How to start an IV : Antecubital Fossa
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- เผยแพร่เมื่อ 24 ก.ค. 2024
- This video demonstrates the technique to start an IV in the antecubital fossa. See our other videos for starting an IV on the dorsum of the hand or other great medical videos!
- วิทยาศาสตร์และเทคโนโลยี
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Watching this for my exposure therapy for my phobia. Well, I made a lot
Of weird sounds whilst watching that! Like cries. Ermmmm. Very relieved once it’s over. But now I have to keep watching it until I’m okay with the video. Wish me luck.
Really awesome video! Thanks for the tips and for being so straight forward.
Melissa B You're welcome Melissa, keep on rockin
This is well illustrated, thanks for using a real model, its easy to relate
The best video I have ever seen on IV insertion! Thank you so much!!!
+Cammy No, thank YOU Cammy
Just watching this over and over again to desensitize myself for when I get IV anesthesia for my wisdom teeth extraction.
Hope it went well for you. I like to watch videos and learn about things in afraid of too, so the fear loses its power. It's an awesome way to overcome your fears.
I was awake when mine were removed. Weirdest feeling ever
Same
Same :(
My mom told me needle would be smaller than all my injections from the past that thing is huge
Once you get a flash, take off the touniquet BEFORE removing the needle. The Flush should be attached to the extension set, then attach the set to the Hub and flush catheter.
I said the same above because that is absolutely true, EXCEPT when you need to draw some blood at the same time, then it can be helpful to leave it on because the pressure in the veins would be too low in patients with bad veins, circulation problems et cetera, so filling your bloodtubes would take too much time, sometimes won't even be possible when removing the tourniquet. :-)
Again... People! The purpose was to demonstrate how to accurately occlude the vein so that when the tourniquet is removed not a drop of blood is lost. This was executed perfectly!
I found this very helpful. Thanks for a great video. Looking forward to more of these.
+sherry melton thanks, sherry
sherry melton 4
Wow its so perfect you did it so smoothly.😍😘
Very well made video. Thanks!
Even with a flash of blood, after removing the needle, and connecting the syringe, I would consider one of two options. 1. let some blood fall onto a gauze pad placed under the catheter to remove all air and then place the syringe or tubing. 2. connect the syringe to the catheter and draw back a small amount of blood into the syringe to be certain that the catheter is in the vein.
great video!
#2
this is amazing !
Other tips. Dont occlude the catheter with your thumb. Use your ring finger so you can hold the end of the cath with your index and thumb. Easier to apply your J loop or syringe that way. Also pull back on a syringe to check if the IV is patent. Blood flowing into syringe means you hit your mark.
Great Video, perfect explanation!
Background f
Excellent video
great work
Great video!
Thank you for sharing.
Well illustrated.thanks
If the catheter is not in the correct position the procedure would have to be done again?
For starters, you start an i.v. by NOT choosing the ante-cubital fossa. This region is reserved for emergencies and blood draws ( done frequently by inexperienced staff ). For mobile regular patients the ante-cubital fossa is an absolute no-go.
Where is the better location? The dorsum of the hand?
@@dman5909 It depends, of course. Generally you work your way up from the hand, to the forearm, the AC is possible but reserved, when need be then there's the upper arm. To go straight for the AC is not professional.
It depends. I was always taught to work distal to proximal, but when I moved to the ED the ACF became the gold standard. Reasons being placement of an 18g or 20g was standard; any pt going for a CT with contrast is going to need a large IVC in a large vein anyway; of course your high risk pts may need rapid fluid resus; and IVCs are used for repeat bloods rather than repeat punctures with butterfly's.
When I do the odd shift on a med/surg ward I go back to cannulating hands. My point is, yes you're right, but it also depends on your use case and policy
wow! great ! great !
Wow your great .thanks
Thank you!!
Thank you Mariah!
anyone else see the big air bubble?
Hey Derek- that amount of air is clinically insignificant and will quickly be dissolved in the bloodstream. A much larger amount of air is necessary to cause a clinically significant embolus. Thanks for watching!
Yea, I used to write it too
As a former IV drug user, air is a myth. I shot mad air. In fact, i like leaving a little bubble so it'll fill with blood when I tap into the vein
@@MedSchoolMadeEasy is shooting into legs (either illicit or medication- I only ever intend to administer antibiotics or pain meds amidst an emergency if say a war broke out etc....) but is shooting in legs bad or dangerous? I once shot in my leg and a water blister showed up days later and then it looked like a hole, known as ulceration or ulceritis or something of that sort? Blood clots?
I'm very concerned as it seems i have terrible veins but hopefully excersize brings them back.... but yeah- is IV administration in legs bad? Or the hip/just above your groin area
@@joenevico7742 yea that's not good, you're not supposed to use femoral veins for IV injections, they're too risky. Too many risk factors like developing ulcers and risk for DVTs (deep vein thrombosis) i.e. blood clots. Plus they really suck. Might be because things have to travel further, poor circulation in the lower extremities. You have to have a Doctor's order to inject into the legs/feet actually.
I know this is from a while ago but it seems like there are many knowledgeable people in the comments. I'm going to be put under for a minor surgery in the next few days. In my experience, every time I've been in hospital, the nurses always mess up IV placement in the back of my hand and lower on the forearm too. They can never see my veins but still try, then pierce through the other side, say it's fine and try put meds through it anyway (which does nothing but cause me loads of pain) or prick me many times until the veins blow. It's very frustrating, so my mother suggested asking them to use this placement as they do for her. However people seem to say that this placement isn't good. Would you say it would make sense to ask for this for my general anaesthesia? Thanks
The antecubital space should be avoided when possible (except for emergencies) as it limits mobility
Thanks
Nice video bro!
Thanks homie, you rock
Awesome video, Thanks. I have a problem when i get flashback of blood..Two things happen with me, 1) I am not able to control needle and go on puncturing vein ahead resulting into failed cannula. 2) If i advance the cannula in after stopping the needle, Cannula kinks and doesnt allow to go further in?? What shd i do to improve? thanks
Amit Kumar Chopra Once you get flash of blood, you can advance the needle a little farther at a decreased angle, then advance the catheter.
Fuck medschool I learned from TH-cam !
I've never seen an alcohol cleansing thing like that before... That's very interesting.
Looks like mastisol
Thanks sir
Thnx
i like the male military setting, what a nice change.
+czCrusheer hooah crusheer
If you have the time do this with other sites for BD antibiotics. Ie., good veins on arms back of the hand etcetera. So people can move without tissuing them. This site even in bed patient is going to work for very short period of time.
How long you going to leave that tourniquet on!
If I am mistaken, please correct me....but I think he put the tourniquet on the wrong way. The tourniquet is supposed to be in a position where the flappy/hanging part ( the extra part) is not hanging downwards. The flappy extra part of the tourniquet is supposed to be facing upwards. The reason for this is because it get in the way of IV insertion which happens a few inches under the tourniquet....
christiiee25 wrong
I have to get an IV soon. I scared as fuck
Thank you
you're welcome Devendra! Thanks
That site is manly for venepunture.
I dubbed this the vein for dummies, since it is relatively easy to find.
Typically for patients who are mobile and can bend their arms, its best not to inject this area as it runs the risk of bending and potentially breaking the cannula. Do IV on the forearm as much as possible but its harder.
what about the tourniquet? some references said that it should be remove just before you injected the drug..
Good and probure IV selected
Good sir
Do not put pressure on the site after you insert the catheter! Just remove the needle and flush. You can ben the catheter or injure the vein wall.
This is wonderful! I have a question if you guys don't mind. I was taught that as soon as you see flashback you pop the tourniquet or it would blow the vein, but you guys did not. Can you explain if this is true? Or only for some veins?
it's possible, but not necessarily true. in young healthy people like in the video, I wouldn't worry about it. It's a whole different ballgame when you're starting an iv on geriatrics or diabetics with very delicate veins. you want to relieve all the pressure inside the veins as soon as you can to avoid blowing the vein. And as always already make sure the constricting band is off before you flush it! Haha
+mightyme87 If you can perfect this skill, it would be good to do. Although in most people this is unnecessary, there are some people (i.e. older adults) who have veins that "blow" much easier- in these people, popping the tourniquet as soon as possible (or not using a tourniquet at all) is a good idea! great question
+Med School Made Easy Thank you so much for your help!
+jlewis1091 Thank you for your help!
+mightyme87 That is a great point, we probably couldn't popped the tourney faster. However, blowing of veins usually isn't as big of a concern with younger, healthier patients as shown in the video. On the other end of the spectrum are the elderly with weaker veins, whom you sometimes don't even use a tourniquet on because the risk of blowing a vein is so high. Thanks for stopping by mightyme, you rock-
Wondrful
wow Best video ever... I have a question. What is the sensation like when the saline is being pushed in? does it hurt, burn? please let me know. Thanks
+aurore0225 Great question! When they were hooking the 10 ml syringe up to the cannula in my arm I was wondering the same thing- but actually, surprisingly I couldn't feel a thing. If I had closed my eyes, I wouldn't have even known it happened. Thanks for stopping by
If the saline enters the vein it will not hurt/burn, but if the vein has been given a hole elsewhere - like if the needle was pushed through the opposite wall of the vein - then the saline will enter into the surrounding tissue, causing a wheal/bulge, causing discomfort. A brand new IV will need to be started "above" the bad site (not toward the hand) or on a different limb.
very good details
nkp parmar one
Thank you for the video! Very helpful. It seems that removing the tourniquet would be better before taking the needle out of the catheter... No?
The point of leaving the tourniquet on was to show that by proximally applying pressure appropriately will stop the flow. If you don't have adequate pressure even when the tourniquet is removed blood will leak.
Thank you :) :)
you're welcome Hosanna! thanks
I can make incisions with a scalpel but can't stand phlebotomies or start an IV. Why? Because the damn thing is awake when you're starting an IV. Give me a central line any day. Have to get used to this...
Would you like a CLABSI with that? :)
Thanks just became a nurse
proud of you Jivya!
Literally trying to get used to needles
I am aiming to be a nurse and am used to seeing everything but the problem is that I'm scared of needles and hate seeing needles go inside the skin. Lol I know I'm too weird.
+Shakar Omar Stick with it- a certain amount of desensitization comes with all aspects of the medical field. Thanks for stopping by!
Are you now in the medical field? I had a bad experience with an IV recently and IVs seem to be making me feel uneasy now. Shots don't bother me, its just IVs. I want to know if you've gotten used to them. Thank you!
Greatly
I need that video on how to put on the band
+sb destiny Haha! You and me both
No check for blood return????????
Yes
@5:27 -- Am I correct in assuming that pushing the needle in after you've pierced the vein is a common mistake among beginners?
Well obviously
Cant you push then pull alittle on the saline flush to show a correct stick?
+DaddyLongLegs44 absolutely
gallimaufryuniverse grac
it would be of great help if you can post a video about central line insertion
Absolutely hilarious, he says bevel up, than shows a diagram of bevel down and inserts it bevel down, and the part I cringed at is flushes always come pre loaded with an air bubble you’re supposed to squeeze out, which he sqeezed right into his arm. 🤣🤣🤣
Great comedic value.
thanks for letting us know nerdhunt!! the air bubbles are inconsequential, as anyone who performs medicine knows. and others haven't had problems figuring out the bevel. but we appreciate you having a good laugh
Anyone who knows medicine knows to squirt out the bubble too, cheers.
Also I’ve never sene anyone who knows medicine not using an IV extension set to flush.
@@nerdhunt proud of you
💚 Merci
Nice video, though I don't agree with your comment about not taking too long to look for a vein. Often, if you do take your time and look for a good vein you will be more successful, especially with those patients who have bad veins.
martha perkins good tip, thanks martha!
Something about the fluid or “saline” entering like that just makes me nauseous. Are you supposed to feel the fluid entering your vein?
sometimes it can be a cooling sensation. if you're injecting a drug, that can also cause temporary sensations. but typically no, you won't notice a saline flush going in
Outstanding lesson! I'd trust you out in the field to stabilize me! Simper Fi.....Hospice Nurse. present date
+Leatherneck Sears hooah sears
IV bedroom oxygen for the day I am a little tired with this feeling Mai thao October 1 2019 from the hospital cough long time and happy to see in office want to be an option but
How far does the needle go into the skin and vein? And how's r does the cap go in?
+Tsundrul Palmo depends on how deep the vein is- you go in as far as you need to go until you see flashback. Obviously you shouldn't have to dig more than a centimeter in most cases though- withdraw and try again. I'm not sure what you're talking about with the "cap." Thanks-
At 4:10 I believe you mean "bevel UP"
Yep! Thanks Erika RN-BC
Love it😇😇😆😇😉😘😎😻
الله أكبر
what type of needle is used in the demo
+Kirsty Kirsty 20ga something, there's all kinds but the retractable ones aren't great if you're gonna be in a vehicle trying to start a line.
Good
does it hurt when the needle goes in
I have done multiple IVs and received IV, both good and bad before.
A good IV should feel like a normal, come and go kind of prick, similar to venepunture or when receiving vaccination.
A bad IV..... has many types of pain. Especially mistakes like piercing through the other side of the vein, advancing the cannula with heavy resistance, push in pull out....... I leave it to you to experience XD
Nope! Thanks for watching Myles!
Hey guys, I'm a student in Austria studying in nursing school. We have just entered our first year practicals and I have a fear of needles. Tips on how to overcome?
Just know that the patient is just as nervous as you, probably even more as he/she is the one going to be stuck. Just take a deep breath and remember to follow the guideline in this video. Over time, you'll find you'll get used to it.
This video has a few errors shown; there are better videos to learn to start an IV. To answer your question I say "Because it has to be done." Just like the times when you'll have to clean up your patient's vomit or strong odor stool. "It has to be done." Do it and do it right.
1997 and 2005
please what is the aim of that injected saline?
Checks patency of the catheter in the vein and makes sure you're in the right spot!
IV's are major sources of sepsis and great care must be exercised in their placement and care. I'd start with triple prep, just like the OR. Stretch the tourniquet before tying it to lessen skin pinching. When inserting the catheter, the finger touched the Luer lock. This is very important because when IV tubing is attached, changed, etc. someone is going to contaminate the tubing tip by touching it to the Luer lock in an effort to find the hole. Happens ALL the time. Put some Betadine ointment on the puncture site. Don't rely of Tegoderm.
can you provide peer-reviewed literature to support any of the claims you just made? I would love to read an meta-analysis about PIVs being a 'major source of sepsis'
A little bit of air was left in the seringe.Thats not good
I seen that, said ok maybe he will just do a few CC's, but nahh he went all the way!!! hahahah air and all lmao
10cc is the deadly one. little bit won't kill you
Silviukawa D I swear I was freaking out! lol
I usually don't inject all the way up to a small air bubble in my NS filled syringe when flushing IVs for that reason, it's almost virtually impossible to keep ALL of the air out of a syringe when working in real time and everything that can happen during an IV site, however that amount of air is of no concern, if it were an entire 10 mL/cc of nothing but air then yes, we would have major concern for an embolus. AC sites are pretty useless when we need an IV for continuous IV fluid therapy however, good site for an emergent situation since we usually don't have a lot of one to pick and choose and we would probably need a large bore catheter for fast IV fluid infusion.
People this is reality not Television. You would need an entire line of tubing filled with air before acquiring an emolism or pneumo. A few bubbles are not problematic in this inservice.
AC is For Emergency but not good for moving eating active PTS Starting hand then up 💉💊🔬
i watched a couple of youtube videos
what type/brand of cannula are you using?
It looked like a 22g Insyte
This is a #20
Is getting an iv painful? Pls answer bc I need to get one and I’m scared
Not at all. You'll be fine
I just put the video of me taking mine out up warning there's loads of blood
It hurts so bad i got my IV removed just now
My name is Jacqueline I'm in LPN now you teach me how to apply an IV
68w
70bravo med students homie
Chris Vargas just signed my contract yesterday for 68w
how to determine the difference of veins and arteries thru palpation'
Ehra bravo is really hard to palpate an artery
Eduardo Diaz because i want to know the difference' i don't want to end up puncturing the wrong vein hehe'
@@eduardodiaz9354 ጀ4አ!*,,(";*&"3"&""& በ😃😙😝😝😢😅😡
@@gwhwmahifhhh7912 wtf
I had an IV yesterday but I have a concern. The person who did the prepatation got it wrong 3 times. After taking the bandages off, I noticed that I had a red splotch where she had inserted the needle incorrectly.
It could be hematoma, meaning your veins that was punctured by IV is internally bleeding slightly.
Minimize the chances of this happening by compressing bandage tightly for a while.
yan nız
Can 100 cc/ml be push/bolus injected???
Unfortunately , you can’t . You will “blow “ their vein “up”.
@@huongma5933 thanks
Mai IV bedroom oxygen for me give your smile and happy day 🎂
I'm starting IVs in class next week.
+Danni Thanks for sharing Danni
Med School Made Easy it's weird
Do i have eyesight problems since I cannot see the veins at all
Not at all! Some people are very difficult iv sticks. If there is nothing visually, some of the veins may still be palpable. If not, a vein finder would be useful
@@MedSchoolMadeEasy like how did u insert needle im wearing glasses I cannot see any veins
We will try to make a new video in the new future to help explain this better. Thanks for your questions, hopefully we can answer it better with a new video!
@@MedSchoolMadeEasy ty but i think i have difficult time seeing veins always maybe my eyesight or just me because i have attention issues
I'm learning myself how to inject myself and somehow after watching this I'm terrifying. hahahaha
diabetic? I am. 😢
+Mackenzie Shackleton To be clear, diabetic injections should never be into peripheral venous systems (like the video)- rather they're most likely subcutaneous injections that should be done into abdomen or upper thing (not pictured in this video). Thanks for stopping by!
I hate getting an IV in my arm they have to poke six times before they get the IV in I suggest to a well-know hospital with their nurse good luck
I was in the er this Monday night and the nurse was very nice and got me in one stick I've heard many bad things about the hospital but I was treated very nicely
I love you I love you I love you
Hey, i went to one of these places before, those evil vampires stole my blood 😱
Lol 😊
They just casually injected this guy with saline
Also that needle looks huge I came for wisdom teeth reassurance and left with me thinking imma die
Giod inf
Why is it difficult to reverse the effects of the drugs if it is administered intravenously comparing to when drugs are taken orally?
This scared me