I just got into nursing school and from what I’ve heard most nursing programs are seriously lacking in IV training, which is making me nervous. This was super helpful!
I have one more year of school left before I can take my NCLEX. We STILL have not learned about IVs in my program but I got a job at the hospital as a Nurse Intern and we’re allowed to start IVs. I literally just started sticking patients and I’ve already had several successful attempts. They aren’t crazy difficult! My first IV I was shaking tremendously but I still got it and just told the patient’s family “oh yeah I shake a lot” and they were fine. You’ll learn and you’ll get it! I’m still learning but working in the ER you start IVs all day. Highly recommend a nurse internship program.
You'll learn alot in clinicals! I just checked off for IVs yesterday (on a fake arm) today @ clinicals my instructor sent me to the ER do do IVs, the nurses all assisted and taught me how they like to do it, I inserted 4 IVs, and observed 3 others.
23 วันที่ผ่านมา
Most programs in united states are lacking in teaching students ANY actual clinical skills. Other countries that are supposedly beneath the US in terms of education have much more robust training for nurses. If you are unfortunate enough to attend nursing school in the united states, in my opinion, it’s better to start as an LPN so you learn some skills. RN programs will not help you in that regard.
Im a nurse. The trick is apply the tourniquet to let the blood pool up and inflate the vein. Rubbing with alcohol pad not only helps plump the vein but the glare from the alcohol moisture lets you see the bump much better. Be very precise on where to poke and line up the needle on top of the vein. Poke shallow initially and advance slowly. Once there’s continuous blood return, stop advancing, angle the needle shallower then advance needle about 2mm, then advance the catheter then remove the needle. Others insert the entire needle but its unnecessary as the needle can poke out of the vein.
FORTUNATELY I have over ten years clean today, but watching this video made me laugh at several points. I became an IV expert without any formal education. I wish I could've watched this video in my using days, rather than learning from trial & error. 🤣
Also about the last part of removing the IV - Make sure to apply pressure to the gauze for atleast 30-60 seconds. Especially in older patients with blood thinners this may get very messy.
Was hoping this would be an April fools video where you missed the vein like 5 times and gave up, but then said “well you get the idea” and just ended the video 😂
That would've been amazing. That was totally my first time tryna start an IV. I missed like 5 times in a row. And then I didn't do it for like 3 weeks and got it first try.
I am enjoying your videos. I was a paramedic in 1975. I was trained by Vietnam medics. They ruled! We did different techniques back them from pushing bicarb , rotating tourniquets for left vetricular heart failure. And trauma trousers. Emergency was my favorite show lol. I am sure old protocols can still work. Even using an old Robert Shaw demand valve. lol
I would suggest that before you flush the saline, to instead draw back. the blood return is the confirmation that's in, not the easy flush forward. Thank you for the demo.
Interesting! I like how it's a bit different in US and Europe too - here, we mostly use what I like to call "Braun-pattern" or "winged" IVs (without that extra tube necessary, and with two little wings on each side). The technique is the same, but the IV is secured by a special non-transparent adhesive dressing that kinda looks like pants. (that's why we call it "iv pants"- a plaster with a cutout halfway through, when you put it over the IV, each "pant" secures it's side of little wing) The fluids and meds are injected directly into the IV, which is covered with a luer-lock screw cap. Green (18G) size is also regarded as most universal, since it has both the high flow rate, and can also be used for plasma transfusion if necessary.
as someone who has started over 100k IVs in a 20 year career i was expecting to be a harsh critic, however this was not only a great video but it touches on a few common mistakes and things that only experience seems to teach, nice job
@mckenziekeith7434 that's about the numbers I used to add it up, I was a paramedic in an ER for a long time and did nearly all the IVs during my shift for the unit
I like this Live demo thing you got going. Whatever your paying Brian it's not enough. Maybe in the Next episode - "Starting an EZ-IO on a live patient" or Live Cricothyrotomy on Brian" . LOL. Good job 👏
Current Navy Hospital Corpsman - we were taught to pull back on the flush a little bit to make sure blood entered the tube and then push the saline in.
The ability to draw off an IV is confirmation that it’s in but the inability to do so doesn’t mean it’s not in, so I don’t usually concern myself with that step.
@@PrepMedic yeah, we were most recently being taught by nurses. We actually didn't do that step in Corps school but I guess it's more of a hospital clinical setting thing
5 year FMF Corpsman. Havnt done it in several years. Never assume your skills are non perishable. I also might anchor that second strip of tape not on top of the first strip of tape as Iv seen a snag pull on the first spot creating a possible issue in the flow or un necessary discomfort. Personal preference.
I absolutely love your channel, and your methods of teaching, and I sent so many students to your channel to learn so much valuable stuff, thanks a lot, I like to subscribe immediately😅
Ah the fun of starting IV's. One can only wish that patients have nice veins and more importantly are cooperative! A well lit ER exam room beats a the back of an ambulance. Or dealing with an entrapped patient. As a wise medic once related....any port in a storm.
I learned in day that you wanted large bore IV's and using 14/16 g was the norm. And, the those days are in the rear view mirror. EJ's were fun! Not that you get to practice them....those are pure OJT. Or starting an IV in a cardiac arrest patient. The first time the RN came to medic class to practice IV starts....it looked like a battlefield! OMG we were awful! Then they sent us to the Outpatient lab at the clinic for 16 hrs of clinical. God only knows how many people I stuck drawing blood for two shifts. The patients with diseases processes that sacrifice their their veins...like chemo are tough sticks. Now we live in the day of the EZ IO if you really need access. Patients with access devices like Port A Caths or PICC lines. And, since the change in administering D50 IV Plus to infusing it via piggy back smaller IV's work. When I was we lad....I watched a medic push D50 direct venipuncture. Infiltrating D50 is not good. And, hospital patients getting Potassium....ouch! Some facilities suggest that goes via a Central Line.
I am a registered EMT now in paramedic school. We kinda learned IV, IO, IM, SUB Q. my physical test is this Tuesday. good video but I wish it were longer.
If the catheter is not inserted properly the first time, what are the instructions on how to safely/properly remove and retry the IV? Thank you for the informational video!
7:23 hits too close to home.. I nailed my first IV on a ride along but stupidly forgot to prep the primary IV line and saline flush. My instructor had to come and save me from my mistake but couldn’t save me from the embarrassment. That memory is now etched into my mind and never will I ever forget to prepare the IV line and saline flush.
Excellent, thank you. You are a great teacher, can you mention the names of the different parts in your description? Is it called pig tail or is it J tube?
It's interesting to see, how different the system in the US works. Of course the principle is the same, but we nearly always connect a 500 ml saline, as our catheter has a port with a cap for medication directly built into it. This way, we don't have to wipe it everytime - that must be a pain in the ass when you have to give another shot because you started with a too low dose. And i've never seen a single use tourniquet, we mostly use a multiuse one. Other than that: good Explaination for everybody who never started an iV before. Btw - having too good vains while working in the medical field can really suck - everyone wants to start an iV on you. Speaking of experience^^
Hey man! Great demonstration! What's the name of the brand of i.v. cath you're using in this video? At first glance it looks way more practical than the ones I'm used with.
I'm seeing ads in my inbox for a newly fda approved clot powder called BleedStop. Can you do a video or a short on it to fill in the community if it's trustworthy or not?
Hey brother, love your videos. I just got a job working on a critical care transport unit for neos and peds. Can you try and make some videos tailored for the younger pts. Thanks 🤞🏾!
One thing i always wondered is why the Cannulas in the US are so different from the ones used in Europe.. The us ones are really just the plastic tube and a connector, the European ones e.g. Have a port for syringes to connect to and "wings" to make it easier to fixate them.. 🤔
We have been instructed to document the IV started per sterile technique, but after watching the video they are done aseptic. This video is a good reminder.
I don't know why I wasn't certified in this with my phlebotomy certification, it's basically the same thing except for leaving a catheter in when I'm done lol
re: infiltration, I've had a missed IV in the hospital before, I told the nurse it didn't feel right (I've had them enough to expect the "cold in vein" feeling) but she didn't believe me until my arm swelled up...oops!
No. It is not a required step, nor amazingly useful. If you get return, great, you are in. but if you don’t get return it doesn’t mean you aren’t in and you are going to flush anyways.
I hate when they don't shave the patient first, especially when they are men, and my IV training this is something that we had to do, and it came with our training, like in our things that you saw him open it will be a razor, and we always had to put a sock over the iv with a 2 by 4, not just tegaderm.
Great video, great production, the vein diagram overlay was very slick. Not to whine and sound too hippy dippy but you touched one personal nerve: please consider not turning the patient into a table when you don't absolutely have to. There is almost always another flat surface, and then I see folks get in this habit and eventually they're putting wrappers and other trash on the patient too and just..... They're a person, not a table.
Is it ethical to deliberately induce pain (even with consent) on a person/subject for a video?? The Dr himself admitted this is a painful procedure. My stomach turned the moment of insert.
If it wasn’t ethical to do a painful procedure on a consenting adult then no one would ever become a nurse, paramedic, doctor, or phlebotomist. Do you know how many times you get poked with needles in school?
They’re not that hard, even a nurse could do it. 😉 “If one hundred people graduated from [medical school], someone came in last. Ask me how I know!” -Clint Smith of Thunder Ranch
Once Again Thanks Brian For Being a Champ and Teaching Medical Prof. for Years to Come!
I just got into nursing school and from what I’ve heard most nursing programs are seriously lacking in IV training, which is making me nervous. This was super helpful!
I have one more year of school left before I can take my NCLEX. We STILL have not learned about IVs in my program but I got a job at the hospital as a Nurse Intern and we’re allowed to start IVs. I literally just started sticking patients and I’ve already had several successful attempts. They aren’t crazy difficult! My first IV I was shaking tremendously but I still got it and just told the patient’s family “oh yeah I shake a lot” and they were fine. You’ll learn and you’ll get it! I’m still learning but working in the ER you start IVs all day. Highly recommend a nurse internship program.
You'll learn alot in clinicals! I just checked off for IVs yesterday (on a fake arm) today @ clinicals my instructor sent me to the ER do do IVs, the nurses all assisted and taught me how they like to do it, I inserted 4 IVs, and observed 3 others.
Most programs in united states are lacking in teaching students ANY actual clinical skills. Other countries that are supposedly beneath the US in terms of education have much more robust training for nurses. If you are unfortunate enough to attend nursing school in the united states, in my opinion, it’s better to start as an LPN so you learn some skills. RN programs will not help you in that regard.
From a RN of 20 years this is the best video I have seen for an IV start.
You're a hero. Thanks 👍
As a retired Combat Medic and Cetified Instructor, I think you did an excellent job!
Im a nurse. The trick is apply the tourniquet to let the blood pool up and inflate the vein. Rubbing with alcohol pad not only helps plump the vein but the glare from the alcohol moisture lets you see the bump much better. Be very precise on where to poke and line up the needle on top of the vein. Poke shallow initially and advance slowly. Once there’s continuous blood return, stop advancing, angle the needle shallower then advance needle about 2mm, then advance the catheter then remove the needle. Others insert the entire needle but its unnecessary as the needle can poke out of the vein.
FORTUNATELY I have over ten years clean today, but watching this video made me laugh at several points. I became an IV expert without any formal education. I wish I could've watched this video in my using days, rather than learning from trial & error. 🤣
Ten years is brilliant ❤
Also about the last part of removing the IV - Make sure to apply pressure to the gauze for atleast 30-60 seconds. Especially in older patients with blood thinners this may get very messy.
Or aspirin lol
OMG Yes! I Remember My First Pt On Floor Clinicals Was On Blood Thinners-Told Me Straight Up. Still, Being New I Had No Idea It Could Get Messy
Was hoping this would be an April fools video where you missed the vein like 5 times and gave up, but then said “well you get the idea” and just ended the video 😂
That would've been amazing. That was totally my first time tryna start an IV. I missed like 5 times in a row. And then I didn't do it for like 3 weeks and got it first try.
Like what I do in real life? 🤣 *never ask a flight medic to start your IV*
@@w.c.6678that’s my favorite vein to go for, personally.
@@w.c.6678 what's an "AC"? And what we're you referring to about the elbow?
@@w.c.6678everything he said still applies even if it were right in the middle of the crook of your arm when bent.
I am enjoying your videos. I was a paramedic in 1975. I was trained by Vietnam medics. They ruled! We did different techniques back them from pushing bicarb , rotating tourniquets for left vetricular heart failure. And trauma trousers. Emergency was my favorite show lol. I am sure old protocols can still work. Even using an old Robert Shaw demand valve. lol
While you guys absolutely set the path for us in the modern day, theres a reason we changed the protocols lol
Brian, the Most Valuable Patient.
I would suggest that before you flush the saline, to instead draw back. the blood return is the confirmation that's in, not the easy flush forward. Thank you for the demo.
Interesting!
I like how it's a bit different in US and Europe too - here, we mostly use what I like to call "Braun-pattern" or "winged" IVs (without that extra tube necessary, and with two little wings on each side). The technique is the same, but the IV is secured by a special non-transparent adhesive dressing that kinda looks like pants. (that's why we call it "iv pants"- a plaster with a cutout halfway through, when you put it over the IV, each "pant" secures it's side of little wing)
The fluids and meds are injected directly into the IV, which is covered with a luer-lock screw cap. Green (18G) size is also regarded as most universal, since it has both the high flow rate, and can also be used for plasma transfusion if necessary.
as someone who has started over 100k IVs in a 20 year career i was expecting to be a harsh critic, however this was not only a great video but it touches on a few common mistakes and things that only experience seems to teach, nice job
That is about 100 per week. 20 per day if you work 5 days a week. Or 25 per day if you work 4 days a week. That is a lot of IVs!
@mckenziekeith7434 that's about the numbers I used to add it up, I was a paramedic in an ER for a long time and did nearly all the IVs during my shift for the unit
This has been long needed!
Yeah, it was time for an updated video. My old one was almost 5 years ago 😂
Best video IV watched on how to start an IV, and I’ve seen quite a few. Bravo!
Thank you for the live demo.
I love having information like this on TH-cam. Just helps to know.
I like this Live demo thing you got going. Whatever your paying Brian it's not enough. Maybe in the Next episode - "Starting an EZ-IO on a live patient" or Live Cricothyrotomy on Brian" . LOL. Good job 👏
Ha! Already asked him and he said hell no.
What about sync cardioversion? I'll gladly volunteer some of my equipment
@@PrepMedicI’m sure there’s a bored marine somewhere that would accept 50 bucks to be an io dummy. (Just don’t tell him how bad it hurts)
There are some YT videos of IO starts on volunteers!
Googling an EZ IO made me rethink my EMS career dream. Thank you for saving me Nate.
This is such an upgrade from your previous video! Thank you for posting!
Current Navy Hospital Corpsman - we were taught to pull back on the flush a little bit to make sure blood entered the tube and then push the saline in.
The ability to draw off an IV is confirmation that it’s in but the inability to do so doesn’t mean it’s not in, so I don’t usually concern myself with that step.
@@PrepMedic yeah, we were most recently being taught by nurses. We actually didn't do that step in Corps school but I guess it's more of a hospital clinical setting thing
Excellent demo and explanation. Thank you.
Next up: How to start an IO - Live Demo
Stop screaming, please!
Great comment lmao only EMS people get it
th-cam.com/video/zimbDqsBSOY/w-d-xo.html
😂
First you'll need a drill from your local hardware store 😂😂
5 year FMF Corpsman. Havnt done it in several years. Never assume your skills are non perishable. I also might anchor that second strip of tape not on top of the first strip of tape as Iv seen a snag pull on the first spot creating a possible issue in the flow or un necessary discomfort. Personal preference.
What's up, Doc!?
My dad used to use 14s and 16s back in the late 70s. Largest he ever used was a 12 gauge needle on a GSW patient.
Love watching a perfect Iv drop. I'm gonna use this with my students.
Thank you for all of your great content
You are an outstanding teacher!
Sam Thanks for the real demo's.
Love your channel! Blessings to you!
Excellent video. Thank you very much.
I love the how to videos!
I absolutely love your channel, and your methods of teaching, and I sent so many students to your channel to learn so much valuable stuff, thanks a lot, I like to subscribe immediately😅
Such a good video I’m a phlebotomist I always wanted to learn how to put an IV now I know but I will have to practice to get some skills
let's practice together
Hey man. I'm in EMT advanced school right now and have been struggling to get I.V.'s. appreciate the reminder and tips.
awesome demo and video. these are great teaching vids for people... now i just need someone to let me try it out on
Great demo!
Cool beans dude! Thanks much! Blessings and Grace!
Thank you Sam . Very helpful
Glad it was helpful!
Thank You Brian. More demo days with Sam the PREPMEDIC.
Greetings From Mascot SYDNEY an Manila PHI;IPPINES
APRIL 2024 MABUHAY!
Foam hand sanitizer will help take off tegaderm.
Great video sir and well done to your friend for his participation in making these "how to" videos. ✝️🇺🇸👍
New AEMT here, just started doing 911 and Ive been pretty nervous to start IVs, thanks for the vid
thank you very much
Ah the fun of starting IV's. One can only wish that patients have nice veins and more importantly are cooperative! A well lit ER exam room beats a the back of an ambulance. Or dealing with an entrapped patient. As a wise medic once related....any port in a storm.
And A Rite Of Passage, Sticking An 18G, Getting Meds Ready, All While Your Basic is Bouncing The Truth To Hell And Back.
Truck 🚑
I learned in day that you wanted large bore IV's and using 14/16 g was the norm. And, the those days are in the rear view mirror. EJ's were fun! Not that you get to practice them....those are pure OJT. Or starting an IV in a cardiac arrest patient.
The first time the RN came to medic class to practice IV starts....it looked like a battlefield! OMG we were awful! Then they sent us to the Outpatient lab at the clinic for 16 hrs of clinical. God only knows how many people I stuck drawing blood for two shifts.
The patients with diseases processes that sacrifice their their veins...like chemo are tough sticks. Now we live in the day of the EZ IO if you really need access. Patients with access devices like Port A Caths or PICC lines. And, since the change in administering D50 IV Plus to infusing it via piggy back smaller IV's work. When I was we lad....I watched a medic push D50 direct venipuncture. Infiltrating D50 is not good. And, hospital patients getting Potassium....ouch! Some facilities suggest that goes via a Central Line.
I have a fear of iv’s so i’m trying to consume more of these videos thank u
I am a registered EMT now in paramedic school. We kinda learned IV, IO, IM, SUB Q. my physical test is this Tuesday. good video but I wish it were longer.
If the catheter is not inserted properly the first time, what are the instructions on how to safely/properly remove and retry the IV? Thank you for the informational video!
Great stuff as always Sam! Would hate to think what running an IV as a flight medic or in non-permissive environment is like 😅 Really cool.
Phlebotomist in me:
"Yay, new toys!!!!"
Instructions unclear: I threw up on the patient
I always thought the needle was left in the arm. But it's a soft thingy🤣
7:23 hits too close to home.. I nailed my first IV on a ride along but stupidly forgot to prep the primary IV line and saline flush. My instructor had to come and save me from my mistake but couldn’t save me from the embarrassment. That memory is now etched into my mind and never will I ever forget to prepare the IV line and saline flush.
Doubt i could ever do this, but was always curious how.
Basket weave technique for the CHG is best practice
Excellent, thank you. You are a great teacher, can you mention the names of the different parts in your description? Is it called pig tail or is it J tube?
It's interesting to see, how different the system in the US works. Of course the principle is the same, but we nearly always connect a 500 ml saline, as our catheter has a port with a cap for medication directly built into it. This way, we don't have to wipe it everytime - that must be a pain in the ass when you have to give another shot because you started with a too low dose. And i've never seen a single use tourniquet, we mostly use a multiuse one.
Other than that: good Explaination for everybody who never started an iV before.
Btw - having too good vains while working in the medical field can really suck - everyone wants to start an iV on you. Speaking of experience^^
amazing great vid
what does holding tamponade mean ?
I am having a hard time with IV....they blow. Everyone says it takes practice, but if my technique is wrong...then I'll never learn correctly.
Good stuff. THanks
Hey man! Great demonstration! What's the name of the brand of i.v. cath you're using in this video? At first glance it looks way more practical than the ones I'm used with.
It looks like a BD Insyte. I use those as well, but I use one that auto-tamponades.
You have to apply tourniquet first to allow blood fill the vein, then prepare all your IV supplies.
I'm seeing ads in my inbox for a newly fda approved clot powder called BleedStop. Can you do a video or a short on it to fill in the community if it's trustworthy or not?
Hey brother, love your videos. I just got a job working on a critical care transport unit for neos and peds. Can you try and make some videos tailored for the younger pts. Thanks 🤞🏾!
10/10
Great video, just missed the blood return 😅 other than that too, loosen the J loop cap
nice channel!
I'm a nursing student here at Puerto Rico, is anyone know where can I buy those sets for my home practice?
One thing i always wondered is why the Cannulas in the US are so different from the ones used in Europe.. The us ones are really just the plastic tube and a connector, the European ones e.g. Have a port for syringes to connect to and "wings" to make it easier to fixate them.. 🤔
Do you care if I use this in my AEMT course?
Can you do a video digging into your ski patrol career?
We have been instructed to document the IV started per sterile technique, but after watching the video they are done aseptic. This video is a good reminder.
what is a needle stick? like when it breaks?
Poor Brian’s getting all the work. Going to put a IO in next. 😂
I have those same jeans
io live demo next ?
stablize while inserting and dont leave tournequiet on so long or vien can blow
Poor Brian! Last week was Npa insertion
Bro showed emotion really only when the tape got removed
Get some.
Plenty of practice on hungover Marines
❤❤❤❤
I’m a medic now
I don't know why I wasn't certified in this with my phlebotomy certification, it's basically the same thing except for leaving a catheter in when I'm done lol
re: infiltration, I've had a missed IV in the hospital before, I told the nurse it didn't feel right (I've had them enough to expect the "cold in vein" feeling) but she didn't believe me until my arm swelled up...oops!
Just not going to aspirate?
No. It is not a required step, nor amazingly useful. If you get return, great, you are in. but if you don’t get return it doesn’t mean you aren’t in and you are going to flush anyways.
Thought this was an April fools video by the thumbnail cause it looked like a knee 😅
I hate when they don't shave the patient first, especially when they are men, and my IV training this is something that we had to do, and it came with our training, like in our things that you saw him open it will be a razor, and we always had to put a sock over the iv with a 2 by 4, not just tegaderm.
My teacher said no tape on the table
Tape doesn’t cover the insertion site. It’s fine to put it on the table.
Great video, great production, the vein diagram overlay was very slick.
Not to whine and sound too hippy dippy but you touched one personal nerve: please consider not turning the patient into a table when you don't absolutely have to. There is almost always another flat surface, and then I see folks get in this habit and eventually they're putting wrappers and other trash on the patient too and just..... They're a person, not a table.
Manies Times they leave it too much in the vein
IV
Just remember to actually get the vein and not punch through it.
Is it ethical to deliberately induce pain (even with consent) on a person/subject for a video?? The Dr himself admitted this is a painful procedure. My stomach turned the moment of insert.
If it wasn’t ethical to do a painful procedure on a consenting adult then no one would ever become a nurse, paramedic, doctor, or phlebotomist. Do you know how many times you get poked with needles in school?
Hardstick scenarios not included😂
Taste the saline?!
They’re not that hard, even a nurse could do it. 😉
“If one hundred people graduated from [medical school], someone came in last. Ask me how I know!”
-Clint Smith of Thunder Ranch
I don't understand why it hard for doctors to let ill patients iv line at home life is a nightmare for me with short 3 times a day
I taste em 😢
I'll never ever have any reasons to learn how to start an IV. NEVER !!!!!