Having IVs Placed

I have to get an IV placed every few months and have been doing so for a couple years. When this began I expected that there would be no problems because I've been climbing for so long and my forearms have plenty of vasculature. Well, quite the opposite seems to be true. Nurses place the IV and usually each visit requires two or three attempts before a successful stick because most often what happens is they can't get blood out. Needle in and nothing out. Or the vein "rolls". 

Today was five before they producing vein. Anyone else experience this? Wouldn't all the forearm exercising give me great flow and access?

You have shitty nurses. People that lack skill in IVs or blood draws always blame the PT or the gear (a lot like climbers) not themselves Veins don't roll if you take positive control of them. I have a strict two missed pokes and get someone better then me (nurse anesthetist or anesthesiologist.) If they miss more then twice refuse treatment until they get someone better skilled to take care of you.

Yeah, when they miss, they will hand off. The more curious issue is they get the stick but they either get just enough to partially fill a tube and then it just goes dry, or nothing at all. Seems to occur a lot. Eventually they find one that delivers

I agree with what Deven said. I would also add to come in well hydrated.

Deven Lewis wrote:

You have shitty nurses. People that lack skill in IVs or blood draws always blame the PT or the gear (a lot like climbers) not themselves Veins don't roll if you take positive control of them. I have a strict two missed pokes and get someone better then me (nurse anesthetist or anesthesiologist.) If they miss more then twice refuse treatment until they get someone better skilled to take care of you.

This. Two tries then someone else. Five sticks from one person is crazy.

Deven Lewis wrote:

You have shitty nurses. People that lack skill in IVs or blood draws always blame the PT or the gear (a lot like climbers) not themselves Veins don't roll if you take positive control of them. I have a strict two missed pokes and get someone better then me (nurse anesthetist or anesthesiologist.) If they miss more then twice refuse treatment until they get someone better skilled to take care of you.

Veins definitely roll and some people are harder to stick than others.   You can try and anchor the vein all you want but sometimes it’s just really tricky.   I’ve had really good luck if I couldn’t get a line in the arm with feet and blind sticks between the fingers but those were under emergency situations.  If I were in a clinical setting with good lighting I would definitely take my time and go for something in the arm for the patients sake.   There are some really cool devices these days that some medics are using that show the vein using thermal imaging or something like that.   A device like that might help in the case of the OP but then again that’s the clinics issue not his.  

What is probably happening is diagram #2 they punctured straight through the vein they got flash back but no to little blood flow. They need to re stick you no way to salvage this one. Possibly diagram 4 but that's an easy fix just drop the bevel and they're good.

Tony Bob wrote:

I have to get an IV placed every few months and have been doing so for a couple years. When this began I expected that there would be no problems because I've been climbing for so long and my forearms have plenty of vasculature. Well, quite the opposite seems to be true. Nurses place the IV and usually each visit requires two or three attempts before a successful stick because most often what happens is they can't get blood out. Needle in and nothing out. Or the vein "rolls". 

Today was five before they producing vein. Anyone else experience this? Wouldn't all the forearm exercising give me great flow and access?

My wife is real good at this, she was the senior doctor in Germany's biggest intensive care unit for premature babies. Still can't cook though.

It’s good to see armchair quarterbacking goes on in nursing, just like in climbing.
You don’t have to expand, but are you taking steroids or another medication that’s going to make your veins more brittle over time? making it easier for the catheter to just go straight through? You’re obviously going in for something chronic, so over time there will also be scar tissue developing around the veins if the nurses are going for the same spot over and over again.
Go in well hydrated, suggest places others have had good luck, ask them to get the vein finder before poking randomly. Rotate sites as much as possible.

B P wrote:

It’s good to see armchair quarterbacking goes on in nursing, just like in climbing.
You don’t have to expand, but are you taking steroids or another medication that’s going to make your veins more brittle over time? making it easier for the catheter to just go straight through? You’re obviously going in for something chronic, so over time there will also be scar tissue developing around the veins if the nurses are going for the same spot over and over again.
Go in well hydrated, suggest places others have had good luck, ask them to get the vein finder before poking randomly. Rotate sites as much as possible.

I'm not saying they're shitty for missing. Everyone misses even very experienced nurses they're shitty for not admitting they lacked the skill to treat the PT. 

You may be building up scar tissue if they are constantly going for the same spot. Switch up arms and locations of where they poke you.

I get an IV every 6 weeks constantly told my viens look amazing then still get two or three pokes everytime from a variety of nurses. 

Bill Schick wrote:

This is a blood draw and not an infusion?  Make sure also the tourniquet is tight.  Vein is return flow - blocking off that flow is what makes blood come out of the needle.  

3 sticks is bad.  Really bad.  5 sticks and someone nearby not jumping in to save you and I'd write off the entire facility.

It's an infusion but they'll draw labs prior. I'll admit I went in dehydrated. Five sticks is a new record but there are sometimes, not always, one dry stick. 

The drug is a "-mab" and I do ask them to rotate sites otherwise they'd all go for the juicy left AC. 

Next time I'll hydrate better and maybe hangboard before going in :p

I tried to do a CBD clinical trial and they stuck me about 15 times in my arms and my hands before telling me I couldn't do the trial. They told me I was dehydrated even though I felt fine and had been drinking water. Not sure why it was so hard to get blood from me.

Dang y’all! I’m 21 and have been getting Remicade (infliximab) with a blood draw prior every 6 weeks for the past 7 years and my nurses have almost never missed a vein.
Didn’t realize how lucky i am.
I could not imagine having to get multiple sticks each time. maybe find a nurse that you like and does a good job with your veins and try to schedule visits when they can work with you. It’s reassuring for me seeing a familiar face and knowing how their systems work.

Not all IV gauges are the same. For blood draws and small injections, my veins are fine. When I went in for open-heart surgery it was a different story. The gauge of the needle was so big because they needed to inject such a variety of drugs—the IV had like five ports—and the valves in my veins were so robust, and there were more valves than a typical patient because the circulatory system in arms had developed to handle the extra lactic acid buildup while climbing, that the fat needle couldn't fit through the valves. It took the experienced nurses so many tries to get the IV started. They eventually gave me a local anesthetic so that they could shove the thing home, valves be damned. I'm feeling that terrible sensation in my left arm all over again as I write this.

I draw blood for work and I have definitely not been able to get someone after the third try and had to pass off to another person. Just becuase you have very visible vascularity doesnt nesscarily mean you will be an easier stick. I have found that those big forearm veins can role out of the way and be very frustrating to hit. As the needle enters it can a force the vein aside instead of entering. Really firmly anchoring the vein with your fingers and coming at the vein from the side instead of straight down has been an effective strategy for me. That's not something you have control over, but just be aware that a big vein doesnt equal easy stick. 

For you, most people have already mentioned some obvious stuff like being well hydrated and finding a nurse that's good. Another tip is to place a hot pack on the area the nurse is planning to stick you. The warmth will bring more blood flow to the area and plump up your veins for an easier stick. As a patient you have the right to request a different nurse try, request a hot pack, and ask for water. Its always a good idea to let the nurse know about previous problems with getting access before they start trying that way they can strategize. Remember you are your own advocate. 

I’m really good at not getting IVs. Some people are really good at getting them. Have at it, good people, and thank you very much. I really dig our IV Team, yes, even fucking Bryan. He’s grown on me.

Bill Schick wrote:

That sounds serious for a 35 yr old - I hope you do well with the treatment.

Thanks. It's lifetime but pretty well managed. Certainly better than the alternative, or lack thereof.

Funny thing, and I think there's a thread on here somewhere, I used to have a port and would climb with it. I loved that thing. Except for the constant fear of having it ripped out

I have Cancer. I've had over 80 IV sticks in the last year. During one hospitalization i received a PICC line because my arm veins were collapsing, and hardening. The PICC line was awful in its own way, being through the bicep and dangling hardware attached to the arm, but better than having more veins collapse due to bad sticks and vein destroying drugs. 

Then i received a very good solution; A chest port. I wish I had known and it had been offered from the get go. Fantastic, easy access, no more peripheral vein trauma. I was concerned about whether it would be a problem under a backpack strap, but since I specifically asked she placed it where it would not be a problem... can't wear a sternum strap though. It is in the wrong place for seatbelt when riding passenger, but I usually just drive. 

I will keep this as long as possible while any chance remains that I need lab draws, infusions and transfusions. That you need lifetime access, I would check into it.

Doh! Now I see your previous post.. wondering why you had your port removed?

mountainhick wrote:

I will keep this as long as possible while any chance remains that I need lab draws, infusions and transfusions. That you need lifetime access, I would check into it.

Isn't long term infection a concern? I think that is an issue with people who get kidney dialysis but correct me if I am wrong. Also when you botch the top out of a boulder with a body snail move you will look super legit when your covered in blood!