Comments on: Why would it be difficult to start an IV on CHF and COPD patient? http://copdlungdisease.com/why-would-it-be-difficult-to-start-an-iv-on-chf-and-copd-patient.html Tue, 07 Feb 2012 02:11:55 +0000 http://wordpress.org/?v=2.8 hourly 1 By: redrosediane http://copdlungdisease.com/why-would-it-be-difficult-to-start-an-iv-on-chf-and-copd-patient.html/comment-page-1#comment-750 redrosediane Sat, 11 Jul 2009 04:38:41 +0000 http://copdlungdisease.com/why-would-it-be-difficult-to-start-an-iv-on-chf-and-copd-patient.html#comment-750 Because of the whole clinical picture, this person does not have an adequate heart function to pump an efficient amount of blood in order to fill all veins. Although the patient has COPD and CHF, she sounds as if she is probably dehydrated so that would also reduce vein filling. From my experience, the patients were taught to monitor their fluid intake but they essentially drink less to avoid CHF and therefore become dehydration. Being short of breath is not fun. I had to lower the arm until something popped up and put the tourniquet on the arm. Not too tight because of bruising and tearing of skin. No heat on these patients and slapping the arm is even worst. I have seen this tissue paper tear just handling the patient. Start IV with care though it may not be easy and may require a blind stick. I havve had problems with steriod use patients because the skin is so thin--tissue paper--that because of the wrinkles, it is hard to see a vein. This patient will probably have multiple bruising, too. Good Luck Because of the whole clinical picture, this person does not have an adequate heart function to pump an efficient amount of blood in order to fill all veins. Although the patient has COPD and CHF, she sounds as if she is probably dehydrated so that would also reduce vein filling.

From my experience, the patients were taught to monitor their fluid intake but they essentially drink less to avoid CHF and therefore become dehydration. Being short of breath is not fun.

I had to lower the arm until something popped up and put the tourniquet on the arm. Not too tight because of bruising and tearing of skin. No heat on these patients and slapping the arm is even worst. I have seen this tissue paper tear just handling the patient. Start IV with care though it may not be easy and may require a blind stick.

I havve had problems with steriod use patients because the skin is so thin–tissue paper–that because of the wrinkles, it is hard to see a vein. This patient will probably have multiple bruising, too. Good Luck

]]> By: kwinch1 http://copdlungdisease.com/why-would-it-be-difficult-to-start-an-iv-on-chf-and-copd-patient.html/comment-page-1#comment-751 kwinch1 Sat, 11 Jul 2009 04:38:41 +0000 http://copdlungdisease.com/why-would-it-be-difficult-to-start-an-iv-on-chf-and-copd-patient.html#comment-751 This Pt may need & benefit from the breathing treatment & not require the IV. Also, with her long hx of steroid use, he veins will be "fragile' meaning that when they are punctured with an IV catheter, they are likely to rupture. There are Lots of medications & conditions that have this effect on a persons veins. This Pt may need & benefit from the breathing treatment & not require the IV. Also, with her long hx of steroid use, he veins will be "fragile’ meaning that when they are punctured with an IV catheter, they are likely to rupture. There are Lots of medications & conditions that have this effect on a persons veins.

]]> By: oakdreams http://copdlungdisease.com/why-would-it-be-difficult-to-start-an-iv-on-chf-and-copd-patient.html/comment-page-1#comment-752 oakdreams Sat, 11 Jul 2009 04:38:41 +0000 http://copdlungdisease.com/why-would-it-be-difficult-to-start-an-iv-on-chf-and-copd-patient.html#comment-752 Things that lead to difficult IV access: Elderly - less connective tissue strength in epidermis, leading to veins that "roll." Chronic steroid use - fragile veins that blow easily. Dehydration - inadequate intravascular volume and thus, small veins. Overuse - Too many previous sticks in veins such as IV drug users or patients undergoing chemotherapy, requiring frequent IVs. Obesity - thick adipose tissue make veins hard to find. Things that lead to difficult IV access:
Elderly – less connective tissue strength in epidermis, leading to veins that "roll."
Chronic steroid use – fragile veins that blow easily.
Dehydration – inadequate intravascular volume and thus, small veins.
Overuse – Too many previous sticks in veins such as IV drug users or patients undergoing chemotherapy, requiring frequent IVs.
Obesity – thick adipose tissue make veins hard to find.

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