How to optimise FLASHBACK with SALINE for the most DIFFICULT VEINS

[@aircavmedic]

You covered it all, the physics behind it. It is so important, no matter how you get in the vein, that you have checked as you did so well, especially if one is pushing anything (chemotherapy) or other caustic agents. Outstanding explanation.

[@aircavmedic]

Nice video. I did go to 1 year extra school for IV Nurse. As you know lowering angle after entering vein is very important. My technique was never losing traction on skin until I threaded “ butterflies, all types of and sizes of catheters(16-30ga), including long intracaths, As you stated pressure is important. I had someone arrest just as I was entering skin( vein collapsed) I got lucky. I rarely used ACF, unless short term need. Start distally as you know work proximal. Thank you for allowing me to share.

[@manojchaudhary4666]

I have seen about ten of your videos continuously today and have enjoyed them equally. Nobody taught me like this. I hope, i wont puncture the lower wall of a vein at least after this video. thank you sir.

[@aircavmedic]

Went to 1 year school to be IV nurse. Everything from 16ga, to 30ga scalp needles. I always kept traction on skin, lowered angle after direct or indirect approach. I rarely used saline. But outstanding videos. However you accomplish, if on long term therapy, I always started distally and worked proximal. Warm regards

[@Marcyang]

Very cool trick. I think it has to do with reducing the surface tension of the blood rather than anything to do with pressures.

[@fabiothebest89lu]

Thanks, I hope I remember this tip when I’ll have a more difficult case. I’m experimenting with more difficult veins

[@ravenchua3768]

Do you have any tips on how to palpate veins better?(Apart from elevating the bed, lowering the arm, applying tourniquet to the right pressure, tapping the veins, swabbing alcohol on the veins, warming the veins?) Are there any ways to predict how veins would run in the cubital fossa i.e any consistent anatomy that would always be there so i can better direct my tactile perception focus towards those specific areas instead of sweeping the entire area hoping theres an easy vein i can palpate? Thank you for your videos!

[@ArranRWilliamson]

About to go to work, next cannula is on me! Can't wait to try this out

[@deedopix]

Thank you so much for your brilliant commentary

[@fhb1997]

🤯🤯🤯 unreal! Whoever came up with this is a genius

[@ABCsofAnaesthesia]

Absolutely!

[@raizero_8]

Thanks for the great tip. I used to rinse the blood from the chamber with saline but I always drain it right away before re-attempting to cannulate a different vein. I'll try this out.

[@villegasrincon4711]

Hey man all your videos have been really helpful. Can you also show us some techniques on finding difficult veins ?

[@jimjab3631]

US is the future.

[@dianekerr9435]

I am an infusion RN so this was great. Cant wait to try it.

[@ABCsofAnaesthesia]

Great! And try it a few times to get used to it :)

[@raidohakuba]

Very instructive, thank you very much 😊

[@mbracken8231]

Hi. Thanks for all the great instruction videos. Could you do a video on how to locate appropriate vein for IV cannulation. Keep up ghe great work. Thanks

[@romanbullet3036]

Great video, I look forward to trying this out, thanks!

[@TheGuerrero612]

My mind has been blown up.🤯🤯 No wonder i can't see an immediate flashback in small or difficult veins, and it's because of he low pressure. I'll consider this technique with my supervisor.

[@vashkarkhan301]

Thanks for this amazing explanatory video... loved it

[@ABCsofAnaesthesia]

You’re welcome!

[@emmabae4426]

Very informative... thank you so much....

[@krassenna]

Brilliant idea, thank you very much! You are a genius!!!

[@ABCsofAnaesthesia]

Haha i wish i could take credit, this skills is passed on from week 1 on paeds rotations

[@michalberesmidwife]

Great tip. I'll use it tonight. Thank you

[@derekm9934]

Never heard of this very cool!! I will have to try at some point!

[@anthonypetrillo841]

This is a great technique! I wish we had these catheters instead of the fancy spring-loaded safety ones.

[@ABCsofAnaesthesia]

True! The fancier the equipment becomes, the less we get to modify 😭

[@dianekerr9435]

@@ABCsofAnaesthesia it was a ton easier years ago w/o the safety devices. We all had latex powdered gloves too (fit better), but then you could always tell who didn't wash their hands. Yuck.

[@joschtuegs2562]

Would have been nice to have seen this video yesterday 😂😂 had some pretty darn difficult veins on a patient today, would have been helpful to know this before

[@MN-li1jy]

Very nice. Do you have any tips for radial artery cannulation for invasive blood pressure monitoring? Thanks

[@ABCsofAnaesthesia]

Still waiting on approval to make this one 😅

[@pedroneely9791]

OMG!!! THank you very much for this superb pro tip!!! Physics makes sense and internship should be a breeze now! :)

[@priyabr17]

You made my day 💕

[@kaouthar96]

Thank you, I'm so trying it out 😁❤

[@miriampasag6602]

Quite informative. Thank you.

[@jingyun4323]

Thank you so much! I've never been taught this before and I will definitely try this. Also, do you have any tips for cannulating an elderly patient with oedema? Thank you!

[@ozzya9977]

Milk out the oedema first with you hand, unmasks the vein.

[@amandabass04]

try doubling torniwuet

[@jingyun4323]

Thanks for the tips guys

[@aircavmedic]

As a former IV RN, for edema, as stated, I would gently push( like checking on shin for peripheral edema) the edema OUT of way if possible, palpate wherever needle is being placed. I preferred cephalic vein, natural split, or some hidden like basilic vein, standing behind patient. Just some thoughts. Excellent video

[@Bishbash93]

Will definitely have to give this a try. Do you think this technique can still be used if cannulating whilst also trying to take bloods? By this, I mean, inserting the cannula into vein, removing the needle, plugging a vacutainer on the end and taking your bloods/VBGs, then flushing/dressing the cannula. I don't know how much of an impact that little bit of saline mixed with blood (vs purely being blood) within the cannula's plastic catheter would affect the haematology/biochemistry of the blood samples

[@amandabass04]

can we get bloods when we cannulate

[@amandabass04]

they said not to get bloods from iv cannula

[@Bishbash93]

@@amandabass04 On first insertion but before you flush it or cap it off, you can take bloods. After that, no because the blood sample would be contaminated with saline flush or be stagnant blood within the now established cannula. Hence why I asked my question because pre-flushing the cannula would leave some saline inside it and, I imagine, contaminate any blood sample taken via vacutainer/bottles.

[@anthonypetrillo841]

You can just waste an mL or two of blood in a syringe before you fill your tubes. Then you know the saline won’t be in there.

[@SpudOfDoom]

This will dilute or contaminate your sample, so shouldn't be used if you're collecting blood while inserting the cannula. You might be able to get away with it for something like a blood bank group & screen where dilution isn't such an issue.

[@dagobah1974]

Thank you for your videos. I have a question. What do you think about leaving the saline attached to the needle, or even better, using an extension line for commodity. I would help with those IVs with valves. As you push the saline to open the valve, you can advance the needle to pass it through. What will be your input? Thank you so much.

[@hzxswyg]

This is really helpful

[@ABCsofAnaesthesia]

Great to hear :)

[@kit_underline]

Thank you, very helpful!

[@rohanmostert4975]

I've actually been using this tip for about 10 years, but never understood why it works.

[@josephinetong8069]

Could you explain why the IV catheter cannot advance into vein even the flashback is seen in IV cannula chamber? Can you provide some real cases with unsuccessful IV insertion and explain the reason of failure?

[@nigelgregory5996]

This usually happens when you hit a valve causing no advance into the vein.

[@Hoepotheis]

Very helpful. Had a tough one today that this would've helped with.

[@tonytan5945]

Thank you for all your tips. Do you know if these tricks can be used with the newer needle auto retraction safety jelcos? If so, would really appreciate a video on these safety jelcos, they are less friendly to cannulating difficult veins.

[@gabrielleandrew542]

That’s what I think Tony Tan I only use these for easier cannulation

[@hassanstormie3612]

Please what's the explanation for the fast flashback when NS is put in the cannula?

[@ABCsofAnaesthesia]

Mainly lack of surface tension.. and diffusion between fluids…

[@RooseveltAliWashingtonX]

Oh wow, thanks!!!!

[@Mus-Doc]

Thanks

[@fsdx416]

Not sure what's happening. This method used to work so well. But recently i dont get any flash back at all with saline, despite being in the vein. I know im safely i vein because when i try retracting the needle, blood rushes into the tube and i could advance it smoothly despite not gutting flashback. But it's a gamble. Could it be because the surface tension of the saline created an obstructing film preventing blood from entering?

[@SandraMcRitchie]

Thankyou

[@shigs21arl]

Can i still collect blood if there is saline in plug?

[@pohbc]

Thank you for this technique. Today I learned something new. Does this technique work for arterial line cannulation as well? Especially in difficult babies and neonates?

[@ABCsofAnaesthesia]

It might! Try it and see :) Generally arterial pressure is high but who knows, it might give a quicker flashback

[@iluvprawns]

Can this be done with BD insyte autoguard? AFAIK we only have the type you are using in an 18g, and I'm not keen on using an 18g on tiny spindly veins...

[@ABCsofAnaesthesia]

hey! i had a look at the product vid and it doesnt look like you can get back access to the chamber... so probably not... but if there was a way to open the chamber, it would be possible

[@iluvprawns]

@@ABCsofAnaesthesia I might have to have a play around and see. Thanls for checking it out!

[@iluvprawns]

Just to update, I've sent you a message and video on Facebook.

[@NightNurseMike]

I wish I could try this but our needles don’t have caps like that

[@helpyhelpertonn]

Would this work for closed IV catheters?

[@ABCsofAnaesthesia]

Hey! It wont work if you cant access the chamber, so prob not for all cannula types

[@ChurroWaffles]

How would you do this with BD Injects?

[@DrAbdulRehman1989]

Holy cow! What a trick! 😁

[@ABCsofAnaesthesia]

Glad you liked it!

[@maximilianfischer5375]

🙏🙏🙏

[@jimjab3631]

Nice trick, nurses will still screw it up.

[@doctorjo5947]

Thanks