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Where to place an IV.....


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71 replies to this topic

#1 FireEMT2009

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Posted 13 November 2011 - 07:01 PM

You are treating a patient with constant contractures bilaterally at the elbow and wrist levels. Both of which would occuld IV sites. You need to start a line and give some fluid due to hypovolemia. I was thinking of the forearm are the upper arm/ shoulder area. Where would ya'll stick? I had a patient like this and was just getting an opinion from more experienced medics. Thanks

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#2 Vorenus

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Posted 13 November 2011 - 07:03 PM

Forearm, possibly. I`d also take a look at the foot.
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#3 FireEMT2009

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Posted 13 November 2011 - 07:07 PM

Forearm, possibly. I`d also take a look at the foot.


I checked the foot and did not see any suitable places for venous access. I was looking at the forearm because the contractures would not occulde the IV sites.
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#4 romneyfor2012

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Posted 13 November 2011 - 07:08 PM

It is always best to start distal and work your way in. Even with contractures, you may still find good veins in the hand, forearm and upper arm. You need to practice finding veins by feel instead of using vision, Do this:

Put a tourniquet on your partner's arm, blindfold yourself with a triangle bandage or just close your eyes, and see how many veins you can find by "FEEL ONLY". Once you get good at that, you will find veins on 99% of patients that others can not find.

Nurses will freak out, but i have used feet/leg veins when I had to, but then after they miss the next 3 sticks and put in a central line, they are glad i gave them something to use until the central line was in. Vein anatomy is generally the same in all people, so if you know where the veins are supposed to be, and learn to use your fingers instead of eyes, you should be great at IVs.
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#5 FireEMT2009

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Posted 13 November 2011 - 07:14 PM

It is always best to start distal and work your way in. Even with contractures, you may still find good veins in the hand, forearm and upper arm. You need to practice finding veins by feel instead of using vision, Do this:

Put a tourniquet on your partner's arm, blindfold yourself with a triangle bandage or just close your eyes, and see how many veins you can find by "FEEL ONLY". Once you get good at that, you will find veins on 99% of patients that others can not find.

Nurses will freak out, but i have used feet/leg veins when I had to, but then after they miss the next 3 sticks and put in a central line, they are glad i gave them something to use until the central line was in. Vein anatomy is generally the same in all people, so if you know where the veins are supposed to be, and learn to use your fingers instead of eyes, you should be great at IVs.


99% of the time I will feel for veins more than relying on sight.

Wouldn't the contractures inhibit the ability of the IV to flow due to compressing the veins?
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