Patient with 14 Failed Peripheral IV Sticks – Nurse Clinicians in Action-08

Patient with 14 Failed Peripheral IV Sticks and no vascular access and how the Vascular Access clinician was able to calm the patient down and achieve Peripheral IV (PIV) access is the focus of this Nurse Clinicians in ActionNurse Clinicians in Action is a spotlight series highlighting some of the interesting cases that Vascular Wellness clinicians have encountered and participated in treatment. These cases generally involve challenging situations or intriguing clinical presentations and may involve more than one Vascular Wellness clinician as our clinicians have the ability to consult each other while in the field, as well as an on-call Clinical Administrator via a HIPAA-compliant communication app.  Our extensive training program and diverse client base including Level 1 Trauma Centers, Short Term Acute Care Hospitals, Long Term Acute Care Hospitals, and Skilled Nursing Facilities provide our clinicians with a wide array of clinical experience and why we believe our clinicians, as a group, are the most experienced and best trained and supported vascular access clinicians.

Patient with 14 Failed Peripheral IV Sticks

– Clinical Case

This case took place in a hospital emergency room.  A male patient in his 40s needed a PIV for blood work.  The emergency room physicians tried to achieve access many times without success, which was very unusual, and they had opened and used over 14 PIV kits.  Having received many painful sticks, the patient was very angry and frustrated.  Even so, much-needed vascular access still had not been achieved for this heavy-set man with deeper veins.

Patient with 14 Failed Peripheral IV Sticks

– Diagnosis and Treatment

The Vascular Wellness clinician arrived to place the PIV and quickly realized he first had to calm the patient down and earn his trust or he wouldn’t be able to place a line.  At this point, the patient was not allowing anyone including the clinician to come near him with any vascular access device (VAD), which was necessary for blood work. The Vascular Wellness clinician empathized with the patient’s medical experience and even apologized for the many needle sticks that the patient had experienced before his arrival.

The Vascular Wellness clinician assessed the patient, an intelligent veteran, and felt that explaining the procedure to him that would allay his fears.  The clinician expanded on his ultrasound (US) machine training and the accuracy of needle visualization for his success in placing lines.  He even showed the patient the US and ran it on his arm revealing his vein on the screen.

When the Vascular Wellness clinician was able to show the patient on the US screen that he could confidently achieve access the first time, the patient finally began to relax. To further calm the patient, the clinician offered lidocaine on the skin to numb the area for the needle insertion, but the patient felt so comfortable that he declined. After vascular access was achieved, the patient thanked the Vascular Wellness clinician and said, “where were you 2 hours ago?”

Vascular Access Specialists

– Key Points

Vascular Wellness prides itself on using the latest technology such as ultrasound machines for vein visualization, especially when the vein can’t be easily identified.  In this case, the patient was heavy set with deeper veins, and the emergency personnel, without the use and accuracy of the US,  were continually sticking the patient hoping to find the vein.  This isn’t a good experience for the patient, who felt he was being hurt by untrained staff with needles.  The US allows the clinician to see the vein and also see the needle enter the vein.  Further, as vascular access specialists, our clinicians can generally feel the vein further ensuring the right access the first time.  Many vascular access nurses do not have US training making it harder for them to achieve access without multiple sticks.  Similar to other medical procedures, having a specialist and expert perform the procedure will improve patient outcomes and reduce costs.

If you require Vascular Access or want to learn more, speak to the team at Vascular Wellness today.  For the latest articles and insights, follow us on LinkedInFacebookTwitterYouTube, and Instagram.

Vascular Wellness Serves North Carolina, South Carolina, and Virginia and expanding to Georgia, Kentucky, Ohio, Tennessee, and West Virginia.

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