Using a "vein finder"

[Older-RN]

I found a vein finder on eBay and have been using it with pretty impressive results.
Has anyone else ever used one or can you pass on any tips to using it to its' maximum capability.
Anyone ever use a different kind?

Also, is anyone still using Heparin locks on INTs or has everyone changed over to normal saline?
Tanks for the input.
Pete

[insenescence1]

I found a vein finder on eBay and have been using it with pretty impressive results. Pete

I'm assuming you are referring to a Transilluminator? Or are you referring to the newer ultrasound-type veinviewer?

Are you using it on adults or pediatrics?

Where I work, there are a couple of the floor-model transill's floating around, and occassionally a hand-held can be found, but I got tired of looking for them so I just keep a small $5 dollar flashlight hooked to my name badge.

Turn the lighting down, and put it next to, or behind the site, and the veins show up.

Saved a lot of money, and it works very well.

Of course, since I currently work in a pediatric ICU (mostly newborns to 1 year old), I haven't tried it on bigger kids. Works great for the babies.

[Carley]

I'm assuming you are referring to a Transilluminator? Or are you referring to the newer ultrasound-type veinviewer?

Are you using it on adults or pediatrics?

Where I work, there are a couple of the floor-model transill's floating around, and occassionally a hand-held can be found, but I got tired of looking for them so I just keep a small $5 dollar flashlight hooked to my name badge.

Turn the lighting down, and put it next to, or behind the site, and the veins show up.

Saved a lot of money, and it works very well.

Of course, since I currently work in a pediatric ICU (mostly newborns to 1 year old), I haven't tried it on bigger kids. Works great for the babies.

Good tip. Thanks.

[Older-RN]

I used an ottoscope for years but they can get hot on the patient. I've also used a regular flashlight but the transilluminator I found on eBay uses red LED light so it doesn't get hot and the red light shows veins up better than regular white light. For $20, it was one of the best buys I've made as far as making my job easier. I've used it on all ages to include neonates and I wouldn't go to work without it.

[daprez1963]

I have been working in Trauma Units for several years and have perfected the technique of using a small compact flashlight (normally $4 at your local home improvement store or bed bath and beyond) to much success. It was while working as a flight paramedic that i first started using this method in low light settings. My equipment is nothing more than a standard small compact flashlight....The best one to use....The flashlight with 9 tiny LED light bulbs because they are easy to hold while insert lab needle or IV catheter. I simply glide the light on the patients skin with the tourniquet on, and once I find a suitable vein and have everything ready, I press gently against the skin above the site and use it to stretch/hold the vein as I would do with my non-sticking hand's finger and guide the needle into the vein. Once I am in, I simply set the flashlight down and continue on as usual. Sometimes I need to dim the lights when locating the vein if the patient has extremely small veins of deeper ones. This method can only locate veins that are up to a certain depth as the strength of the light is not strong enough to go very deep. I have used some stronger lights as some of those small ones that are carried by police officers that are very powerful (they cost around $70). While some may feel the need to buy fancy vein finders, I have worked as a flight paramedic for years and also as a trauma unit tech and started many many IVs (majority of those required fast IV access and some in not so ideal situations) I have used this method with great success and doesn't cost much. I have used it on ped patients as well. I get many compliments from patients that state they are usually tough to get and have been stuck multiple times before anyone can get them. Your patients will appreciate the effort in performing this task with minimal sticks as they don't enjoy being a pin cushion or used as a training tool for people without any proper acupuncture skills.

[SarahJane5]

Hi dapres1963, I plan on using an LED flashlight as a vein finder. Does your flashlight use white LED bulbs or red bulbs? I was thinking about getting one of these red bulb flashlights that I found here astrogizmos.com Thoughts?

[daprez1963]

Hi dapres1963, I plan on using an LED flashlight as a vein finder. Does your flashlight use white LED bulbs or red bulbs? I was thinking about getting one of these red bulb flashlights that I found here astrogizmos.com Thoughts?

This may sound cheap, but I have found that those little $4 flashlights with LED lights, usually the 9 little bulbs is all you need, works just fine. The white ones for me are the best. I am able to hold the flashlight and use it to pin the vein down while using my other hand to thread the vein with the iv needle and then once I line it up and get the flash I thread it in and finish up. I have had many people that have never seen this done be amazed with it. I am called on by several co-workers and several of the regular floors for IVs. The IV therapy team is great but they are busy and I can use this to start those hard to get ones. I dont rely on this for all...I am able to do must the regular way, but in those extreme cases, it comes in handy...hope this helps

[NURSEDETROIT]

Oh, the reliance on gadgets these days. . . .Back in the day; I learned on drug addicts, for "if" you could find a vein that hadn't been sclerosed by the caustic substances they'd inject, you were good. . .they didn't mind the pokes as much. . . I also had a fabulous preceptor, Jan B., she had taught me the "Braille" method; close your eyes, you know the anatomy, feel for it, visualize the vessel, stabilize, then watch your angle. . . I can still hear those words echoing in my head. I teach this method to new nurses as well, still works. . .

[daprez1963]

Oh, the reliance on gadgets these days. . . .Back in the day; I learned on drug addicts, for "if" you could find a vein that hadn't been sclerosed by the caustic substances they'd inject, you were good. . .they didn't mind the pokes as much. . . I also had a fabulous preceptor, Jan B., she had taught me the "Braille" method; close your eyes, you know the anatomy, feel for it, visualize the vessel, stabilize, then watch your angle. . . I can still hear those words echoing in my head. I teach this method to new nurses as well, still works. . .

Not questioning your skills, but I think you have mistaken my comments on this. I have been doing this for 20+ years...I am able to find veins the traditional way as do my co-workers with years of trauma and ICU experience....I am talking about patients that come in with little to no veins and often have to have EJs done because they get multiple failed attempts. I use this method in EXTREME cases. Mind the pokes? Drug user or not, people don't need to be used as a pin cushion for others to perfect their "skills". Feeling for the veins, while clearly not a method that was invented by your preceptor, is the sign of a good sticker as opposed to one who "looks" for them. You are kidding yourself if you think you are 100% successful in finding and sticking every patient you have ever come across. The "reliance" of these gadgets as you stated is not necessarily that. Its just handy to have a method to aide both you and the patient in saving them from being tortured at the expense of someone thinking they are the god of vein sticking...but thanks for your input.

[NURSEDETROIT]

Not questioning your skills, but I think you have mistaken my comments on this. I have been doing this for 20+ years...I am able to find veins the traditional way as do my co-workers with years of trauma and ICU experience....I am talking about patients that come in with little to no veins and often have to have EJs done because they get multiple failed attempts. I use this method in EXTREME cases. Mind the pokes? Drug user or not, people don't need to be used as a pin cushion for others to perfect their "skills". Feeling for the veins, while clearly not a method that was invented by your preceptor, is the sign of a good sticker as opposed to one who "looks" for them. You are kidding yourself if you think you are 100% successful in finding and sticking every patient you have ever come across. The "reliance" of these gadgets as you stated is not necessarily that. Its just handy to have a method to aide both you and the patient in saving them from being tortured at the expense of someone thinking they are the god of vein sticking...but thanks for your input.

Whoa there cowboy. . . Never said that these "gadgets" weren't useful, sure they are in some instances. We didn't have the technology then. . . Nor, in my early days of "practice" had I ever considered "torturing" any patients. . .little harsh there, don't you think? I had always (still do) asked permission of every patient, made them aware that I was indeed a "new nurse" (back in the day) and offered the patient the option to have someone more experienced do it if they'd prefer. . . My limit then and now with any patient: 3 attempts for an adult, 2 for a child. Never ever to exceed that. . . Still not 100% successful. . .But, dammed good, ; ).

I was just saying, you have to first rely on your intuitive sense, not to rely solely on gadgets. . .

[daprez1963]

Whoa there cowboy. . . Never said that these "gadgets" weren't useful, sure they are in some instances. We didn't have the technology then. . . Nor, in my early days of "practice" had I ever considered "torturing" any patients. . .little harsh there, don't you think? I had always (still do) asked permission of every patient, made them aware that I was indeed a "new nurse" (back in the day) and offered the patient the option to have someone more experienced do it if they'd prefer. . . My limit then and now with any patient: 3 attempts for an adult, 2 for a child. Never ever to exceed that. . . Still not 100% successful. . .But, dammed good, ; ).

I was just saying, you have to first rely on your intuitive sense, not to rely solely on gadgets. . .

whoa there nurse from detroit.... let me just repeat myself...again..... and leave it at that. Not questioning your skills, but I think you have mistaken my comments on this.
btw, our rule is a bit more stricter than your limits...ours is only 2 failed sticks per adult patient, 1 per peds before seeking a more skilled person. When I am called its only one attempt because I am the person they only call when no one else can get them and am their last hope before they get EJ (and not all of those are guaranteed). Our hospital has a $20,000 form of this gadget that surgeons use...so even the ones who think they are "damn good" rely on useful tools available to them. Once again, thanks for your knowledgeable input and all...

[NURSEDETROIT]

[QUOTE=daprez1963;69276]whoa there nurse from detroit.... let me just repeat myself...again..... and leave it at that. Not questioning your skills, but I think you have mistaken my comments on this."

Dear "Da Prez," No need to repeat yourself. . .again. You were absolutely mistaken with regard to my original post. I had not even addressed your commentary. . . Just so happened that "my post" followed yours. Don't recall, or was it noted in that post, that I quoted you. Check my original post here; it was just a general commentary that I chose to make; never was it directed at you or anyone specifically. "If" this had been the case, I would have quoted your post, however, as it was, I did not. Happy now? ; )

[jayne1975]

Couple of questions... how does using a light help to find access on patients? I've seen the red light transilluminators (we piloted one in the ER for a short time, but with limited results it wasn't something my hospital chose to invest in). I've been pretty good at IV starts and am one of the people who get called to start the lines on the 'difficult sticks' and would use any advice available to avoid sticking a patient more than once. Our hospital also has a 2-stick rule, and particularly with some of our dialysis patients limited to using one arm... even 2 feels like you're torturing someone if someone else has failed before you even get into the room. So, can anyone explain how the flashlight or LED lights work to find access? Do they work on all skin tones? Where are they best used? (the forearm, the hands, fingers, etc.) Usually as a last ditch I can always find an access in the thumb or fingers, but with CT barking all the time about having and 18ga in the midforearm or higher for contrast studies, I've been trying to avoid starting anything smaller or more distal so am wondering if the light would work on larger access or should I rely on US for that?