Difficulty in Finding Veins for IVs,
Injections and Blood Draws
Cancer patients are usually stuck with needles many many times. Since
chemotherapy can cause veins to collapse, it can become very difficult
for nurses to find veins. Here are some suggestions for ways to make
- If you are given the choice of having a 'port' installed
(preferably one of the types that goes under the skin, as they are
easier to keep clean), go for
it. Not only does this make it much easier for the nurse to find the
vein, but it is also much less painful. Most patients prefer arm ports
to chest ports.
- The veins at the elbow (the cubital fossa) are close to the
surface of the skin and easier to see.
If the nurse has trouble using a vein at the elbow, she may want
to try the back of the hand. Although this is easier, the nerves are
closer to the veins on the back of the hand, so the nurse is more
likely to hit a nerve on the way to a vein. This is very painful, and
lasts for several minutes.
- Have the nurses alternate arms, using one arm one day and the
other arm the text. This will give your veins a little time to rest,
allowing them to last longer before collapsing.
- Drink a lot of water about an hour before they need to stick a
needle in you. If you are dehydrated, the veins won't show up as well.
- Squeeze a stress ball or pump your fist (open and close your hand
- Instead of using a tourniquet around the arm, have them try using
the tourniquet over the shoulder.
- If the tourniquet doesn't feel very tight, tell them so they can
try making it tighter. Make sure they put the tourniquet above the
mound of the bicep. Inexperienced nurses will tie it on top of the
- Ask the nurse to use a blood pressure cuff instead of
a tourniquet. They should pump the pressure until it is just above the
- Have the nurses wrap a hot moist towel around the arm. Microwaving
a damp towel for 15-30 seconds should be sufficient. (They should
check it first to make sure they haven't made it too hot.) A hairdryer
or soaking in warm water can also work.
- Tapping or rubbing the arm can sometimes make veins 'pop'.
- If you will be in the hospital for several days, ask whether they
can leave the IV in for longer. Often, if they cover the area with
tegaderm they can leave the IV in for up to three days. They'll need
to inject it with saline from time to time and make sure it has a good
- Before the give you an IV, try jumping jacks, pushups or running up and
down the stairs to get your veins to pop.
- A new device called a 'vein viewer' uses infrared light to make
veins more visible.
Three strikes rule: After a nurse has unsuccessfully poked you three
times with a needle, suggest that she ask another nurse for
help. Every hospital has an "IV team" of nurses who are very skilled
at finding veins.
If they put the IV in at the elbow, keep your arm straight and try to
avoid moving it. The more you move the arm, the more likely the IV is
to 'infiltrate' (move out of the vein and into other tissues).
Copyright © 2005-2009 by Mark Kantrowitz. All rights reserved.
Suggestions and corrections are welcome and should be sent to