Archive April 2017 XVIII, No. 4

Ideas That Work: Anesthesiologists Start Their Own IVs To Build Rapport With Patients

starting an IV AT EASE Starting an IV with confidence can calm the patient. It also sets the tone for the rest of the surgery.

Anesthesiologists Start Their Own IVs To Build Rapport With Patients

Starting an IV is typically the only part of the surgery completed while the patient is awake, which is why the doctors in our anesthesia group start their own IVs. Anesthesiologists spend almost no time with the conscious patient as it is, so this is our chance to build a little rapport. That's not the only reason. Although most IV starts are easy enough for a first-year nursing student, we're seeing more situations that can present challenges for anyone who's not as skilled or as confident as the task requires. Obese patients with few adequate veins are a fine example.

On patients who have difficult veins, locating the appropriate target is the key. If you start with the wrong vein, you're not going to have much success, so spend more time looking before you start sticking. Once you find the right target, have these 5 things in hand before you begin: an IV catheter; a tourniquet; an alcohol pad; 3 pieces of tape for securing the IV; and a small syringe of lidocaine to inject for patient comfort. With these at the ready, you should be able to get the IV started in about a minute or so. It's a small investment of time that serves as a bond between the anesthesiologist and the patient. Doing so with confidence will put the patient at ease and set the tone for the rest of the surgery.

Rick Novak, MD
Waverley Surgery Center
Palo Alto, Calif.

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