The veins are an important part of the body’s circulatory system and contain up to 75% of the body’s total blood volume at any given time. Veins are three-layered blood vessels that have valves on the innermost layer to prevent the backflow of blood. The major purpose of the veins is to carry the blood from the organs to the heart. This blood may be de-oxygenated, in the case of systemic circulation or oxygenated in the case of pulmonary circulation.
Veins also have great medical significance as they are the site for IV (Intravenous) administration and collecting blood samples (phlebotomy).
Intravenous administration is a common, minimally invasive medical procedure that involves the insertion of a thin tube (catheter) into the vein through the use of a single injection. This procedure is used to introduce liquid substances into the body (either blood, medications, or hydrating fluids).
How do you carry out an IV procedure?
Although this procedure is minor, if done incorrectly, it can pose a risk of infection and venous collapse. Thus, extreme care should be taken before this procedure is carried out.
A certified nurse or a medical practitioner is the person most suited to carry out this procedure, but in the case of a medical emergency, the following steps should be adhered to:
- Clean the site: The first step you should take in carrying out a venous procedure is to clean the chosen site with an antiseptic (an iodine solution or isopropyl alcohol are suitable examples). This reduces the risk of infection and increases the visibility of the vein.
- Access the vein for insertion: Next, the proper vein needs to be accessed. You should ensure that the vein is healthy and is at no risk of rolling or collapsing. Healthy veins are well-hydrated, firm, supple, and easy to reach.
- Tie a tourniquet: After the proper vein has been identified, a tourniquet is tied about 20-25cm above the insertion site. This increases intravenous pressure and causes the vein to dilate (which further improves visibility).
- Insert the IV catheter: The needle, with the catheter over it, is inserted into the vein with the bevel facing upward. Once you notice the backflow of blood in the hub of the needle, lower the angle of the needle to avoid puncturing the walls of the vein and insert the catheter.
- Begin the infusion: After the catheter has been firmly inserted into the vein, remove the tourniquet and secure the IV line to the hub of the catheter. Make sure you secure the catheter to the skin with tape before you begin the infusion.
What are the common veins that are used for the IV procedure?
Based on location, veins are generally divided into two types: Central veins and Peripheral veins.
The peripheral veins (especially the superficial peripheral veins) are located beneath the surface of the skin, which makes them easier to access. Peripheral veins, located in the upper extremity that are straight and less branched are more anchored and roll less than those in other sites. As such, these are preferred for the IV procedure. Some of these veins include:
- Basilic vein and its tributaries
- Cephalic vein and its tributaries
- Median antebrachial vein
What are difficult veins?
In some cases, veins can be problematic to access. These veins are termed ‘difficult veins’ because they tend to have very thin walls that can collapse very easily and are also fairly hard to find. These veins occur as a result of a variety of causes, some of which include:
- The age of the patients: Children and the elderly tend to have more difficult veins than others.
- Genetics: Some people may naturally have weaker venous walls than others.
- Poor hydration: In cases of poor hydration, the veins tend to be constricted and, as a result, are smaller in size.
- Poor overall health condition: Health conditions, like obesity, can make veins harder to find.
How do you access difficult veins?
To access difficult veins, some of these actions can be employed:
Physical position
Before starting an IV line, the patient’s fist should be clenched, as this will enable the veins to be seen. If this does not occur, the patient should take some time (about 15 minutes) to relax.
Get the body warm
A warm body improves blood flow which causes a dilation of the veins. However, it should be noted that too much heat can lead to the patient getting burned, so care should be taken when heat is applied. Here are some methods that you can use to introduce heat:
- A warm compress can be applied to the site.
- Encourage the patient to take a hot shower before the procedure.
- In the absence of a warm compress, the arm can be soaked in warm water for a few minutes, or a clean, warm washcloth can be placed on the area.
- Gently massage the area for a few minutes before starting an IV line.
Light exercise
The patient should be encouraged to do some light exercises, like jumping jacks or a few bicep curls. This would improve blood flow and ultimately make the veins more visible.
Use gravity
Before starting an IV line, the patient should be encouraged to assume a lying or sitting position with the arm dangling downward. The force of gravity would slow the blood flow through the veins and cause them to become distended and visible.
Ensure proper hydration
If your patient is known for having veins that are difficult to access, you should encourage the client to hydrate properly with water or a sports drink before the procedure.
THE NATIONAL IV ASSOCIATION REVIEW COURSE
The IV administration may seem like a straightforward procedure, but if done incorrectly, it can cause various complications for the patients. As such, this procedure should only be carried out by IV technicians with the right IV certification.
But not many people have the time to spend going to class and attending lectures. To combat this problem, the National IV Association offers online courses at subsidized prices that will equip you with the necessary skills and knowledge needed to pass the National IV Certification Exam and help you become a certified IV technician.
This course is 100% online, with videos and study guides that can be studied at your own pace. Better still, enrolling in this course allows you to sign up for the National IV Association exam at no additional cost.
To register, just sign up here.
