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I need an IV started once or twice a month, sometimes more often. This has been going on for a year now. It is getting harder and harder to get them started. 4 weeks ago it took three tries. Yesterday it took only one, but I was crying out in pain (it really burned) and ended up with tears streaming down my face. The nurse wanted to remove it but I didn't want to go through that twice so I had her keep going. Once the needle was in place, my vein spasmed shut. By concentrating on breathing and relaxing I managed to get the vein to open again. The blood draw they needed to do required a syringe to actually pull the blood out. However once the IV was hooked up and the meds were flowing in, I was fine for the next hour or so, and after it was removed.

Things I know already:

  • be hydrated. Avoid caffeine and drink extra liquids in the hours before the IV will be started
  • work on being physically relaxed despite pain and fear. Breathe deeply. Keep your eyes open.
  • the body part where the IV will be started should be warm. They wrap me in a heating pad.
  • if there is a spot where attempts have failed before, tell the nurse when that spot is being considered, "they tried that last time and couldn't get in" or "they tried that last time and got in but didn't get blood on a pull back" or whatever.

This rather small arsenal is not enough for me. I am very motivated to get these IVs started -- it's where the miracle goes in -- but the nurses really don't like pushing sharp metal into someone who is yelling ow and ouch, who is crying real tears, etc. And it's not the best part of my day. So, how can I make it go more smoothly?

  • Have you ever tried a topical analgesic prior to the IV. Something like a lidocaine patch. – Debbie M. Jun 5 '17 at 15:46
  • Hm, the EMLA thing? We did that for the kids with injections. I wonder if it goes deep enough? And if it has any effects on reaching a vein? I am certainly going to mention it next time. – Kate Gregory Jun 5 '17 at 15:48
  • @DebbieM. Can you add an answer so that others can up/down vote, comment on possible contra-indications etc? I think this is going to be a good idea but some references and such would be very useful. – Kate Gregory Jun 5 '17 at 15:56
  • Kate it was just something that popped into my head. I have no personal experience and don't have the time to do the research. If it works for you, you can write the answer and accept it :) - or anyone else is free to run with it. – Debbie M. Jun 5 '17 at 18:37
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You've already hit all the main points so there's not much to add. I'm sorry to say that some people are simply a "tough stick" and there's not much you can do about it. For example, I have a friend who looks like he should be an easy stick. He's athletic, muscular, with very little body fat, and those types usually have pipelines for veins that you can hit from 50 feet away-- but not him. He suffered an MI recently and the paramedics ended up having to use his external jugular to get an IV. (And when paramedics can't get an IV on you, you are definitely a tough stick.)

The only thing I can think to add to your list is to get the arm lower than your body. Let it hang off the edge of the bed for a minute or two before they try. You want all those veins as engorged as possible.

Definitely keep track of which veins work and which ones don't. Sometimes veins look good but they're not, or vice versa. It helps if the patient knows from past experience.

If push comes to shove, there are other ways. They can use the external jugular like the medics did on my friend, they could place an indwelling catheter that remains in place for months, or they can even do a cutdown, but a nurse isn't going to have the authority to do any of those things so you would have to bring the issue up with the doctor.

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  • +1 those types usually have pipelines for veins that you can hit from 50 feet away. You had me bursting into laughter there. Good answer! Without too much nitpicking, if you could include in your answer why hanging an arm off the edge will engorge a vein, your answer wouldn't even need references because you provided the explanation yourself. – Narusan Jun 5 '17 at 8:01

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