Whilst discussing the finer points of a recent surgical proceedure, we got to wondering why I.V.s are placed in top of the arm (forearm or back of hand). I hypothised that perhaps arteries ran along the bottom of the arm and veins ran along the top of the arm (as I had barely enough knowledge to grasp that arteries carry blood away from the heart and veins carry blood back to the heart, and it would seem to make sense they would want an in-bound lane, so to speak). So I did a very brief search on “where to insert an I.V.”, and found a step by step tutorial for it. My favorite bit?
Select a good insertion site. A 20g in the back of the hand can be a pain in the anus for the patient, especially if it is in his dominant hand. It’s fiddly and frequently occludes with dorsiflexion. There are usually plenty of veins on the forearm…..well at least have a look. And don’t forget the basilic veins hiding under the forearm.
Make sure you shave the area with a surgical shaver if he/she is a hairy fellow. The tapes will adhere better and remove easier. Don’t use a disposable razor that might damage skin integrity. Confucius say; “pulling out arm hairs of big man sure way to hear sound of one hand slapping.”