Thanks Paul. Your notes were very helpful
On Wed, Mar 1, 2017 at 3:44 PM, Paul Paquette <dmarc-noreply@xxxxxxxxxxxxx>
wrote:
I haven't had to use a vein finder & the Drs I've worked for don't like
the quality of an oral FA & find it useless in most cases so I haven't done
that in years either.
Kirsten Locke & I give a course at OPS Annual Program on IV Tips. Can't
give all the tips now but heres a couple suggestions:
If your having difficulties finding a vein:
-make sure your tourniquet is tight & not more than 3"-4" from the site
you choose to look at i.e. just above the wrist if looking at the hand,
just above the elbow for anticubital site. Often times the pts complain its
too tight but when you go to release it you find it's not tight at all. It
may help to place a towel or go around the pt's shirt sleeve were you want
to apply the tourniquet.
-Stay open minded. Everyone has their favorite location, left or right arm
or hand etc... But don't limit yourself to only those sites. I had to use a
pt's foot everytime he came in.
If you're finding small veins but they always blow or infiltrate:
-Try an "open butterfly" technique. I learned this from a nurse who
administered Chemo to Cancer pts, who consistantly have the smallest veins.
Don't attach the syringe with dye to the butterfly needle. Remove the
needle used to draw up the dye & set the syringe nearbye with tip propped
up so as not to contaminate the open end. Uncap BOTH ends of the butterfly
again being careful not to contaminate open end (I hold it up between 2
small fingers). When you stick this "open butterfly" even into a small vein
you'll notice the "Flash" of blood in the tubing quicker & it will continue
to flow to the end of the tubing rather than stop a mm or 2 into the tubing
or inside the needle itself if the syringe was attached (no back pressure
to stop it). Don't worry, even with the tourniquet attached, the flow is
slow enough to be able to grab the open syringe & attach it to the
butterfly. Draw back any remaining air in the tubing & you're ready to push
SLOWLY & release the turniquet midway thru the push (this help to keep the
vein a little more firm).
Good luck
Paul Paquette
-----Original Message-----
From: wgraham6 <wgraham6@xxxxxxxxxxxx>
To: optimal <optimal@xxxxxxxxxxxxx>
Sent: Wed, Mar 1, 2017 9:53 am
Subject: [optimal] Re: [optimal] AccuVein
We have a few patients a year that are extremely hard or impossible to
stick. We will get out the vein finder but usually not very helpful. So not
to torture these diabetic patients with more than my limit of sticks oral
FA is a great option. We use the Optos California and get amazing images.
BJ Graham, CRA
Bjgrahamphoto@xxxxxxxxx
336-469-4951 <(336)%20469-4951>
Sent from my Verizon HTC Smartphone
----- Reply message -----
From: "Sara Morales" <sjmorales13@xxxxxxxxx>
To: <optimal@xxxxxxxxxxxxx>
Subject: [optimal] AccuVein
Date: Wed, Mar 1, 2017 12:00 PM
Our department is looking to purchase a vein finder for those seemingly
impossible patients. I can't believe how expensive they are and need to
make sure that they actually work on the difficult patients. Easy patients
are easy and I don't need a $5,000 device for them.. Do these devices work
well for the obese, dialysis patients, severe diabetics etc.
Sara Freeman Morales, CRA, OCT C
Scheie Eye Institute
Philadelphia, PA
