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notesivexcuses ( ** )

Intravenous catheter placement excuses when the vein is blown

We all miss IV’s occasionally, but the excuses which are offered for the missed IV can be very entertaining.  I have heard all of the following excuses:

  • “The vein rolled.”
  • “The vein was too squiggly.”
  • “The catheter hit a valve.”
  • “The vein was too small.”
  • “The vein had a curve in it.”
  • “The vein was crooked.”
  • “The IV needle wasn’t sharp.”
  • “The needle was dull.”
  • “The vein collapsed.”
  • “The vein ballooned.”
  • “The vein was too deep.”
  • “The catheter just wouldn’t thread.”
  • “The catheter was too stiff.”
  • “The patient moved.”
  • “We have a bad batch of catheters!”
  • “The vein wouldn’t accept the catheter.”
  • “I missed because Dr. Taylor was watching me.”
  • “Dr. Taylor likes to come in and ‘show me up’ if I don’t get the IV started.”
  • “Oh sure. You used that vein? I could have started it in THAT vein!”
  • “The catheter was in the vein, but when I began the flow of IV fluid, the pressure blew the vein. The patient told me her veins tend to do that.”
  • “The other nurse distracted me.”
  • “I used a tourniquet and I shouldn’t have!”
  • “This box of IV’s is old and out-of-date.”
  • “The patient had a vasovagal reaction just as I entered the vein with the needle, and the vein literally exploded.”

Three keys to successful IV starting:
1) Vein stabilization
2) Angle of entry
3) One-handed threading of the catheter, while maintaining skin tension

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