How to make an IV poke more successful?

JanJan63

Apparently I have small veins and I'm a 'hard start'. I've had issues in the past where they've had to get a pedo nurse in or been poked several times until they get one that works. I've asked the if there's anything I can do but they don't really have any suggestions. They make me do the fists and put hot towels on my arms or get the 'expert' to do it but it's still very hard.

I make sure I'm hydrated and yesterday I hung my left arm down while I was waiting and she managed to get it on the first try. Does anybody have any other suggestions? I hate needls and I'm a big baby about it and I'm ashamed to say that I often cry because I get anxiety and its embarassing. I can't use the cream that numbs it because I never know where they're going to put it in. When I had the port I found that it didn't really help anyway.

Any suggestions? I have two more treatments this time and then am getting a break and then I think I'll be back on it for another stint. I dread the pokes.

Thanks,

Jan 

abrub

Ask about a port

If you're going to get more treatments,  ask about getting a mediport. They don't have to find the vein and you can use numbing cream so you don't feel the needle. 

NHMike

They used to go after my

They used to go after my right arm all the time and even did the back of the hand thing until my right arm made it look I was a junkie. I have an old injury and can't straighten my arm completely (15 degrees from straight is the best I can do). So a while back an IV nurse suggest the left arm and that was easier and I've been getting it done on the left arm since. It makes life a little easier as my dominant arm doesn't have the tape and gauze to restrict it.

JanJan63

No port please

Thanks Abrub but I've had a port and hated it. I had to have it removed when it started coming out through my skin. Plus it's still a poke. And half the time mine had issues and I'd have to do things like march around the room or cough over and over to get it working. Plus you have to go get it cleaned on a regular basis when it's not in use and that's another poke. Not to mention that when they inserted it they screwed up and hit a nerve and caused a panic and it was incredibly painful for days after. Plus it bothered me when the seatbelt was across it and I'd cringe when people went to hug me. Sorry, I just hated mine and was so happy when it was gone. My onc offered to line me up for one if I wanted last tme I was there.

As for the cream, I never know where they're going to poke and it takes about 15 mnutes to work. Plus they keep a hot towel on until the last minute so it would probably wipe it off as the towels are wet.

Thanks NHMike. They have been using the same arm most of the time because it seems to be more successful. My veins are completely invisible, I can't see anything, not even the colours. They like trying my hands but they hit a valve every single time so now I tell them not to bother. Apparently some are rolling veins as well. 

I was thinking about something like making sure I'm hydrated, which Im already doing. But I can only drink so much because we have an hour drive to the hospital and I'll have to stop and use a bathroom. I know there are little tricks for some things that doctors don't know like the eating a marshmallow before you change your ostomy bag to lesson the chances of the stoma leaking while you're doing it.

Jan

 

abrub

JanJan63 said:

No port please

Thanks Abrub but I've had a port and hated it. I had to have it removed when it started coming out through my skin. Plus it's still a poke. And half the time mine had issues and I'd have to do things like march around the room or cough over and over to get it working. Plus you have to go get it cleaned on a regular basis when it's not in use and that's another poke. Not to mention that when they inserted it they screwed up and hit a nerve and caused a panic and it was incredibly painful for days after. Plus it bothered me when the seatbelt was across it and I'd cringe when people went to hug me. Sorry, I just hated mine and was so happy when it was gone. My onc offered to line me up for one if I wanted last tme I was there.

As for the cream, I never know where they're going to poke and it takes about 15 mnutes to work. Plus they keep a hot towel on until the last minute so it would probably wipe it off as the towels are wet.

Thanks NHMike. They have been using the same arm most of the time because it seems to be more successful. My veins are completely invisible, I can't see anything, not even the colours. They like trying my hands but they hit a valve every single time so now I tell them not to bother. Apparently some are rolling veins as well. 

I was thinking about something like making sure I'm hydrated, which Im already doing. But I can only drink so much because we have an hour drive to the hospital and I'll have to stop and use a bathroom. I know there are little tricks for some things that doctors don't know like the eating a marshmallow before you change your ostomy bag to lesson the chances of the stoma leaking while you're doing it.

Jan

 

I also used a Lidoderm patch when getting IVs

After I was done with chemo, my veins were so painful that I couldn't tolerate having blood drawn or an IV of any sort (not the needle stick, but the actual presences in my vein of the needle or tube.)  I requested and started using Lidoderm patches.  I'd cut them up and put them on the night before on the several areas they were most likely to stick me for my IVs (for CT scans and all) or for blood draws.  That helped tremendously.  Chemo mucked up my veins so badly that when they put in the IV for sedation for my port removal, I couldn't tolerate it.  I was in tears from the pain.  They removed the IV, and removed my port with just local anesthetic (which was fine for me.)

JanJan63

Ew, that sound horrible! My

Ew, that sound horrible! My veins are damaged, too, so they say. I didn't know they did the port removal with sedation. Mine was local when it was placed and when it was removed. So I got to see the pandemonium when they hit a nerve and my heart went nuts. I'm sorry that it hurts so much for you. Like having cancer isn't bad enough, we have to have all these crappy little extras.

Jan

tanstaafl

sticks

What style, gauge and brand of needle are they using ?   

There are differences that matter.  With the smallest needles, flow rate can become an issue.  Sometimes wife needed more bag height with pediatric butterfly.  The brands and styles matter because there is a special polished, double bevel finish that aids insertion, sliding in easiest that was developed by Becton Dickinson decades ago but not uniformily available and makes manufacturing more expensive.  Some BD adult catheters may not have small enough versions eg. smallest is 24 gauge, no 26, 27 or 28.

I think they play with blood sugar levels, and also with outrage, veins can stand out.

Perhaps the facility needs the imaging vein finder to image the veins better, or find better spots.  

Experts and ped sharpshooters vary greatly.  She can get fobbed off in the hospitals and has to crack a whip to find someone who can do it for IV constrast on scans, ready to walk out. My wife had one IV nurse that stood way above all others, made a science of everything, studying each move and keeping notes. A total pro.   Of course, then they also  got a better offer a long ways away and moved away...

NHMike

JanJan63 said:

No port please

Thanks Abrub but I've had a port and hated it. I had to have it removed when it started coming out through my skin. Plus it's still a poke. And half the time mine had issues and I'd have to do things like march around the room or cough over and over to get it working. Plus you have to go get it cleaned on a regular basis when it's not in use and that's another poke. Not to mention that when they inserted it they screwed up and hit a nerve and caused a panic and it was incredibly painful for days after. Plus it bothered me when the seatbelt was across it and I'd cringe when people went to hug me. Sorry, I just hated mine and was so happy when it was gone. My onc offered to line me up for one if I wanted last tme I was there.

As for the cream, I never know where they're going to poke and it takes about 15 mnutes to work. Plus they keep a hot towel on until the last minute so it would probably wipe it off as the towels are wet.

Thanks NHMike. They have been using the same arm most of the time because it seems to be more successful. My veins are completely invisible, I can't see anything, not even the colours. They like trying my hands but they hit a valve every single time so now I tell them not to bother. Apparently some are rolling veins as well. 

I was thinking about something like making sure I'm hydrated, which Im already doing. But I can only drink so much because we have an hour drive to the hospital and I'll have to stop and use a bathroom. I know there are little tricks for some things that doctors don't know like the eating a marshmallow before you change your ostomy bag to lesson the chances of the stoma leaking while you're doing it.

Jan

 

It can also be the skill of

It can also be the skill of the IV Nurse. I've been poked a lot the past three months as you can imagine but the last time was quick and easy. She was an older lady and asked the right questions and listened to my suggestion on using the left arm.