How to start an IV: Dorsum of hand

As an oncology nurse, I'll give you all a little trick for when you insert an IV in a hand or near the wrist. Put the patient's arm on a table or armrest and ask him/her to grab underneath the table. The wrist is now flexed and the skin is pulled so you can see the vein better and your thumb isn't in the way :)

Because the needle’s bevel sticks out a little farther than the catheter, you have to advance the needle a little further after you get a flash. If you advance the catheter as soon as you get a flash, the catheter is likely not yet in the vein and you will probably push the vein off the needle, missing it completely and causing pain and bruising to the patient.

As an RN, also get your syringe read, burped, etc. if using an extension set, prep and burp air out. Apply one 3”x 1/2 inch tape under wings of catheter so that once in vein, you can fold like a butterfly and hold cath down. Also, super important, determine that the location in the vein is not in such a location that it will protrude past their knuckles. Ie, when their fist is clenched, it sticks out. That situation always ends badly with it getting caught on blankets, trays,toilets. Consider use of non dominant arm, and possible going on dorsum of forearm to keep it more protected. Also a flashlight can be helpful in finding a vein, along with alcohol wipes. PLEASE clean the skin more and look several times before trying. Do it right and once. They will thank you.

This video is particularly valuable because it focuses on the dorsum of the hand. For a lot of practitioners it’s the antecubital fossa or nothing. In the field I’ve seen, more than a few times, someone spend twenty minutes looking for a vein when they could have used the hand and had fluids flowing in five minutes.

Before you flush the saline, its always good to pull back on the plunger to make sure 100% you're in the vein. Blood will flow back into the flush, if you are in.

In my experience I would rather spend time choosing & prepping in order to stick once. If the patient seems to be getting the impression that I don't know what I'm doing I reassure them. Working on an IV team taught me that :)

"Don't spend too long looking for a vein." Um no. I will take my sweet time and stick once I am confident I have found a good vein. I would much rather continue to communicate with and reassure my patient than be hasty and have to stick them multiple times because I'm worried about their impression of me.

the real pain will be when removing that surgical tape off a hairy hand.

I love watching this💖 It gives me inspiration to pursue med school... Im from the Philippines, 💖God bless

That retractable needle was the coolest thing I've ever seen.

I just got out of the hospital and this video was more respectful then actually getting it done they poked me 3 times trying to start a iv because my veins are so small

Being a med student in this pandemic is challenging...thank you for this video

The digging for vein not gold comment made me laugh so hard 😂. ♥️

Thank you guys for a concise video without all of the frills and extra. You rock.

“I typically hold the vein..” 4:27 I almost had a heart attack.

My biggest tip for new IV placers is don't doubt while putting the needle through the skin. Puncture the skin in 1 smooth and quick motion. I had 1 nurse who was new in placing IV's and she took atleast 5 seconds to pierce through the skin. This was absolutely horrible, so yeah, don't do that

Watching this to desensitize myself to needles puncturing veins

I am 57 years old and had Lupus since I was 17 years old....only ONE time in my life did someone start an IV and was painless. So many are clueless on how to start an IV.....they need better training I think and love what they do. It would help a lot!

I always had a hard time with hand IV sticks. This was very helpful. Thanks, Med School Made Easy!

When he pulled the needle out before removing the tourniquet, I almost screamed! That could end in a bloody mess! You don't need the tourniquet on anymore after you've advance the catheter. Ah!