Tuesday, 27 March 2012

IV Start Class

WARNING: Graphic Images to follow of actual blood and IVs!!
I mean, of course we didn't cause anyone to bleed... that would be cruel!  
It's all fake, just tell yourself it's all fake and you'll be fine.
Or you might just want to skip this post if that kind of thing bothers you.
Consider yourself warned!
Oh, and this is also NOT a tutorial... just a fun photo essay of our day a few weeks ago.

On this beautiful hospital ship in west africa, dozens of cultures meet on the wards.  We have nurses trained in many different countries, including Norway, Germany, Switzerland, England, Ireland, New Zealand, Australia, USA, Canada and South Africa.  With this many countries, there are many different training styles, kinds of experiences etc.  Some of our nurses come from jobs where they start IV's (or cannulate) daily.  Others haven't put one in since nursing school, and still others were never taught to start an IV.  Here, we start IVs regularly.  I love it.  
I mean, I enjoy the skill.  It's satisfying.  Immediate results.  I'm a nurse, I love my job, is that so bad???

Ahem, moving on.  We need to help some of our nurses gain skill/courage to insert IV cannulas.  So our lovely educators, Laura and Laura organized an afternoon IV start class.  Basically, whoever wanted to learn or teach or be a pincushion (hey, someone has to get poked!) showed up at the appointed time, and we all went to work.

Some people set themselves up on mattresses on the floor.

Others were lucky enough to get to sit by the table, or use a wheelchair or other sitting area.  It was a small space, but well used.

First step was gathering supplies and setting up a clean surface, such as the bluepad on the desk above.

Then comes a little bit of teaching and a willing volunteer.

And finally it's time to find a good vein.  Check out both arms, sometimes one has more obvious "good" veins than the other.

It helps to have a nurse as your volunteer, she usually can tell you all of her best veins and what approach to use.  Putting the tourniquet on helps to fill the veins and make them "bounce" better.

Sometimes a little discussion helps to decide on the best spot.

Sometimes you can find the vein before putting on a tourniquet!

Once you have an appropriate vein, clean the site and off you go!  (okay, there's a LITTLE more to it than that, but this isn't an actual tutorial)

Rope-like veins that show up like thick blue roads under white skin are really helpful for the first-time IV starter.  Unfortunately, this may give false-confidence to those who then go to try and start one on a dehydrated person who has skin so dark you can't see the vein through their thick sun-damaged skin.
Sometimes people just have to ham-it-up for the camera.  

Successful IV start (Josh may have had the MOST IV starts of the day... pincushion with great veins!)

Another success!

And another!

Tape it down, add extension tubing, and date your IV.  Finished.
Now that everyone is getting good at IV starts, it's time for some fun!
IVs are measured in gauges.  24G is used for small infants, even premature babies.  20G is used for a lot of adults for IV fluids.  18G is used for surgery and CT scan patients.  16G is for when you give blood, or if you've come into the ER and they need big IVs to give you lots of fluids etc.  14G is rarely used, but is practical for emergencies and for giving blood.
My friend Anna decided she needed to increase her comfort with 14G.  And she had a willing volunteer!
Intense concentration...  you can do it!

Success!  IV is in, needle being pulled out.

Apparently, a 14G is a HOSE and you need SIGNIFICANT pressure in order to stop it from bleeding out until you are ready to attach tubing to the cannula.  Anna was somewhat shocked at the mess she was creating!

Bleeding stopped, needle out... Everyone is fine.

Here's a reference for size!

Starting Jugular IVs?  NOT today.  Even if you can see a nice juicy one!

1 comment:

Kari Griffis said...

Haha ... Of course the hardcore flight nurse would love playing with 14 g and be looking for a good EJ! Dan you rock!! c: