There are only 3 ways you can fail iv cannula insertion

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  • Опубліковано 22 лип 2024
  • So I've tried to simplify this to 3 main areas of immediate cannula failure.
    I believe that If you know how to fail, you will know exactly what to do not to fail.
    When supervising doctors just starting to learn cannulation, I understand that failure occurs. However, if failure occurs and the student knows why they failed, this allows them to improve next time with deliberate attention to detail on their next attempt!
    1) miss the vein altogether (no flashback of blood is observed)
    2) puncture the deep wall or side wall
    3) The needle and cannula isn't advanced far enough prior to advancing the plastic cannula.
    that's it!
    Thanks for watching!!!
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КОМЕНТАРІ • 228

  • @bloodvenomthestrongestoldh2778
    @bloodvenomthestrongestoldh2778 2 роки тому +679

    Me: * inserts and blows vein *
    Patient: “is it in yet?”
    Me: “you’re quite dehydrated sir you should drink more water” lol

    • @dranilbabuswarna
      @dranilbabuswarna 2 роки тому +20

      😂😂 can relate..

    • @sheveenvassell2060
      @sheveenvassell2060 2 роки тому +2

      🤣🤣🤣

    • @wansangoh4951
      @wansangoh4951 2 роки тому +4

      😡😡😡 Immediately after IV insertion, when the doctor wanted to test my IV line by running normal saline through my IV, I felt an intense burning sensation around my IV site. It was one of the most excruciating pain I’ve ever felt in my life! I asked her why it was so painful running normal saline through my IV, she said she can remove the IV & start a new IV line. I gasped! The area around my IV site was swelling so badly .

    • @sonuthing3567
      @sonuthing3567 2 роки тому +51

      @@wansangoh4951 It happens. Dont worry

    • @meenumeenu7964
      @meenumeenu7964 2 роки тому

      😅😅

  • @yamomma7891
    @yamomma7891 3 роки тому +64

    My man straight up has blood on his right hand at 2:27. Now that's someone who does this for a living.

  • @iplayCoDandBF
    @iplayCoDandBF Рік тому +40

    This video genuinely changed my life. 99% of the time I've failed an IV it's because I wasn't inserting the catheter and needle far enough. Havent failed a patient since. Thank you so much for this.

    • @asianboy2177
      @asianboy2177 Рік тому

      are you a Radiologic Technologist?

    • @iplayCoDandBF
      @iplayCoDandBF Рік тому

      @@asianboy2177 RN

    • @asianboy2177
      @asianboy2177 Рік тому

      ​@@iplayCoDandBFoh that's great! do you know if Radiologic Technologists also do IVs? How often? and are they doing other kind of insertions aside from IV?

    • @iplayCoDandBF
      @iplayCoDandBF Рік тому +2

      @@asianboy2177 as far as I know, it is sometimes something that's required of you.

  • @pb5640
    @pb5640 3 роки тому +91

    I can think of some rare others to add to your list for example: Improperly using a tight tourniquet on an elderly frail vein (especially patients on long-term oral steroids) can actually cause it to “blow up” on piercing. Another is choosing a vein that’s been recently cannulated or where they arm is been recently traumatized. Since I’ve been using ultrasound I’ve been occasionally finding superficial clot in a vein’s that would have been selected for standard IVs. Another very rare cause for a miss is that the needle lumen cores some skin or fat and so while you’re actually in the vein, you don’t see flash and pull the entire needle out when in fact you were in. In this last scenario, when you’re reasonably sure that you’re “in” but you didn’t get a flash, pull the trocar out to see if you have blood return rather than pulling the whole catheter out.

    • @1packatak
      @1packatak 3 роки тому +4

      Elderly veins can really be challenging! Add any amount of dehydration to the equation and it becomes even worse.

    • @_nurse.lian_
      @_nurse.lian_ Рік тому

      I honestly don’t know the relation of steroids use to frail veins. I wanna learn what is the rationale behind.

    • @asianboy2177
      @asianboy2177 Рік тому

      are you a Radiologic Technologist?

    • @nancydowe1203
      @nancydowe1203 10 місяців тому

      Thank you for this answer.

  • @JaneDoeowo
    @JaneDoeowo 2 роки тому +3

    I have a connective tissue disorder and have had many ivs and blood draws and central lines. Even with ultrasound they struggle to get lines in me. Central lines included. Peripheral lines that are in infiltrate within a few hrs/a day or less usually. As a nurse, I try to help out anyone trying to treat me but it's hard. Haha good video! Helps a lot with what the basic issues are! We should all know these things to help our patients

  • @marabanara
    @marabanara 2 роки тому +11

    As a nurse working in Day Onc, not only do my pts often have terrible veins from super frequent cannulation & path venepuncture, I also don't have local anaesthetic prescription privileges nor easy access to US guided cannulation. I LOVE your tips however, even though you assume in some vids that it's doctors doing the cannulating ;-P
    In all,seriousness, thank you very,very much for your content. Anaesthetists are amazing at everything they do. I particularly appreciate when you are able to demonstrate on a real person. The tip about vasospasm after getting flashback was definitely a lightbulb moment for me, and I still raise the cannula while advancing it, taking advantage of that blunt edge of the bevel.
    Thanks again, from a chemotherapy RN.

    • @lir3379
      @lir3379 2 роки тому

      Thank you for choosing your profession. Even as a medical professional, I now have a personal reason for truly admiring the work done by a chemotherapy nurse ... every.day.

    • @juki6377
      @juki6377 2 роки тому

      Central lines for everyone :P - I wish there were some tips in cannulating obese people, i find them the hardest

    • @caneswarrior
      @caneswarrior 2 роки тому

      @@juki6377 ultrasound guided iv lol.

    • @juki6377
      @juki6377 2 роки тому

      @@caneswarrior ain't nobody got time for dat

  • @caffeinefix2751
    @caffeinefix2751 2 місяці тому

    Dr Lahiru, really enjoyed your pain management lecture at Sunshine yesterday, thank you for having an awesome energy and being so very approachable. Keep up the good work!

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  2 місяці тому

      Hey thanks so much! Always a privilege to teach the doctors of tomorrow :)

  • @angelavanhorn7335
    @angelavanhorn7335 3 роки тому +14

    You give some of the best most detailed advice!! ☺ thank you!

  • @dranilbabuswarna
    @dranilbabuswarna 2 роки тому +1

    Nice explanation sir 🙏🏽

  • @keshavarsa5279
    @keshavarsa5279 2 роки тому +4

    I don't know why but when I am pushing cannula , back flow of blood is coming but the cannula is not moving forward

  • @rishabgill866
    @rishabgill866 2 роки тому +4

    Mate you got the best explanation out there

  • @Edoc-kc9mn
    @Edoc-kc9mn 4 місяці тому

    Thanks for the tips!

  • @mariatubangura-di2pr
    @mariatubangura-di2pr Рік тому

    Perfect explanation sir

  • @yanoliveira2171
    @yanoliveira2171 3 роки тому +1

    Great tips!

  • @ninaakerstrom5327
    @ninaakerstrom5327 5 місяців тому

    Any tips as for stretching the skin before attempting an IV cannulation? Is it better to pull the skin down or to the sides from the chosen vein?

  • @nasj7704
    @nasj7704 Рік тому

    number 2 picture if I pull out gradually and relevel without coming out of the skin, could be successful but the infiltration already happened. do we still keep the needle in?

  • @waggingthroughlife
    @waggingthroughlife Рік тому +1

    Thank you so much for this.

  • @karenbaldry8096
    @karenbaldry8096 2 роки тому +1

    Thankyou great tutorial

  • @abdulshaphi
    @abdulshaphi 2 місяці тому

    nice explanation...thank you

  • @varunsharma7521
    @varunsharma7521 3 роки тому +1

    Nice one thank you keep it up 👍👍

  • @yugoboss4life
    @yugoboss4life 3 роки тому +10

    Amazing, thank you!

  • @pennychurchward1481
    @pennychurchward1481 3 роки тому +184

    My main issue is advancing the cannula....I get a good flash back but the cannula doesn’t move forward

    • @SychJess
      @SychJess 3 роки тому +5

      This! I usually float it in when that happens... but Id love to hear his technique.

    • @chadp5530
      @chadp5530 3 роки тому +67

      That usually means your bevel is in but you haven’t advanced the extra couple of millimeters after the flash. Remember that the catheter has to be advanced into the vein as well as the bevel tip.

    • @1packatak
      @1packatak 3 роки тому +18

      You may also have hit a valve in the vein.

    • @rossmoorman9335
      @rossmoorman9335 3 роки тому +3

      It's true that you may have hit a valve, but this is usually not the culprit when new nurses get flashback but cannot advance the catheter. 9 times out of 10, the problem is that they are trying to advance the catheter after the needle has pierced the vein (and caused flashback), but before the catheter has entered the vein. This video explains it well, and how to avoid it: ua-cam.com/video/lq1T8tvrFuk/v-deo.html

    • @aminaseethi7452
      @aminaseethi7452 2 роки тому +5

      Me too

  • @MrAditanaya
    @MrAditanaya 3 роки тому +1

    Can you make subtitle in video?

  • @missknowall
    @missknowall 3 роки тому +1

    Very useful info, thanks.

  • @roy-nk4vq
    @roy-nk4vq 2 роки тому +1

    My problem is, I get a flash, but cannot advance the catheter. It kinks and will not advance. I must not be inserted far enough, before trying to advance the catheter. (vet med).

  • @FortheBudgies
    @FortheBudgies Рік тому

    Which of these feels like the needle is scraping on tendon and bones in my hand?

  • @prasadmattaparthi6799
    @prasadmattaparthi6799 2 роки тому

    Super Sir but easy technic iv channels and easy identify veins please help me

  • @yosraalhady6583
    @yosraalhady6583 3 роки тому +6

    You gave us huge information 😊thanks for these efforts

  • @RemyRolo
    @RemyRolo 3 роки тому +2

    Hi what about valves! Any specific checks pre-insertion of cannula. Sometimes you get initial flashback and then secondary flash, which then stops as you advance tubing which then does not advance?!?!?

    • @reddog6433
      @reddog6433 2 роки тому +2

      If this happens, remove the needle keeping the cannula in the vein. Attach your bung +/- extension set (primed) and saline flush and gently flush. If the cannula is actually in the vein stuck up against a valve then this “flush” will open it allowing you to advance the cannula further. Then disconnect the saline syringe and secure with tape / dressing etc. Hope that helps

  • @ninakilbridesheehan4334
    @ninakilbridesheehan4334 16 днів тому

    Vasospasm IS a thing, but very uncommon. I had a 14 year-old girl who had POTS and weekly infusions (she refused any other vein but the same one). After 6 months, she had an issue for a few weeks where the IV would run fast and then slow (one liter over 45-60 minutes on gravity) even though she was diligent about keeping her arm still. My last cannulation to that vein was easily successful with flashback and advanced cannula easily, but absolutely no blood return when the needle was removed. No swelling, no bruising and connected fluids to flush line and it would not flow at all. No infiltration. Scarring of the vein would have been at the insertion site, so not that. Her mom allowed her to refuse the IVs and after 2 weeks her migraines came back and she agreed to using the other arm.

  • @Feathers181
    @Feathers181 2 роки тому +18

    I get flashback, lower the angle, advance what I think is a few mm then try advance it completely and it either blows or I can see the plastic cannula flexing/bending as I try advance it in which then eventually blows. So frustrating as I need to cannulate multiple times a day for my infusion clinic job. I wish there was a practical course I could attend 😅

    • @DetectiveCreeps
      @DetectiveCreeps 2 роки тому +2

      Advancing a bit after flash is good. I've pushed the vein off my needle with the cath a few times. Lol. I'm getting a lot better now though. Am EMT.

    • @ofafa2897
      @ofafa2897 2 роки тому +3

      I was doing that, then someone watching me suggested going in a little more flush with the vein. This is also felt less by the patient. I'm always trying to improve.

    • @roy-nk4vq
      @roy-nk4vq 2 роки тому +1

      I have the same problem. Very frustrating. In veterinary medicine, we place several catheters in the morning, while preping patients for surgery, or dental prophy's.

    • @Feathers181
      @Feathers181 2 роки тому +2

      Hey guys! I got my clinical educator to watch me closely for a few different cannulas and yes I was definitely not advancing enough. I now advance more into the vein (lowered and flush with skin). I can now say I have a very good success rate with my cannulas 😊

    • @Feathers181
      @Feathers181 2 роки тому +1

      @@roy-nk4vq yeah it is super frustrating. Turns out I wasn't anchoring down the skin/vein firm enough and I wasn't advancing nearly half had much as I should have been. Good luck 😊

  • @tressssureTfresh
    @tressssureTfresh 2 роки тому

    Tanks nurse Toyin

  • @fsdx416
    @fsdx416 7 місяців тому

    How about being able to feel the vein in a fleshy person but not being able to aim at the vein and having the patient telling you to give up cause it hurst to much to reattempt

  • @ASMR-pp3hc
    @ASMR-pp3hc 3 роки тому +4

    Such easy to follow and interesting clips!

  • @yaradarine8866
    @yaradarine8866 10 місяців тому +1

    Thanks ❤

  • @dr.riffatawanofficial5132
    @dr.riffatawanofficial5132 3 роки тому

    JazakAllah sir

  • @granrappanotyouraveragemoe2682
    @granrappanotyouraveragemoe2682 2 роки тому

    You Made the difficult, easy.
    GranRappa

  • @lm4358
    @lm4358 2 роки тому +1

    So if I don't have a flash, but bleeding above the skin, so no hematoma, does this mean I was never in the vein (also not partially)? And what can be done about it? I always think I'm deep enough.

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  2 роки тому +6

      If you didn't get a flashback, you probably didn't get into the vein wall. either too shallow, or the vein moved.
      But caution if the vein is very small and not enough time passed to show flashback of blood.
      After you withdraw, if there is no haematoma, this is good, because the vein is still intact. the skin insertion point may still bleed but that isnt an issue with the vein integrity.
      So what can be done about it? - within reason, try again, maybe with a different approach, position, angle, insertion point. and then follow all the other techniques I suggest.
      Good Luck!

  • @newsmansuper2925
    @newsmansuper2925 2 роки тому +1

    put in cannula - to large vien, no flashback - withdraw - exactly on target can see the dot - no roll - ????

  • @duck-zq7zo
    @duck-zq7zo 3 роки тому +24

    Although this is not for the general public, it is still interesting.

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  3 роки тому

      haha thanks :) I think

    • @nobodynothing2594
      @nobodynothing2594 2 роки тому

      @@ABCsofAnaesthesia what does it mean & what actually happens when you say the vein “disappears”?
      Can you pls explain?

  • @ravenchua3768
    @ravenchua3768 3 роки тому +28

    Awesome video! Im really new to this and some questions i have are:
    1) how many cm of (straight) vein do i need to palpate in order to use it as a site for cannulation? Most of the time i can only feel up to 0.5cm to 1cm of vein, and then im not sure whether the vein travels left or right thereafter.
    2) Is that 1cm "runway" enough for me to insert the cannula in and then just push the sheath hoping that the sheath will just follow whatever course the vein takes? I.e even if the vein courses left thereafter, as long as my sheath is inside the 1cm "runway", the sheath would just follow the vein and turn left.
    3) Should my point of skin penetration be say, 1cm distal to the most distal part of the vein im able to palpate? Or should i just penetrate the skin right above where i can feel the vein?
    4) Do you have any tips for antecubital cannulation? Regarding how the arm should be positioned, where the most common vein spots are and the typical course of the vein, as well as any other tips one should know if attempting to cannulate the AC region etc...
    Im sorry for the numerous questions but I would be very appreciative and thankful if you could answer them! Thanks!

    • @fhb1997
      @fhb1997 3 роки тому +51

      Hey, so these are my thoughts;
      1) ideally you want a vein the length of the cannula, although this is rarely appreciable unless the pt has good veins. When i palpate veins I tend to DRUM my fingers around where I think the vein is, as if I’m like typing on a keyboard using middle index and ring fingers on non dominant hand. Some people slap, but I think this is a bit much lol. Alcohol wipes are THE best way (I think) to bring up the veins. Anyway - I drum my finger tips around the vein and this often helps engorge it. While drumming lightly you’ll being to feel the bouncy texture of the vein. This technique also helps you determine the trajectory of the vein as you begin to feel it’s direction with the drum fingers. Ideally go for veins you can FEEL rather than SEE.
      2) sort of answered above but also: ive done this many times myself (cannulating a vein while not being 100% sure of direction). What you wanna do I in this situation is get the flashback and advance enough to have the sheath of the cannula in the vein (1cm should be more than enough to do this). THEN retract the needle from the sheath slowly while advancing the cannula. As you extract the needle, the plastic sheath becomes quite flexible and is able to go round most bends within reason.
      3) No. Your point of entry should be AT the palpable part of the vein. If you attempt distal to this you may miss if the vein has dove deeper / changed course as you have no way of knowing. Just insert the needle right on the palpable spot, ensuring that you have a reasonable amount of vein to thread the cannula on through.
      4) Personally I rarely cannulate in the AC fossa. This is just because its quite uncomfortable for the pt and its more likely to kink if they bend their elbow. My ‘go to’ area is the forearm, as these veins are longest and straightest usuallyHowever sometimes needs must... When you’re going for this location you want the pt to extend their elbow pretty much fully (you’ll get a feel for how much extension you need based on the patient). The veins in this area most often form a sort of “Y” shape as they meet to form the median cubital vein (lol i hope i got that right). Quite often theres a good towards the medial epicondyle. Occasionally, if you cant find one in the fossa itself, there is sometimes a good vein around the anterior aspect of the medial epicondyle.
      General tips:
      - Use alcohol wipes to the absolute max
      - Tether the vein with your thumb (theres a vid on this channel)
      - Use a blood pressure cuff as a tourniquet if you’re struggling to find veins - pump it up to mid way between systolic and diastolic.
      - There’s usually a good vein down at the wrist - on the radial (lateral) side - it used to be called the ‘housemans vein’ cus its so good lol
      - Dont stop doing cannulas - it’s easy to get put off when you miss a few or have a bad day of them, but honestly the more you do the better you become. There genuinely are no secrets other than those mentioned in this video (which aren’t really secrets I suppose, just great advice!). The number one best way to get good at cannulas is to DO them, so keep at it!

  • @jbdebbielish8483
    @jbdebbielish8483 3 роки тому +2

    Best illustration Saudi Arabia 🇸🇦 🇸🇦 nurse care thanks

  • @kawolaprecious4965
    @kawolaprecious4965 Рік тому

    Good evening, so I insert the canular ,get the back flow but after a while the area swells what am I doing wrong? Pliz help me

  • @sugerless20
    @sugerless20 2 роки тому +18

    As a person who has been to the hospital thousands of times & had so many blood draws throughout my life I wish nurses & phlebotomists would watch this. So many times people tell my oh my veins are tiny, it rolled or it blew. ER nurses are the best at IVs. Recently I started noticing when the blood doesn't come its not a good sign. Then I get stressed but I'm not afraid of needles. I wish there was a new technology for blood draws. I do have a lot of scar tissue from years in the medical system.

    • @arjunvaradarajan1527
      @arjunvaradarajan1527 2 роки тому +4

      Unfortunately it gets harder the more you get stuck. Sorry for you. Only advice is to always stays well hydrated

    • @Tawny593
      @Tawny593 2 роки тому +19

      IV cannulation is not exactly the same as a blood draw. For one thing, they use different needles.

    • @Holypikemanz
      @Holypikemanz Рік тому +1

      there are new vein "lights" that are expensive af but may help blood draws in the future

    • @sugerless20
      @sugerless20 Рік тому

      @@Holypikemanz Yeah its called a vein finder & usually it doesn't help me

  • @MedicalBroadcast
    @MedicalBroadcast 3 роки тому

    Helpful

  • @user-si5sj2qv4e
    @user-si5sj2qv4e 5 місяців тому

    nice video

  • @janeannelson9332
    @janeannelson9332 5 місяців тому +1

    What happens when they hit a nerve or go through a vein on keep pushing and not taking it out and trying again! That is what happens to me

  • @camillercueto
    @camillercueto 3 роки тому +3

    You are the best!

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  3 роки тому +1

      too kind :)

    • @camillercueto
      @camillercueto 3 роки тому

      @@ABCsofAnaesthesia your new video did not disappoint as well; direct and straight to the point. 😊

  • @keithdanmendoza2559
    @keithdanmendoza2559 Рік тому

    Amazing tips. Buy this doctor a new marker people! haha

  • @vinodd890
    @vinodd890 Рік тому +1

    Actually just now I tryed for cannualation but I failed 3 times I m getting irritating

  • @ok-qx8ez
    @ok-qx8ez 2 роки тому +5

    I was curious as a patient who just had a blood draw, and the young lady was being trained she didn't get the first arm. I encouraged her to try again on second arm. The supervising nurse told her she blew the vein. They messed with it for bit and it hurt. Switch arms again and got it. Can something like this cause a blood clot because I have a lump on my shoulder now?

    • @slotnickproductions6862
      @slotnickproductions6862 2 роки тому +3

      That doesn’t sound like a blood clot, you should get that checked out by your doc. In general, blown veins just hurt and ruin the line, it’s just not a good experience for the patient but doesn’t cause much harm other than bruising and pain.

  • @marijnverwijs566
    @marijnverwijs566 3 роки тому +1

    Any neonate: "Hold my milk bottle."

  • @mussaelia8693
    @mussaelia8693 3 роки тому +14

    A best illustration to improve skills

  • @stevewilson8146
    @stevewilson8146 Рік тому

    I need some help .can someone email me or something.but…. I’m a bad diabetic and my sugar dropped extremely low .the ambulance came out and gave me a iv at the bend of the arm .well now my vein is kinda hard and in one spot there’s a bulge and it’s hard hard.

  • @gouthambm1507
    @gouthambm1507 3 роки тому +1

    What is flashback ?is it show of blood ?

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  3 роки тому +1

      Yes, it’s the blood appearing in the chamber of the cannula as soon as the needle enters the vein

    • @gouthambm1507
      @gouthambm1507 3 роки тому

      @@ABCsofAnaesthesia thank you so much I appreciate that and please can y demonstrate placing central line

  • @breezygirl974
    @breezygirl974 2 роки тому +13

    I often have a flashback of blood, but loose the flashback when attempting to advance the cannula. Could you point me to the most likely problem, and give any tips?

    • @iasian246
      @iasian246 2 роки тому +13

      from my experience, what you experience often times happens when you immediately try advance the cannula right when you get the flashback. a tip is to go in around that 1cm more with the needle before advancing as you've only just reached the vessel wall but haven't entered the lumen yet (like scenario 3 in this video)

    • @sergiomachuca4554
      @sergiomachuca4554 2 роки тому +7

      Don’t forget to lower the angle of your needle, advancing said needle + cannula, then finally advance the cannula itself.

    • @breezygirl974
      @breezygirl974 2 роки тому +1

      @@sergiomachuca4554 thanks for the tip, i think this was the problem! I just applied your tip, having a successful insertion.

    • @aminaseethi7452
      @aminaseethi7452 2 роки тому

      Me too🥲🥲what u do after

    • @user-ou5nl7gm4w
      @user-ou5nl7gm4w 2 роки тому

      can i know so actually there is backflow and i inserted it, so when flushing it will cause bump..is that also because it is not deep enough??

  • @CaeiroElsa
    @CaeiroElsa 3 роки тому +11

    Hello😉. Can i ask you to do a video for the role of nurses in the different fases of anesthesie. In the the country(Belgium) that i work, i have to help the anesthesiste in Endoscopie(digestif, lungs, and urinary), but at the same time i have to help the opérateur. So some times i feel lost and i don't no what to do, and when. Some of my colleagues just don't feel concerned about de fase of anesthesia, and waking up of the patient. But I think we need to understand what is happening, and what to do in case that something go wrong. Sorry about my English (but my first language is portuguese, and second is French). Thank you for your videos 😉 congrats

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  3 роки тому +2

      thanks for the request! that's a great idea and I'll definitely work on something for that :)
      in the meantime I have a few playlists that might be useful
      ua-cam.com/play/PLKoga8GNPk1VdkzxHFjWBymSjwBJrtqS7.html

  • @nancydowe1203
    @nancydowe1203 10 місяців тому

    Have a very ill regularly visiting patient that has great looking veins, get flashbacks, advance Cannula then blood disappears. I am not only practitioner w access issues. Oncology, phlebotomy, nursing all have problems. Pt. has chemo, radiation, & mthfr, now not getting chemo or radiation. Please suggest reasons other than your video for failed access. He is 50's ambulatory, ill frequently, and still income producing for the family. Please help.

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  10 місяців тому

      Hi, i would love to help. Are u able to take a video of an apparently
      Successful cannula attempt /video call me while doing it?
      With patient /hospital consent.
      If possible please email me abcsofanaesthesia@gmail.com

  • @BlinkOnWheels
    @BlinkOnWheels 2 роки тому

    Nobody has done local anesthetic unless I request it. So… I get to feel the whole digging experience when they miss a vein.

  • @mhine3420
    @mhine3420 3 роки тому +5

    The flashback in our country is called backflow haha

  • @roy-nk4vq
    @roy-nk4vq 2 роки тому +1

    Also, don't forget applying the tape! Tape can be very tricky! :-)

    • @roy-nk4vq
      @roy-nk4vq 2 роки тому

      Our method of applying tape to hold the catheter in place is different in veterinary medicine.

  • @PaulBakertx
    @PaulBakertx 2 роки тому +56

    Been preaching this for years. It's either too shallow, too deep, or you missed. "blowing" and "valves" are so rare I can probably count on 1 hand how many times that's been an issue in 10 years.

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  2 роки тому +24

      so glad to see your comment! I feel like failing something is not the problem, the problem is when one attributes the failure to something incorrect.. it prevents learning and improving. Thanks Paul!

    • @kirschmichel147
      @kirschmichel147 2 роки тому +6

      Yes. And I actually never liked it when professionals attributed failures in front of patients incorrectly. If you fail, admit it, everybody fails from time to time. I always tried to tell patients that I failed, and yes, veins can be difficult to find. But "blaming" it on the patient or something else always seemed like a bad decision to me.

    • @joestevenson5568
      @joestevenson5568 2 роки тому +15

      Really depends on your patient cohort. Blowing veins is not that rare with geriatric patients.

    • @DetectiveCreeps
      @DetectiveCreeps 2 роки тому +5

      Nah, valves are pretty common for me. Pull back some, hook up a flush, and float it the rest of the way. Blowing is usually really older people

    • @camdenswife
      @camdenswife 2 роки тому +10

      Valves are so real. You get flash, advance, and you can't advance. This is a valve.

  • @digiac4027
    @digiac4027 2 роки тому +1

    Number 1 is the most common in my experience as a patient, number 2 is the most uncomfortable
    Stabbing through the vein made me vomit, it feels super uncomfortable

  • @scherenschnitt6333
    @scherenschnitt6333 2 роки тому +11

    Nr 3 is the most common reason in my ER. I always tell the nurses to push the needle in. But mostly they are afraid of producing a nr 2.
    Once I have seen one nurse pushing the cannula, with the needle not retracted all the was through the tissue. A green without the ring. Damn.. This was a big hematoma.

    • @ok-qx8ez
      @ok-qx8ez 2 роки тому

      was curious as a patient who just had a blood draw, and the young lady was being trained she didn't get the first arm. I encouraged her to try again on second arm. The supervising nurse told her she blew the vein. They messed with it for bit and it hurt. Switch arms again and got it. Can something like this cause a blood clot because I have a lump on my shoulder now?

    • @scherenschnitt6333
      @scherenschnitt6333 2 роки тому +2

      @@ok-qx8ez yes it can cause a clot. Depending on the location of the injectionsite the vein will close itself.
      Usually the clots arent too big and wont harm your life.
      The biggest clotproblem during this procedure is, if the nurses dont sweep the fresh blood away with a syringe of NaCl. The blood will clot inside the canule and you will press this into the vein and accordingly into the lung next time.

    • @juki6377
      @juki6377 2 роки тому

      yes when i first started i used to be too afraid of hurting the person and would be too light, i watched someone ram one in within a blink and it was an aha moment. Also it was a field where we would avoid cubital fossa Ivcs, as well as hands.

  • @karenguzman351
    @karenguzman351 Рік тому

    I’ll hold the skin below and above where I’m inserting and see flash and let go of the skin and lose the vein

  • @ainstenoseias6753
    @ainstenoseias6753 2 роки тому +1

    Gostei vós fazer aqui no Brasil

  • @faatty1
    @faatty1 2 роки тому +8

    I've really struggled with the 3rd mistake when placing US IVs using the longer 18 gauges

    • @juki6377
      @juki6377 2 роки тому

      wait a minute or two once tourniquet is on for veins to "fill", then lower as much as you can once you get a solid flashback

    • @mywifesson782
      @mywifesson782 Рік тому +1

      if you are using ultrasound dont go off flashback you need to trust the 'bullseye' and continue to advance a safe amount.

    • @nicholasthompson8772
      @nicholasthompson8772 Рік тому

      @@mywifesson782 walk that dog! I honestly don't even look at the flash chamber until I've walked it a few times.

  • @mounikabitra9054
    @mounikabitra9054 3 роки тому +1

    Sir this is mounika.... Your's new Subcriber...I'm from India🇮🇳..... I always failed👎for insertingCANNULIZATION to the patient..... I'm not able to understand stand tips of this process 😫... While I'm inserting cannula my hands got Shevaring..... 😞

  • @iforce6567
    @iforce6567 3 роки тому +1

    Simple but need thousand hand memory

  • @rexthegamer4095
    @rexthegamer4095 2 роки тому

    When ur ex comes to u to get a canula : u watch this

  • @newsmansuper2925
    @newsmansuper2925 2 роки тому

    Touch vien - explodes. Just pierce skin - who hand extraves - like a catalytic reaction.

  • @pubudupelarachchi6854
    @pubudupelarachchi6854 2 роки тому +1

    R u a Sri Lankan?

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  2 роки тому

      yes, I was born in peredeniya :) love so much about Sri Lanka, and so many fond memories of my relatives and the trips and the food!

  • @Clarkson350
    @Clarkson350 11 місяців тому

    After they miss once its onto the next.

  • @CS-kb6by
    @CS-kb6by 3 роки тому

    Is that blood on his right ring finger? haha

  • @eunicerogers618
    @eunicerogers618 3 роки тому +2

    Great tips indeed. Thanks

  • @FaTaLthe13th
    @FaTaLthe13th Рік тому

    Been a medic for a year and these past two weeks have been nothing but misses and blows

    • @ruthie1horse
      @ruthie1horse Рік тому +1

      I think that happens to everyone, don't lose heart. It's easy to doubt yourself before you've started. It will come with practice.

  • @kawolaprecious4965
    @kawolaprecious4965 Рік тому

    Am a 1st year medical student

  • @merzouguighoufrane5656
    @merzouguighoufrane5656 2 роки тому

    I didn't think there was another way to f up but then I inserted the needle flipped over.
    Hurt the patient and had to change sites 😭

  • @bethanymaedona7820
    @bethanymaedona7820 2 роки тому +5

    The most difficult part in inserting iv cannula is when the patient moves a lot like in pediatrics or irritable adult patients

    • @joestevenson5568
      @joestevenson5568 2 роки тому

      Thats easy in paeds because you just get the nurses to pile on them.

    • @roy-nk4vq
      @roy-nk4vq 2 роки тому

      You should try placing a catheter on a dog or cat that won't sit still, and has short legs, with twisty veins! :-)

    • @eveyk.1204
      @eveyk.1204 Рік тому

      You should also listen to your patients more. If a patient screams during blood draw, he/she may just be very afraid but if they scream during iv cannulation and beg you to stop because the pain is excrutiating, you have to stop! Most of the times it is because you hit a nerve or a tending or in my case, the stupid nurse was pushing the saline salution in my arm for like 5 minutes despite not being in the vein but probably close to a nerve. I ended up with a swollen arm, huge amount of blood that wouldn't stop coming out but no hematoma, and nerve damage that will probably take years to repair.

  • @Charlie-ov1bj
    @Charlie-ov1bj 2 роки тому +1

    i did my 5th cannula today.... im currently at clinical practice...
    so what happened was i think my cannulation was correct... i got the flashback so i pushed the cannula all the way in... the n/s flash also went in nicely... but after an hour or so the cannulation spot was very much swollen...
    now was my cannulation wrong?... and have i made a terrible mistake?... if anyone can help me out... im very nervous

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  2 роки тому +1

      Firstly Well done! I wouldnt worry too mucj about this one… it could have been in and then tissued.
      Check out my video to
      ua-cam.com/video/4SR8UofiaI4/v-deo.html
      And each time you use it always be suspicious about whether its still working.
      Nice one!

    • @Charlie-ov1bj
      @Charlie-ov1bj 2 роки тому

      @@ABCsofAnaesthesia alright, thanks so much

  • @sylshoemaker6734
    @sylshoemaker6734 3 роки тому +11

    How to find a vein on obese patients?

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  3 роки тому +14

      this is definitely challenging!
      I go through this approximate sequence:
      1) maximise vein size - heat, gravity, open close fists, tourniquet, tapping vein,
      2) Ultrasound scanner
      3) try different sites for limited use (feet, wrist eg.. saphenous vein at medial ankle is large and superficial and usually hasn't been attempted yet...)
      4) local anaesthesia to minimise patient discomfort
      5) escalate to central access (IJV, subclavian, femoral vein, PICC)
      6) intraosseous
      importantly I never delay access centrally or intraosseous if the patient needs volume asap. so I have someone attempting iv access while I set up for the other techniques.
      also only use some of these advanced techniques if it is within your scope of practice and skill set and under the correct supervision
      hope that helps!

    • @sylshoemaker6734
      @sylshoemaker6734 3 роки тому

      @@ABCsofAnaesthesia thank you so much for that great reply.

  • @AliHamza-vt5qm
    @AliHamza-vt5qm Місяць тому

    Great😂

  • @DetectiveCreeps
    @DetectiveCreeps 2 роки тому +1

    4th way to miss a vein:
    Try to start IV in moving Ambulance on a bumpy road on a guy in a lot of pain. Lol

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  2 роки тому +1

      Haha yep so true! And lets not forget the intoxicated road trauma and you’re trying to avoid being punched while getting that lifesaving iv in…

    • @DetectiveCreeps
      @DetectiveCreeps 2 роки тому

      @@ABCsofAnaesthesia yeah. EMS is fun. Lol. I wouldn't trade it for anything.

  • @CreditsBackBruh
    @CreditsBackBruh 2 роки тому

    Ted Bundy joined the chat

  • @jungapo2
    @jungapo2 3 роки тому

    just use ultra sound to ensure it can be done correctly.

    • @geletmote
      @geletmote 2 роки тому

      even ultrasound they cant guarantee it

    • @jungapo2
      @jungapo2 2 роки тому

      @@geletmote i agree, it depends on skills too

    • @geletmote
      @geletmote 2 роки тому

      @@jungapo2 my mum the poor woman has been pricked and prodded and they cant even draw blood from her at the hospital, but when a phlebotomist comes to take blood for a home visit they find it instantly, not sure what to do at the hospital as they cant give her treatment..

    • @jungapo2
      @jungapo2 2 роки тому

      @@geletmote i suggest to ask for a nurse who is skilled using ultra sound machine when drawing blood from
      your mom. not all nurses are skilled using the ultra sound machine.

  • @bi0lizard1
    @bi0lizard1 2 роки тому +1

    Good god …. I’m SO BAD at this!!! I blow veins EVERY f*n time!!!! 😡😡😡

  • @yukhimli1807
    @yukhimli1807 3 роки тому +4

    So another way of failing to cannulate the patient which I had experienced. When i insert the cannula into the back of the patient’s hand, i advance the cannula all the way in and it hit a valve.
    It might have collapsed the vein or something because although initially blood came out, we can’t draw more blood and i have to put another one in.

    • @1packatak
      @1packatak 3 роки тому +1

      Check the distance from the insertion point to the placement of the valve. If it is very similar to the length of the cannula, then find another spot. That way you will not hit a valve.
      Taught to me by a CRNA 35+ yrs ago.

  • @autumnm2075
    @autumnm2075 2 роки тому

    I usually prefer when the anesthesiologist or CRNA does my IV, they often do a much better job at placement than a nurse even.

  • @ponselvarajrj8186
    @ponselvarajrj8186 2 роки тому

    Anesthesiology speciality need much of mathematics ?😅

  • @cooperholland3976
    @cooperholland3976 2 роки тому

    14g in the thumbnail.....fuck that

  • @MissWhiskers
    @MissWhiskers 3 роки тому +2

    This is so disgusting. I use this as exposure therapy to better handle my severe fear of blood and blood testing.

    • @ABCsofAnaesthesia
      @ABCsofAnaesthesia  3 роки тому

      Thanks lily, prob a novel use for UA-cam these days!

    • @annanguyen5591
      @annanguyen5591 3 роки тому +1

      Same here. I have a fear of blood and needles that I hope to overcome. I do hope to overcome my fear. And maybe become an anesthesiologist haha.

    • @MissWhiskers
      @MissWhiskers 3 роки тому +2

      @@annanguyen5591 Watching these videos and going to my cognitive behavioural therapy sessions has actually allowed me to have a blood test done on me without fainting and without using distractions. So I do feel it works, although I still get very disgusted and anxious from these videos. But still... progress! =D

    • @TheOutlawMan
      @TheOutlawMan 2 роки тому +1

      @@MissWhiskers Hang in there, Lily. I'm watching these to mentally prepare for my IV class in January.

  • @casey6104
    @casey6104 2 роки тому

    You are missing another way to fail in this: destroying patients arterial walls.

    • @briannawalker1223
      @briannawalker1223 2 роки тому

      IV means intravenous, not intra-arterial. The cannula in this case is going into a vein, not an artery.

    • @aleksandrakorus2469
      @aleksandrakorus2469 2 роки тому

      @@briannawalker1223 I think they meant that it is possible to nick the artery when trying to cannulate/draw blood in the cubital region when you go too deep. At least this is something my anatomy textbook warned against