Five attempted IV starts tonight; three were ultimately successful.
The first one was on a young woman with abdominal pain. I completely missed with the first stick, the second I got into the vein but somehow pulled out. I let the nurse do the third one. I have no idea what I did; I had good flash (when the blood comes out of the cath, showing that you are in the vein), I started to advance the cath, then somehow, the cath was out of the skin. Embarassing.
The second attempted start was on a convict with seizures. He was supposedly seizing at the facility then seizing every minute or two on the way to the hospital. One of the nurses told me before the guy arrived that she had worked at a prison and that inmates could feign seizures really well. The guy arrived, seizing. We put him into a bay and started working on him. I attempted to start a line but was unable to get it in the vein; he had really bad veins, in fact, no one was able to get a line in him. So I didn’t feel so bad about missing his. I did fish around rather a lot trying to find a vein; no luck. His seizures seemed really suspicious as he would come out of a seizure just about instantly and with no postictal phase. If he was really seizing for twenty or thirty minutes, he would be exhausted and dazed. As it was, he would sit right up, comment on what was going on and remarks that were made while he was seizing, then demand a particular sedative by name.
The third and fourth were both on a chest pain patient. They both went right in like I was a pro; I didn’t spill a drop of blood on either one.
The fifth was on a second chest pain patient. I missed on the first attempt but struck a gusher on the second. I thought I had cannulated an artery for a minute… Blood squirted out under pressure and made quite a mess. The nurse was out of the room when I got it started and I had most of the mess cleaned up by the time she got back. The patient rather enjoyed the whole scene and it distracted him from his discomfort.