Anyone Else Have a History of Difficult IV Insertion?

Updated on March 22, 2008
D.D. asks from Springfield, IL
15 answers

I am getting ready to give birth to my third child hopefully before this weekend is over. I have small veins and have always had a difficult time with getting blood draws. With my first delivery, it took two nurses a total of three attempts to get my IV inserted. Thankfully they were patient and understanding as I was contracting at the time. With my second delivery, it again took two nurses a total of five attempts to get my IV inserted. It took almost an hour and I ended up with three blown veins not to mention I nearly missed my window of opportunity for my epidural. My IV finally ended up in the bend of my left arm which made it very difficult to hold my son and breastfeed immediately after delivery. They actually removed the IV so I could nurse. Would it be too pushy of me to inform the nurses of my previous difficulties when I arrive at the hospital? Any suggestions on how I should go about this?

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So What Happened?

Thank you for all of the wonderful advice. I helps just knowing so many others have dealt with the same issues. Well, I am happy to say that I went into labor last Friday. I spoke to my labor & delivery nurse (who was outstanding) about my concerns and she was able to IV me in one attempt. The rest of the labor and delivery had it's ups and downs of course but baby girl is here and we are all healthy and doing well. Thanks again to all you mamas!

More Answers

J.S.

answers from Chicago on

I feel for you! Before one surgery, they blew my veins 5 times before the anaesthesiologist (sp) inserted it by my elbow, which hurt badly. I looked like I was beaten up.

It is not pushy to inform the nurses as soon as you arrive about your IV insertion difficulties. Tell them about the blown veins too. You can also talk to your doctor about it. Make sure that he/she puts a note in your file.

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A.M.

answers from Chicago on

I just spoke to my OB about this same thing today. I have never had a successful IV in my hand - I have veins but they don't like to have a needle in them and it's PAINFUL !! She made a note on my chart and included a request that the anesthesiologist inserts the IV instead of a nurse - I'm assuming that means they are better at it? Last Friday my husband had hernia surgery and they inserted the IV midway between his hand and the bend in his arm.....that may be an option as well. Definitely talk to the OB about it and have it written in your chart that you have a history of IV problems and don't hesitate to reinforce at the hospital about you previous experiences. It's your birth! Good luck! I'm due April 27th: hoping I go much sooner :-)

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J.R.

answers from Chicago on

YES YES YES!!! UGH! I had my doctor put the note in my 'chart' and somehow, the nurse disregarded it. I said I need a 20 gauge needle (per my doctors/multiple phlebotomists instructions) and she had the nerve to tell me 'if we have to give you blood, it will get damaged in a catheter that small' - my retort "well, then it's going to get damaged in my veins because they're not big enough for an 18 gauge!"

So now... I'm just being difficult - she blew out two veins trying to get an IV, called in another nurse who blew out one and got the 4th FINALLY. I can tell you, I STILL have a lump in my arm right above where the catheter was in my vein and it's blue... looks like a bruise, and it hurts when I touch it... that was 2 months ago!

It is really aggravating - my doc did tell me to make sure I am really hydrated - that helps.

Good luck...

p.s. most hospitals have a policy about IV's - I know it's there for our safety... I wouldn't have an issue with it if somebody would just stop treating me like I don't know my own history - not all veins are one size fits all.

Stand your ground, and insist on an IV specialist. I don't want to knock the medical community but it's not necessarily that you have a fear of needles/IV... you'd just like to walk out with as many whole veins as you walked in with and not look like you are an IV drug user.

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J.P.

answers from Chicago on

I know if you are dehydrated your veins fall back a bit. Try to be super hydrated before hand and see if that helps at all.

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C.M.

answers from Decatur on

Being a nurse, and also having three babies (all vaginal) I know all about having IVs and starting them. The problems usually with labor and delivery is that most MD's want a large gauge IV, usually an 18 or 20, just in case mom would need emergency surgery or blood products. I would think a 24 would be probably too small, but a 22 might be jsut fine, even for blood products. The idea is the larger the IV the more fluids they can push in when they need to. So, your options include asking for a bee sting to numb you before the IV insertion, application of some numbing cream (EMLA is one) or asking for anesthesia to start it. Make it clear you have had difficulty in the past. Also, some hospitals used a LED light now under your hand that lights up larger deeper veins in your hand. Find out what options are available at your L & D unit. THey may be able to page anesthesia and use their little LED light to find a large, deep vein that will work better. I hate to use the tops of hands or the AC (the crook of the arm). I like the vein right on top of the wrist (it's deep), the one directly above the thumb is good too. Usually if you talk to them first, you can get a plan together. ANd, i will say, in defense of the nurse. I am a GREAT IV starter, one of the best, and I am a young nurse. I can still see one i think is an easy stick and it blow. And, i have mentors who have been starting IV's for 30 years and they can't get it and I can get it first shot. It's really in the way you hold your mouth! LOL..So, dont assume youth or age will make it better or worse. Try to ask your MD for a 20 or 22 would be better, ask what options are available in your hospital and try not to stress out about it. I know it's hard, but it can be done, and you never know! Good luck!

C

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M.R.

answers from Chicago on

I have the same problem. Ask them to put a warm blanket or towel where ever they are going to try to insert the needle first. A nurse did this once when I was going in for surgery and it is the only time I did not have problems. Also I know this might not be possible but try to stay hydrated it helps. The more dehydrated you are the harder it is for them to find a useable vein. With my first child they had the IV in wrong and my whole arm swelled up. I found out later there could have been serious complications.

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A.B.

answers from Dallas on

I've never had anything quite that drastic, most of my problems have been from incompetent nurses. Sometimes good nurses are more important than a good OB. Don't be afraid to advocate for yourself, you're the only one who can. I've gotten louder with each pregnancy. Get your IV in your forearm if you can, halfway between elbow and wrist, I've never had a problem with it there and make sure they tape it down right. Talk to your doctor and make sure it gets written in your chart. Good luck!

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M.C.

answers from Chicago on

I had a ton of trouble with IV insertion. First of all they had to induce me 2x's because of "high blood pressure" which I ended up not having, and the first induction with cytotec did not work. They stuck me in the left hand first and it would not go in at all then she did the other hand and I told the nurse I did not want it there, and she told me that that is where they need to do it, that they do not do it in the arm at all. So the next morning after all this, it ended up clotting and nothing was getting through so the next morning nurse came in and had to take it out, then re-insert it in my right arm a little above the wrist. (she knew what she was doing, and I told her that the other nurse did not want to put it there because they can't and she told me that the older nurse was stuck in her ways and thats where she wanted to do it.) I ended up going home that day because my son was not ready to come. I ended up going back in a week later and again they had issues in one hand so they tried to put it in my wrist area. She kept moving it in and out in and out to try to get it into the vein. It hurt like hell and I cried. She took it out and then put it back in my right hand. It was sore, and it hurt the whole time I was there. I went 12 hours natural until the nurse scared me enough to get an epidural because she said I may have to have a c-section, and at least I would get some rest. So I ended up with the epidural and the delivery from hell. After I had him, the IV had swelled my hand so bad that I could hardly bend it. They would not take it out because apparently I needed the fluids (of course after pushing and going through labor, who wouldn't need fluids?!?) I complained the next morning that my hand was killing me, and the nurse came and finally got it out. (the fluid had stayed in the top of my hand for a while after that. ARGH! I hated it, and I will make sure my next delivery WILL NOT go the same way! I will be refusing the iv unless I absolutely need it or pitocen. (the next one we will be trying with a midwife because I did not like my hospital experience. good luck!!! =)

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K.T.

answers from Chicago on

D.,
Congrats in advance! How exciting this time is for your family!
I am a labor and delivery RN.
Unfortunately, most hospitals require you to have an IV during labor. ( I don't always agree with this policy...) Sometimes, if you arrive "ready to deliver", then there is no time for an IV; some midwife patients won't need an IV, but a majority of patients will have an IV if they deliver in the hospital.

1. You must have an IV prior to receiving an epidural. If you decide not to get an epidural, the other medication you can receive in labor is administered through your IV...(narcotic).
Pitocin is given through the IV, if you need it. Most women will receive Pitocin after they deliver to help the uterus contract down and minimize bleeding.

2. You absolutely SHOULD tell your L&D nurse about your IV history! Your OB might not be there when you are admitted, so make sure to tell your nurse when you arrive.
Also, ask the nurse if there is an IV TEAM or IV Therapy at the hospital. This a nursing department that specializes in IV therapy only. IF so, ask if they will have them come start your IV.

3. Most hospitals have a policy in which the nurse can choose to use lidocaine (local anesthesia) at your IV site prior to inserting your IV. This is a very small bee sting, with a small needle. It numbs the area where the IV will go in, then the RN can take her time with your "difficult" vein, and you will not feel it at all. If your RN does not like to use it, politely ask for another nurse that uses the "local"to start your IV. SPEAK UP FOR YOURSELF HERE.

Good luck! Discuss these things with your support person ahead of time. This way, he/she can be your advocate, and if you are too busy contracting away to worry about these things, your partner will be able forward these requests along to your nurse/caregivers!!

Have a Great Birth Day, D.!
K.
www.babyfeat.net

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A.M.

answers from Chicago on

I've had a hard time myself....lots of attempts, and always an ultimate failure on my hand. I ended up needing my IV in my arm, too. I found that having it taped and then wrapping wide gauze around it (sort of like ace bandage style) helped to alleviate discomfort of holding and nursing my daughter and later my twins. Also, I had to have 3 separate anesthesiologists do my epi the first time before it was in and stayed without leaking or hitting a nerve! It was horrific, to say the least. When I had my twins, it was by planned C-section, but after reminding my OB of the first experience (which was over 4 years prior), she not only noted my chart, but hand picked my main delivery nurse and the anesthesiologist for me. It was a WONDERFULLY different experience. I felt like I had the royal treatment compared to the first time feeling like multiple people were coming around to literally take a stab at me! Have your OB hook you up with the right people. Be sure to ask in advance, but don't hesitate to let the nurses know as soon as you get to the hospital. Tell them you've spoken to your doctor and ask them to help you. Chances are, they're going to know who works best with problems like these even if your doctor doesn't request specific people. No one wants to hurt you and they can't help you unless they know what kind of trouble you've had in the past...so definitely tell them! Just treat them like they're your best friends and not enemies out to get you!

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A.G.

answers from Rockford on

I'd definately tell the nurses about your history. Your already pregnant and uncomfortable.. don't worry about hurting their feelings. They are trained to deal with upset, pregnant women. They'll understand if you seem a little "pushy"... With my first son it took five nurses and a total of eleven tries before they called in my doc to administer my epidural so HE could do it because no one else could get it to work. I had blown veins in my hands, bends of my arms and feet. It was terrible!!! Those nurses are there to assist you and make your delivery more comfortable... so don't spend your time worrying about them. You just focus on you, your family and your beautiful baby about to be born. That's your ONLY job while your there.

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M.W.

answers from Detroit on

D.,
If you have not already gone into labor by this point I have some advice for you. I worked in a Labor and Delivery Unit for 10 years. I was an OB Technician who started IV's all the time. ASK FOR LIDOCAINE! It will numb the IV site before they start poking. They don't always offer it but you can request it. Also, usually the Anesthesiology Nurse is the person they call when no one else can seem to get an IV going. Ask for this person, if available, after the first attempt has failed. They usually get it in in one try. Also, after delivery for postpartum blood draws(CBC) ask them to use a butterfly needle. It is small and always worked for me. THEY WILL MOST LIKELY NOT USE ONE UNLESS YOU ASK! GOOD LUCK AND CONGRATS!

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A.P.

answers from Chicago on

i have same problem....warm towel for a few minutes really works. good luck ;-)

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M.B.

answers from Chicago on

I also have trouble with IV insertions, My doctor told me to tell the nurses or IV tech to use a smaller sized needle because my veins just kept popping because the needle used was too thick. Hope this helps

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K.

answers from Chicago on

Technically there's no need for an IV at all unless you're planning to have an epidural. You can most definitely refuse one if there's no medical need for it.

In that case yes, I think it doesn't hurt to tell the nurses that you've had trouble in the past so they need to get someone good. And as another poster said, being well hydrated will help.

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