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How to start an IV for nursing 2021 – (IV Insertion Tips)

I used to SUCK at inserting IV’s. It was terrible, I knew how to do them but no matter what I did I KEPT blowing the vein or going “through and through” and it SUCKED. IV access is probably one of the most important nursing interventions in all of nursing. I would put it as important as giving CPR to a person that is coding – assuming they are full code of course :).

Make sure you watch my previous video on how to start IV’s if you are interested in learning how to start them!

In this video I will talk more about inserting IV’s and tricks that REALLY helped me be able to insert them with a 90% success rate.



Level I Veins visible Easy to palpate Large in size Level 2 'Ans visible Easy to pa Ipete Moderate i n previous IV undamaged Level 3 v' 'Ans visible Easy to pa 'pate Small in size Limited veins e.g. some sclerosis Long term IV therapy Level 4 \kins difficult to see Can be pa I gated Patient's previous IV therapy has reduced vein quality Elderly (age Level 5 Cannot see veins Cannot palpate May need to utilize several techn iq ues to visual veins Patient has central access on previous admission

61目 ~•• •m훼크 1 移: S" 1까d S -

BD Nexiva™ closed IV catheter system Single Port, packaged with MaxZero™  needle-free connector - BD

1. Look at the end of the bevel. You can see that it that there is a tip at the end of which is sharp. Make sure you that you are going into the vein with the bevel up like so.
2. Make sure you go into the vein at the appropriate angle. Here are some examples.
3. Understand the depth of the vein. Goes back to the “level of IV”.
4. Do not insert the needle in ALL THE WAY. You only have to go a little bit and then push the plastic part through the vein.


  1. Turn on lights. This may seem obvious but good lighting is key for good veins to insert IV’s in.
  2. When you’ve applied the tourniquet, make sure you palpate the vein and see if it is really “rolly”. That means if you see it roll around in the arm, the tells you it is important to pull the skin tight so the vein doesn’t move. I pull the skin down. HOWEVER this creates a problem. You can’t see the vein anymore. So right before insertion make a note OR use an alcohol swab and put the corner of it where the vein is so you can keep track. Like so:

Why Do Some People's Veins Appear Through Their Skin?

  1. Appropriate gauges… The hand has really small veins don’t go for a 18 gauge IV. Realistically you can get like a 22 or MAYBE a 20…
  2. Choose the appropriate spots for insertion…
  3. Be sure to identify the type of patient you have, some are more likely to move, others can just handle the pain better of an insertion… Always consider the patient.
  4. Identify where it is in relation to patient behavior. If the person makes fists a lot or is not able to listen to your instructions well then maybe the hand isn’t the best place, the forearm is better.
    • HOWEVER, I will say sometimes you do not have time to get a PERFECT placement but you need IV access to control the pain, nausea or even HR, so just get an IV anywhere for now and re-assess later… (of course this isn’t best practice but what can you do, better to control the symptom that get a perfect iv placement)
  5. Identify the patients need for an IV, any special considerations (CT with contrast? Will probably need a 20 gauge to be safe)…

BD’s website:

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