I'm a grown man of forty years young. I've clacked shines with Muay Thai fighters, chipped teeth sparring, broken bones and bruised ribs. I don't say all that to flex, I say it because I feel like I'm a tough fella but NOOOOOOOOOOOOOOOOOOOO THANK YOU with the top-of-hand IVs. I've been through several surgeries and as one wonderful nurse at the Hospital always tells me when I come in "Don't worry, baby. We got you your Lidocaine." Ah, she's such a sweet young lady.
I do understand reason for starting in the hand, as you can still move proximally, whereas if you blow the vein at the elbow, everything connected below it shuts down too It’s difficult, as it’s more uncomfortable in the hand going in, but more restrictive in the arm
As someone whose dealt with large open wounds down to muscle with nothing but adrenaline keeping me sane (saying too for pain reference and comparison to the IV), you’re absolutely right - the hand IV is a whole different beast. Even as a vet assistant who pricks and prods a few animals a day for some blood work, you’d think I wouldn’t be squeamish with this video but I was cringing and looking away!! I just envision the times it’s been done to me and feel a bit sick. I don’t know what it is!!
It's good you discussed yips. It's such a thing. After i have a couple of tricky failures in CT, it's hard to be confident. Good thing is in there you often dont get to stop, more patients to cannulate! Messes with your head though. To your colleague: don't fret, happens to the best of us, and we dont have a camera on!
Dr . Gill , The i.v. cannulas used on our Advanced Life Support Paramedic Ambulances have a tab on it to retract the needle once the cannula is in to prevent accidental needle sticks . I have done so many of these that it had become second nature . When we learned how to start i.v.s in paramedic class , we started on training arms , then moved on to real arms for practice . Once we proceeded onto our clinical and field rotations , we were actually doing this on real patients with real problems . This skill is also required to pass in the National Registry of EMTs Paramedic Cognitive Skillls Exam here in America .
@@DrJamesGill The i.v. cannulas commonly used on our ambulances here have a button on the upper end that is pressed after the catheter is inserted into the vein which retracts the needle into the shaft for safe disposal into the sharps container . It also prevents accidental needlesticks to the paramedic or other advanced healthcare provider .
A little perspective from the other side: Anytime I'm having a lab draw or IV, I always start by giving them a heads-up: "My veins are small, deep, and roll away....good luck." Then I also list all the different locations that have worked before: forearm, wrist, back of hand, first joint of index finger, etc. My record is 5 tries....1st person tried twice, as did the 2nd person; 3rd person finally got it in one try. I've also had some who resorted to ultrasound or the red light scanner. But through it all, I always stay positive with whomever is working on me....and usually have a chuckle or two. 🤔 It's never a good idea to anger those with sharps. 😁
I got UC and I get these put in every 4-6 weeks. The first time it was done by a nurse in the ER and it not only took her 3 attempts but once it was done it was extremely debilitating, it hurt all the time and I couldn't move my arm much, couldn't shower properly and the plastic bit was always digging into my skin. Later, when the people in the gastro department put a new one in it didn't hurt at all, never felt it enter even. Moral of the story I suppose; it's really important that it's done right.
As someone who took Anatomy & Physiology and gotten IVs myself for surgeries and infusion therapy, I had to watch it for myself. I’m always a hard stick. My friend who is an EMT even had a hard time. Why is that?
That makes sense. Could dehydration also be a factor? I noticed dehydration, usually after a patient vomits a lot from chemo, side effects of medications, viruses, infections, etc, IV insertion can be difficult.
Is this surgical or standard ANTT? If standard, it is imperative not to compromise the cleanliness of the area occluded by the cannula dressing. It is a perfect breeding ground for bugs.
I haven’t cannulated humans only animals but the first time I was so timid I couldn’t advance it into the vessel even though the animal was anesthetised 😅 so my instructor said encouragingly to give it some welly and so of course I pushed too hard and went through the bottom of the vessel. Managed to save it though and it was a good first lesson after practicing on models lol
From the patient end I have Raynauds among other things that makes it more difficult to draw blood or get an IV when it’s cold! So I’ve ended up with four needles in at once and I think the students / nurses usually feel worse than I do because they feel guilty! But I figure it’s good practice for them, we all had to learn through practice!
That’s the thing I find many struggle with initially, you can still save a cannulae that you made a few small mistakes-steps on if you are calm and focused
How my doctors and nurses do it Step one: Tell me about 6 hours before in which time I ruminate on every possible outcome. Step 2. When the time comes they spend a few hours convincing me to have the procedure done. Step 3. After me telling them in no uncertain terms in no way is another sharp thing getting stuck in my skin, they arrange for sedation and do it anyway 😂
Yes, often that’s a problem for us as well. If somebody is having blood taken, I often advise them to make sure they’ve drunk plenty before they do say
Getting an IV is my least favorite part about going to the hospital. I get a routine every couple years for my stomach and since I’m an adult now I have to get the IV while I’m awake. I’m not even worried about the procedure itself the IV is the only thing that I don’t like. I deal with it though as much as I don’t like it
I once had an inflamed appendix and several doctors were begging me to consent to surgery. I was so scared of the needle that I kept refusing. It eventually sorted itself out for some reason. Edit to me half way through the video: guess who just vomited
oof. Pass. Cannot watch this one. 🤢I have to look away if a needle comes anywhere near my skin. Phlebotomists have told me we men are the worst about needles.😊
Your ending was very wholesome with encouraging words. Getting those dad energy vibes really early aren't you!
I’d hope I’ve always tried to support my students in this way. But thank you for saying it regardless 😊
I properly laughed at "re-evaluation of the rules". Really interesting video, thank you!
Glad you enjoyed it!
Imagine Dr Gill and Dr Berryin one video. If only we could locate Dr Berry
I'm a grown man of forty years young. I've clacked shines with Muay Thai fighters, chipped teeth sparring, broken bones and bruised ribs. I don't say all that to flex, I say it because I feel like I'm a tough fella but NOOOOOOOOOOOOOOOOOOOO THANK YOU with the top-of-hand IVs. I've been through several surgeries and as one wonderful nurse at the Hospital always tells me when I come in "Don't worry, baby. We got you your Lidocaine."
Ah, she's such a sweet young lady.
I do understand reason for starting in the hand, as you can still move proximally, whereas if you blow the vein at the elbow, everything connected below it shuts down too
It’s difficult, as it’s more uncomfortable in the hand going in, but more restrictive in the arm
As someone whose dealt with large open wounds down to muscle with nothing but adrenaline keeping me sane (saying too for pain reference and comparison to the IV), you’re absolutely right - the hand IV is a whole different beast. Even as a vet assistant who pricks and prods a few animals a day for some blood work, you’d think I wouldn’t be squeamish with this video but I was cringing and looking away!! I just envision the times it’s been done to me and feel a bit sick. I don’t know what it is!!
It's good you discussed yips. It's such a thing. After i have a couple of tricky failures in CT, it's hard to be confident. Good thing is in there you often dont get to stop, more patients to cannulate! Messes with your head though.
To your colleague: don't fret, happens to the best of us, and we dont have a camera on!
I’m so needle squeamish but had to click on this vid because it’s new dr gill
👍
here french nurse, nice to watch your videos! thank you!
Glad you like them! Any other areas you’d like us to to cover?
@@DrJamesGill well, you did already so much! But why not anything in the psychiatric field?
Dr . Gill , The i.v. cannulas used on our Advanced Life Support Paramedic Ambulances have a tab on it to retract the needle once the cannula is in to prevent accidental needle sticks . I have done so many of these that it had become second nature . When we learned how to start i.v.s in paramedic class , we started on training arms , then moved on to real arms for practice . Once we proceeded onto our clinical and field rotations , we were actually doing this on real patients with real problems . This skill is also required to pass in the National Registry of EMTs Paramedic Cognitive Skillls Exam here in America .
I’ve not seen one with a retractable tab on it. Is it something you have to do actively, or is it like the safety clasp in the video - automatic ?
@@DrJamesGill The i.v. cannulas commonly used on our ambulances here have a button on the upper end that is pressed after the catheter is inserted into the vein which retracts the needle into the shaft for safe disposal into the sharps container . It also prevents accidental needlesticks to the paramedic or other advanced healthcare provider .
@derrickw5204 that’s very cool, and I’d assume has reduced a lot of stick injuries
Thank you Dr Gill for this video, truly appreciated it. Refreshed the concepts right back in my brain. You explained this well. Thank you, thank you.
I'm needle squeamish but I still find your videos amazing and very informative
A little perspective from the other side: Anytime I'm having a lab draw or IV, I always start by giving them a heads-up: "My veins are small, deep, and roll away....good luck." Then I also list all the different locations that have worked before: forearm, wrist, back of hand, first joint of index finger, etc. My record is 5 tries....1st person tried twice, as did the 2nd person; 3rd person finally got it in one try. I've also had some who resorted to ultrasound or the red light scanner. But through it all, I always stay positive with whomever is working on me....and usually have a chuckle or two. 🤔 It's never a good idea to anger those with sharps. 😁
Hahah. I think that’s very fair 😊
My first day to insert cannula l did well l was even surprised because l am MCA ❤❤❤. thank you very much 👍
I could’ve done with you last week. Took hospital 4 attempts to get my Cannula in for my CT scan. 2 goes in my left and 2 in my right arm.
I’m sorry you had a bad run of it. Sometimes the cannulae gods abandon all of us
I got UC and I get these put in every 4-6 weeks. The first time it was done by a nurse in the ER and it not only took her 3 attempts but once it was done it was extremely debilitating, it hurt all the time and I couldn't move my arm much, couldn't shower properly and the plastic bit was always digging into my skin. Later, when the people in the gastro department put a new one in it didn't hurt at all, never felt it enter even. Moral of the story I suppose; it's really important that it's done right.
As someone who took Anatomy & Physiology and gotten IVs myself for surgeries and infusion therapy, I had to watch it for myself. I’m always a hard stick. My friend who is an EMT even had a hard time. Why is that?
There can be so many reasons, everything from patients fitness to air temperature
That makes sense. Could dehydration also be a factor? I noticed dehydration, usually after a patient vomits a lot from chemo, side effects of medications, viruses, infections, etc, IV insertion can be difficult.
Is this surgical or standard ANTT? If standard, it is imperative not to compromise the cleanliness of the area occluded by the cannula dressing. It is a perfect breeding ground for bugs.
Usually faints during blood draws .. seeing this video hoping your voice will make me calm and let me watch in full😅
Amazing, thank you very much
Great video thank you!
I haven’t cannulated humans only animals but the first time I was so timid I couldn’t advance it into the vessel even though the animal was anesthetised 😅 so my instructor said encouragingly to give it some welly and so of course I pushed too hard and went through the bottom of the vessel. Managed to save it though and it was a good first lesson after practicing on models lol
From the patient end I have Raynauds among other things that makes it more difficult to draw blood or get an IV when it’s cold! So I’ve ended up with four needles in at once and I think the students / nurses usually feel worse than I do because they feel guilty! But I figure it’s good practice for them, we all had to learn through practice!
That’s the thing I find many struggle with initially, you can still save a cannulae that you made a few small mistakes-steps on if you are calm and focused
Yes, "don't panic and try again" is easier said than done but it really does make the difference to stay calm!
@@DrJamesGill
very good video
👍
Luckily most places don’t use sterile technique in most hospitals because it’s unnecessary. In Bristol we just use ANTT, the same as venepuncture.
I have severe Trypanophobia. The fear of needles. I'm on the verge of a panic attack just typing this. This is one video I will have to sit out.
How my doctors and nurses do it
Step one: Tell me about 6 hours before in which time I ruminate on every possible outcome.
Step 2. When the time comes they spend a few hours convincing me to have the procedure done.
Step 3. After me telling them in no uncertain terms in no way is another sharp thing getting stuck in my skin, they arrange for sedation and do it anyway 😂
This Gonna be Good, 3 hours left!
Do you know a doctor that lives in Richmond Virginia who specializes in people with disabilities
The only time I’ve had an IV I was so dehydrated that they had to ultrasound my upper arm to find a viable vein.
Yes, often that’s a problem for us as well. If somebody is having blood taken, I often advise them to make sure they’ve drunk plenty before they do say
Ant you ment to flush the line before hand
Didn't know doctors did those things. Around here only nurses and other lenses nurses that do that
it is usually nurses, but i believe it's still required for medical students to learn
Getting an IV is my least favorite part about going to the hospital. I get a routine every couple years for my stomach and since I’m an adult now I have to get the IV while I’m awake. I’m not even worried about the procedure itself the IV is the only thing that I don’t like. I deal with it though as much as I don’t like it
Ive had this done to me. Itchy, aggravating, and uncomfortable. WAS SO FUCKING HAPPY WHEN IT WAS REMOVED
They can be quite bothersome when they are in for a white can’t they!
I once had an inflamed appendix and several doctors were begging me to consent to surgery. I was so scared of the needle that I kept refusing. It eventually sorted itself out for some reason.
Edit to me half way through the video: guess who just vomited
👍🏻
oof. Pass. Cannot watch this one. 🤢I have to look away if a needle comes anywhere near my skin. Phlebotomists have told me we men are the worst about needles.😊