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Had an instructor tell me once that in his world he found it to be cyclical. He could go for 6 months and hit every attempt, first time. Then he'd go for 6 months and not hit a one. Essentially, don't stress over it. You'll need more than 20 to get comfortable with your technique.

What I've found is that I have to find the vein. If I try to go for a vein that someone else finds for me, I miss them. They have a different vantage point/light source so if you shoot for that - you'll need to move to where they are standing.

Also, right now, I'm working with an EMT partner who apparently is a jinx. If he is on the truck with me, I miss first time...every time. So, I've been having him start the drive or simply step off the truck and we are good. Odd.Funny maybe. True. :D

Edited by tcripp
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Its all about confidence, not skill, so keep at it, it will come to you (assuming you know basic vein anatomy).

I kinda agree with this. While there is some skill involved, a large portion of the process comes down to confidence. In the beginning it can be tough to just go for it and stick someone. After all, you are puncturing your patient with a sharp object, many people hesitate when they are new to IVs. Find the vein and advance the needle with confidence. If you advance it slowly you are often causing the patient more pain and sometimes resulting in an uncessful stick.

Another tip is to make sure you are pulling traction when you advance. Veins can get pretty squirly and move around. Apply traction below the site to make sure it stays in place.

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Also, preparation is 90% of the battle. Make sure you have all of your setup convienetly available. Your drip tubing primed and flushed. Whatever you want to use to secure the site ie. Tegaderm or tape. INT. Flush. Or any vacutainers and tubes you may need if you are drawing a blood set.

When you get your own style you can even get nifty and get your glucometer sample right from the catheter before you plug any saline in.

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In my experience, IV's are all about practice and repitition. I can honestly say that its difficult for me to tell someone exactly what I do to make me successful in starting one. There are numerous variables that I consider subconsciously, simply because I have started hundreds, perhaps thousands of them over the years.

The best advice I have ever had from an experienced partner was simply, make your first attempt your best attempt. Meaning of course, find the best vein possible for your IV, get the line, and move forward with your Tx plan.

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