CancerPoints

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 this easier.

  • 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 rapidly).
  • 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 muscle.
  • Ask the nurse to use a blood pressure cuff instead of a tourniquet. They should pump the pressure until it is just above the diastolic.
  • 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 blood return.
  • 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.
www.cancerpoints.com

Suggestions and corrections are welcome and should be sent to .