein can be deceptive though, it is very visible but can collapse easily. agree?
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/
Excellent - thank you
We are glad you found it useful!
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/
Very informative video. Good job!
Glad it was helpful! Greetings!
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 u my great teacher
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/
I don't even have enough blood to attempt that. Brave soul!!!😮
That was painful to watch. Thank you for all the teaching.
It happens! But we need to learn on mistakes. Best regards.
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/
I don’t have hands and the veins on my foot is not that visible. I have to go to the hospital which has vein finder and it’s not available everywhere. Can you guide to puncture vein from foot easily rather trying in femoral artery or anywhere that is kinda painful for me
Leaving the other two iv’s open to air is a brilliant idea.
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/
this patient is very patient (no vein problem )
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2 in the hand at the same time is wild
Great video! When will be a follow up video with the answers to the questions asked here?
Hi Sylwia! Glad you are enjoying the content. Will do!
@@nysoravideo Great 🤩!
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/
sir i appreciate the video and the style. You guys rock, as a turkish anesthesiology resident, there are few little add-ons i would like to suggest:
-if the iv is going to be catheterised by a resident, selected vein must be as distally(and of course adequate) as possible, in case of failure(in this video, the more experienced person could open the vein more distally, i can see that there is a distal fork of the vein, but it is always be easier said than done, so all credits to the operator)
-Mostly we use forks of the veins, and our initial puncture is not above the vein, it is above the normal skin tissue. after the puncture of the skin, we can puncture the vein(under the skin) with little more control and add a little more manoeuvrability. That way, you are not puncture the vein in a vertical position(much harder thing when you slide the cathater) but in a horizontal position
-in the anesthesia mind, the iv catheter's broad tip(the fluid-connector side) is not directly connect with the saline/fluid. We add a 3-way tap in order to add our anesthetic/vasopressor(anything that must be used in a specific time or event) connector: because if you give it with a distal 3-way tap and an emergency situation occurs: like hypotension, all the medication and the fluid push a little more anesthetic to the vein. To avoid it, our main or most trustuble iv access is always connected at the opening of the catheter so we can always control and manage all the ways at all time(i hope i can express my concerns despite being not a native speaker)
Dear Utku dönmez! Thank you so much for your kind words; we really appreciate your feedback. Greetings from NYSORA!
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/
Oof that was tough to watch. That last part with the needle bend is always interesting though
Even I'm curious why that cannula was bend a little. Can somebody explain why?? I have a hard time inserting IV on female patients with small veins.
@@swanisabellaoh pls,female dont have small veins,veins size doesn't depend on gender you sexist
@@swanisabella 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/
Awesome video ❤
Glad you liked it! 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/
@@nysoravideo Thank you so much. I’ll definitely look into it. 🫶
Really it's useful for us thank u
Keep watching! A lot more are coming soon! Greetings from team NYSORA!
Please make a video for neonatal population including preterm infants please.
Thanks so much. Amazing videos
Dear MiRO! Great suggestion! We will definitely put this on out list. 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/
Love your videos! Can you please i need som tips/tricks for artielblod gas
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/
It's a amazing vedios .I really appreciate it👍
Hi Pakiza, Thank you for your comment. 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/
Poor lady
I had lumbar fusion April of 2023, they put the IV in my forearm on the top, and it hurt bad when it went in and usually I don't even feel it. The nurse said you have thick skin? I said normally I have no issues with finding veins or it going in. The day of surgery I was only taking Tylenol no Morphine, muscle relaxers or anything. (so high pain tolerance) When they removed the IV for me to go home, the next day, the vein hurt in my arm and all the way to my hand. The vein in my hand was bigger than a pencil. It has been 5 weeks now and is hard and hurts when I touch it, also I noticed on the bottom of my forearm I have a knot in a vein there. When I put my finger on the spot the initial IV needle went in there is a nodule or bump there. Could they have inserted the needle in an artery instead of a vein? I have tried massaging the vein, heating pad and it doesn't seem to be getting much better. Thanks for anyone that has any ideas. I see my surgeon in a week and will mention it but wondering if I should worry.
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/
Certified IV nurse. I would never reinsert, also would have went for indirect approach
'gone,' not "went."
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/
great advice again, thank you! the background music was a bit too loud and bothersome though
Dear Sophie! Thanks a ton for your feedback.
And....would love to hear a recommendation on the use of music - YES< NO
@@nysoravideo Music in general is a good idea I think. But I wish the music was quieter and at a constant volume throughout. And maybe go for something more serene or relaxing rather than uplifting? Aside from the music your videos are great as usual though!
@@nysoravideo NO music is needed.
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/
Am I the only one bothered by people palpating the already-cleaned area with a non-sterile finger prior to puncture? What's the point of cleaning the area if you're going to poke around with an unclean glove afterward?
Is the bending system used for superficial veins ? Meaning the ones you can see??
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/
Very use full
Glad to hear that
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/
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/
Can someone explain the physics behind bending the catheter prior to insertion? Thank you.
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/
dude, the patient's veins are beautiful, but due to the difference in the technique and catheter used, this man damaged the vein and made his job more difficult.
Can you enlighten me more about the speed of the catheter insertion? I notice I tend to insert the catheter a bit slowly but others tend to insert it very quickly.
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/
mentally preparing myself for getting my cat scan with contrast
Very nice 👍👍
Hi Mix! Glad you are enjoying the content. 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/
One question: why the nurse/doctor are not trying the vein with a NaCl before connecting to the IV drip. Saw the same thing on Your another video. Thank you for the content.
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/
I think previous videos clarified a lot of mistakes people make (being too far or not enough in the vein). first attempt, going distal from an attempt above, not looking at the side of the wrist (i know anaesthetics like hands) tourniquet placement could be better if he is going to use hand. Second attempt, erm he is barely taunting skin but not anchoring vein, and yeah that is going to bruise... I cant see if bevel is actually pointing to patient (this was painful to watch) - if this were me i would start elsewhere and certainly not try hooking it up to a line. if it is just for fluids maybe reevaluate the needle size? - attempt 3 is he withdrawing the needle before threading it ?! (oh now there is a choice E) - i am not sure the experienced operator should suggest the volar side of the wrist (some policies may prevent nurses from going there also). I dont always like bending the needle, but positioning oneself to have a better view of the angle helps (being tall i can hover above giving the wrong perspective)
Great comments! Greetings!
@@DRBLUESNYC Hello, doctor! Small suggestion: when you pose your questions, you do not realize that only experienced specialists may answer and explain what is being done wrong. The rest of us… well… have no clue and do not understand what is going on. The better way of teaching newbies would be explain mistake at every stop with posing the video. The very same way when you circled hematoma. Seriously. For example, look: needle went too deep. That is why we can see this and that. Or student is holding needle too low, or student did not wait 3-5 sec for blood to return… Or look how it could be corrected while in the vain…. not with a new stick. If you really targeting students, explain wrong movements. Sometimes, explanation of correct techniques is not enough.
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/
This is probably an unconscious patient
Does the speed of insertion affect it? I always thought it was better to go slow, that way you don't accidentally push it through the other side.
That's my concern too
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Hello! I’m looking for the follow up video, but couldn’t find? Thank you
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/
I have very difficult veins. They are very tiny and uncooperative. Even when they are visible.
Good video. Very annoyed he didn’t answer all the questions he posed in the video though like dude I’m clicking this to find answers because I already have questions!
Hi! What questions would you like answers to in particular? We might be able to organize something :)
@@nysoravideo what went wrong with the 1st ans 2nd attempt and why was there haematoma formation?
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hi. my wife is hospital last week.. they draw bloods thru iv in her one hands with extension. at 1st there is blood,then 5 seconds it stops. then the nurse use a syringe to draw more blood ..she pull the syringe but still no blood, the syringe just get back to original position. does it cause air embolism?
Not enough air to kill.
You need A LOT more air than that, A LOT.
The angle of entry into the skin should always be steep. Parallel entry into the skin is extremely painful. At 4.57 you can see the experienced person had a split moment where the entry angle was about 30 degrees but the learner was literally scraping along the skin.
Sometimes steep, but not always. A second stick due to backwalling the first attempt is arguably more painful than one shallow angle attempt.
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/
The catheter bending technique doesn't always work...the stylet might not come out of the cannula after insertion!!!
What is your technique for insertion of IV cannula in veins in guttural/sunken surfaces [due to lack of other feasible veins]???
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excellent
Thank you! Cheers!
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Cephalic is natural splint. Just don’t start at flexion point
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I struggle alot for hand iv insertions. Everything I've seen in the video I have done by mistake and I am trying to learn from my mistakes. Will there be a follow up video to discuss this in more detail. Please and thank you very much! -nurse
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The first person did not withdraw the needle when it just entered the vein and simultaneously he did not insert the tube into the vein. First person inserts the needle more than 50% which makes the person fail in IV cannula insertion. The second person removes the needle and simultaneously push the tube into the vein, which makes him successful in IV cannula insertion. ❤😊
What about drawing on harden veins
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is the patient conciou or onconciou?
Gostei muito
Thanks for cc
Any time!
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Some good free acupuncture on display here :-)!
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Brings back ER visits from DTs with alcohol vein scaring dehydration and getting an IV on the sixth try cause I couldn't stop shaking they keep rolling it is what they said 🤔?
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The patient really tried
Personal experience is that I just imagine the catheter inside the vein and try to follow it
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I never see someone bending a catheter before insertion! Is it safe? Could you please give some information or bibliography about it? 🙏
Hi there. Not all techniques have made it in publications.
Yes, this techniques exists.
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Well done sir.
Pls sir I want to ask you questions
Hi Samson! Glad you are enjoying the content. Thank you for your comment!
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The last attempt was skilful and I really like that method and I used it almost during iv canulation
Hi Rn Hasan, Glad to know this and thank you for sharing your experience. Greetings!!
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Why faster insertion is required? Could anyone give reason
This makes the process of puncturing easy which will create less pain and also this gives no time to slip the vein.
@@sohanlalpoonia7993So does proper stabilization and tensioning of the skin prior to insertion. I always tension the skin and stabilize. This reduces pain significantly. Furthermore, going fast can result in puncture of the vein. I tension and stabilize by folding down the knuckle and drawing skin tight below knuckle. Then, I go in slowly at shallow angle (don’t scrape the skin, as in this video) and stop at flash. Once I have flash, I further drop angle to parallel that of skin, insert a mm or two to ensure catheter in lumen of vein, and then liberate catheter from needle.
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I like the format in general, but the loud music in combination with the questions thrown in makes it very gameshow-y, for lack of a better term. Just my two cents though.
Hi Marc - THanks a ton for the feedback! I have to agree with you. Greetings!
And....would love to hear a recommendation on the use of music - YES< NO
@@DRBLUESNYC either no music, lowered or benny hill soundtrack
@@DRBLUESNYC No music or very soft. Thx!
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This person has great veins
What facility and country are these IVs being done? I have NEVER seen anyone recommend bending the needle and catheter, and nowhere is it recommend in any standards of care for nursing IV protocols and procedures. We also don’t choose an IV site at the wrist that will be situated right at a bend. That’s a terrible location.
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There is nothing frustrating than unable to cannulate easily visible veins. Even though those jutting out very superficial juicy veins are very inviting, they are very tricky. In my experience they are very superficial and hardly any gap between skin and vein. They can easily slip away from where you punctured. In my experience stabilising lax skin from either side of the vein helps.
Can't talk to anyone but this is vary important for madical students 👀
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A suitable vein and a suitable location must be chosen
Those veins are huge compared with some.
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2nd attempt: needle was too medial (towards 5th finger) and tried to advance catheter while not intravenous. 3rd attempt: needle was too lateral (towards the thumb) and again tried to advance catheter while not intravenous (needle tip may be intravenous but not the catheter).
Needs more practice. With more practice, technique will improve.
We really appreciate your feedback! Thank you!
Hayirli mesailer değerli meslektaşlarim,
Terminolojik olarak elde "medial"den bahsediyorsak orta parmağa yaklaştıkça "medial"leşiyoruz demektir. Video ve yorumlar için teşekkürler..
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Vein detector is good instrument
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I don't think it was mentioned on the video, but my instructors don't want me to reinsert the needle into the catheter so we don't risk cutting the catheter and releasing a fragment into the bloodstream.
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Good thx sir
Is it true you can’t go lower in the arm after missing higher up on the arm? I’m a new practitioner
Its to avoid hitting the same vein. If you puncture it higher up and then insert lower, the drugs/fluids can potentially "leak out" from the puncture.
You CAN go lower, provided the ozzing/bleeding from the proximal attempt has been stopped. Greetings!
No such rule. It was likely invented by a 'pseudo expert'. I guess the only caveat is how much lower are you going? If it is 3 cm more distal to the site of insertion then that's not ideal.
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/
Good grief... Some people need to be remediated...
Yez this is how i get iv all the thime ...on top of my hand it takes them 5-8 times very painful they used my foot one time hurt like hell...my hand still gets knomb at times sad this hurts
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In the beginning, to me the bevel appears sideways, they didn't wait for blood return, the practitioner need to go up further and don't stick directly on the bifurcation and they need to stabilize the vein and wait for blood return.
Hi there! Thank you for sharing your experience with us. 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/
Why there is no tourniquet?
Hi there! The tourniquet was used - just not visible in the video. Greetings!
@@DRBLUESNYC I was wondering about that too
Sometimes you dont need tourniquet for massive veins. :)
If a vein is already engorged on it's own, sometimes having a tourniquet will make the vein even more prominent and therefore more likely to roll away from you. I've also heard that being over-filled can make the vein more likely to rupture. At the end of the day the tourniquet is just a tool in the toolkit to be used as needed.
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do Radiologic Technologists do this procedure?
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Thought second one is correct to the intra
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Patients who are edema or have H/D, their veins always are hardest to on
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The needle is large
1 the May tried and removed the inserts catheter must keep in until next found
2 they started from the ankle of the vain and it isn’t in vain shouldn’t be flashing 😮 but must stay in.
3 all of above
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That was painful to watch 😬
Might be, we understand that! But pretty much needed to improve our technique.
Angle of insertion is too shallow on missed attempts.
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🙏💯 Thanks
You're welcome
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