IV Inservice Tips & Tricks
04 Feb 2021
Exude confidence - Believe in yourself and reassure the patient you know what you’re
doing. The patient will be encouraged by your confidence and you too, of course. This
will help the patient with calmness during a time they’re not feeling well and anxiety
may be high.
Assess for needle Phobia - Needle phobia is a response as a result of previous IV
insertions, usually gone wrong. Symptoms include tachycardia and hypertension before
insertion. On insertion bradycardia and a drop in blood pressure occurs with signs and
symptoms of pallor, diaphoresis, and syncope. Reassure the patient with a soothing
tone, educate the patient, keeping needles out of sight until the last minute before use,
and use of topical anesthetics can help manage needle phobia (especially peds).
Assess the vein & Skin - Before inserting a needle into a patient’s vein, you
have to assess its condition first. A well-hydrated person has firm, supple, and
easy-to-reach veins. Well-hydrated veins are bouncy, making them the right fit
for insertion. These 2 combined will provide optimal rebound. Some patients
need IV therapy, but are dehydrated, so it is a challenge to hit the vein in one
go. To avoid injuring the vein, always assess first that you are aiming for a vein
that is not frail enough to blow up during the insertion. Take your time.
Feel rather than look - If you can’t see a suitable vein, trust your fingers even
more than your eyes. Sometimes the better veins are felt and not seen. Closing
your eyes while assessing rebound can help you better assess the feel. It’s also
an excellent opportunity to familiarize yourself with a suitable vein. A tendon
may feel like a vein but palpating it through a range of motion may prove that it
is not.
Ask your patient - The patient may know more which veins are suitable based
on his previous IV history. They know their body better than anyone. Especially if
they’re chronically ill, they will know popular locations of other medical staff.
Anchor The Vein – Veins tend to run away from needles and patients tend to
jump or squirm once the needle hits the skin. You can ensure your vein doesn’t
move by anchoring it BELOW your intended entry point.
Make the Vein More Visible –
 Gravity is your friend - let the arm dangle – this promotes venous filling & slows return
 Use warm compress - Apply warm towels or fill a glove and tie it. Let it sit on the skin for
10-20 minutes prior to insertion. Warm temperatures dilate veins and push it to the surface
 Do not slap the vein –Veins have nerve endings that react to painful stimuli causing them
to contract. Instead, flick or tap the vein. Use tourniquet, palpate & w/ the same finger
gently tap the vein to cause rebound and flow without contraction.
 Flow where you want it to go – When disinfecting the insertion site, rub the alcohol pad in
the direction of the venous flow. This will improve the filling of the vein by pushing past the
valves. (Use this method in conjunction with dangling for better results)
IV Inservice Tips & Tricks
04 Feb 2021
Use the best size for the situation – Below is a chart I have found helpful.