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attempts, we notify the doctor, who decides whether to continue
or cancel the procedure," say Ms. Pulitano and Ms. Uhrmacher.
Finally, it pays to listen. "When the patient tells you she's a tough
stick, believe her," says Shauna Hutchinson, BSN, clinical manager of
the Surgery Center of Kalamazoo in Portage, Mich. "Have the patient
suggest locations that have worked in the past."
What's the best site for an IV?
The best site for starting an IV? Depends on the patient and the
procedure, but in our online survey, the hand was by far the pre-
ferred place to start an IV, chosen by 57% of our respondents, fol-
lowed by the arm (27%) and then the wrist (8%).
"Start in the hand and move up the arm," says Ms. Rich. "I try to
avoid the wrist, because it is very painful for the patient." Barbara
Wynne, RN, BSN, manager of Gamma Knife in Memphis, Tenn.,
prefers the hand, but she considers areas with less chance of IV
occlusion during the procedure.
"Many of our staff use antecubital first, but I think they should
begin in the hand or wrist, especially if the patient is a hard stick,"
says another. "Frequently I'll visually inspect the area where I want
to start an IV, and then place a tourniquet on to see if I can palpate
anything. This works well for me, and I've been doing it for 36
years this way."
OSM
E-mail
doconnor@outpatientsurg ery.net
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