Key Points on Choosing Veins for Blood Draws and IVs

Understanding Vein Selection

Vein Knowledge: Know the name, location, and capacity of veins.
- Different veins can handle different gauges (e.g., 20/22 vs. 18/16).

Median Cubital Vein
- Location: Bend of the arm.
- Use: Ideal for blood draws, also used for IVs.
- Caution: Can cause pain or infiltrate if the patient moves.
Accessory Cephalic Vein
- Location: Off the cephalic vein, not in the arm bend.
- Use: Preferred for starting IVs.
- Advantages: Does not roll, easy to stabilize, can hold an 18 gauge.
Median Vein of the Forearm (Antebrachial Vein)
- Location: Forearm, avoiding the arm bend.
- Use: Suitable for a 20 or 22 gauge IV, sometimes 18 gauge.
- Note: Veins might be deep in patients with more subcutaneous fat.
Dorsal Venous Network (Hand Veins)
- Use: Good for blood draws or IVs.
- Caution: Stabilize by having the patient make a fist to prevent rolling.
- Note: Veins can be superficial or fragile in patients with more subcutaneous fat.

Patient's Purpose
- Evaluate if the patient is there for short stays or needs extensive treatment (e.g., blood products or vesicant drugs).
- Vesicant drugs like vancomycin require larger veins.
Patient Preference
- Ask where they prefer blood draws or IVs.
Limited Options
- In difficult cases (e.g., severe cardiac or renal patients), look for veins in unconventional areas.
- Consider asking for a central line if necessary.

Always align vein choice with patient needs and medical requirements.
Ensure effective communication with patients regarding their preferences.
Don’t hesitate to consult with physicians for challenging cases and consider alternative strategies like central lines.

Understanding vein options and patient conditions are crucial for successful blood draws and IV placements.
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These notes summarize the key points discussed by Sarah from RegisteredNurseAriene.com on drawing blood and starting IVs.