How to Start IVs Like a Boss. Advanced IV tips & tricks - Nursejanx




Is this Popeye? :laughing:

Jokes aside, I agree that holding the vein at the top and bottom like this is the best traction technique. Just be careful to not accidentally stick yourself.


Thank you so much for this thread! Reading these types of threads help me learn new things that might have taken a long time to pick up at work. We might have 1-2 IV starts every shift where I work, and there aren’t tons of opportunities to get practice and learn.

Now I just need to seek out patients who need IVs and get experience in person. But I feel better prepared now.



A note about using the AccuVein

Be careful that you actually ensure what lights up is a real vein and not just a false positive. When using the AccuVein we found that sometimes skin with scars or other darkened patches will make the machine act like there is a vein when there isn’t one. Use the valve test technique to see if when the blood is pushed out of the vein that it disappears and then watch it refill under the light. That will confirm that you’re looking at a real vein.


They really need to teach IV starting better in nursing school. A lot of our instructors have been in education for so long, I wonder if they’re really any good at starting IVs at this point. This post has been incredibly helpful for someone new to nursing like myself. We weren’t even technically allowed to start IVs in my nursing school’s clinical rotations. Guess I just have to start practicing now that I’m an RN!


Ok sooo…I’m not a nurse, hell I’m not even in the medical profession, but I’m married to an RN who needs infusions every 3 weeks so I do her IV starts.

Thanks for the tips, I spent most my life as an aircraft mechanic for the military so needed to have some things explained from a different view point then my wifes, especially after this weekend when I couldn’t get her IV started to save my life.

Any additional tips for someone who is maybe dehydrated and you can’t really do much to the vein cause it wants to just blow it seems.


Dehydration certainly makes things very difficult. I remember we went to start an IV on this lady who was just admitted to the hospital with AKI from severe dehydration and it took forever just to find any vein that would take a little 22 gauge. The next day after she had gotten fluids we needed to get a better IV, and it was like she magically sprouted veins everywhere and was super easy.

If you can get them to drink fluids that will help, use gravity to pool blood into the arm, use heat to make veins expand, and look in all the common vein places: Best Places to Find a Vein for an IV


Yah that’s what I did last night, swapped to a 22g and had her drinking lots of water. Her infusion requires her to get 1L of normal saline before the immunoglobulin, but when she wasn’t hydrated it was just impossible lol.

Even last night her veins were still barely visible, but I was able to get it started anyways, thanks again for the advice.


Hello forum.
I have a dying question.

I know there is a post talking about how you should angle the catheter before going in. 15° max to avoid puncturing the vein.

That does not work well for my patient because he/she can feel their skin being pulled.

I do not want to cause my patient pain and having to go at a smaller angle will mean I will have to go trough alot of tissues before I reach the vein.
Leading to wasting of time.

How can I still keep entering at 30° angle, primary backflow seen then angle lower to 15°and position catheter parallel to the vein. Advance catheter slightly(4mm) and advance cannula.

Without puncturing the vein.

Yours Sincerely,
Md Haziq


I think you kind of answered your own question. This is what I would advise.

Just be sure to not advance much further after a flash, and go slow if you have to to avoid not pushing too far and going through the vein.


Just a silent reader to every thread I need. And mostly are answered well on comments. Thanks to all.