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In the course of thirteen hospital stays in a single year, Robert (the author of this article) had to be given over 150 fresh IV ports for various kinds of intravenous therapy to be delivered.

Robert commented that his favorite nurse for giving IV lines, which he regularly had to have changed at 3 in the morning, was a usually male nurse who generally came into his room looking just a little disheveled, like he was running late for work (which he in fact had been).
Robert and his nurse would always find something to chat about for a few minutes, whether it was the nurse's experience as a Marine combat medic in Iraq or Robert's experience dodging bullets reporting from elsewhere in the Middle East, or the weather, or football, or the women in their lives. And during the course of the conversation, the nurse would insert the IV when Robert wasn't paying attention, always with a single painless stick. The whole thing was over before Robert knew it.
Of course, if you are trying to make the experience of getting an IV less traumatic for a child, talking with an ex-Marine combat medic about women isn't the best way to go, but these ten general rules apply to pain-free IV lines for hospital patients of all ages.
1. Let the nurse make small talk.
Skilled nurses know how to use conversation to distract their patients from the fact they are getting an intravenous line placed in a vein. Relaxed muscles make it easier and less painful to penetrate the skin and easier to place the catheter in the vein. If you are a parent, you may have to make a judgment as to where it is better for you or the nurse to talk to your child. If you are the patient, you'll know they're probably only talking to you to distract you. Don't try to outsmart them. Be grateful.
2. Let the nurse look for the best vein.
Nurses will usually take a minute or two to look for the best site to insert the IV. They need good light to see your veins. Don't make a fuss about turning the overhead lights on, and definitely don't complain that it's all taking too long. And let the nurse look at sites on both arms to find the placement that will cause you little or no pain.
3. Don't look at the IV going in.
Most people find the process of getting an IV much less traumatic if they close their eyes or at least look away. Robert, the writer mentioned above, observed several IV insertions just to be able to describe the experience better. When one insertion Robert was watching required six sticks with a needle, however, he decided he knew enough about the process and all the later IV's went in much more smoothly.
4. Hold still.
Your nurse has to guide an 18- to 24-gauge needle, an object that is just about 3/100 of an inch or 8/10 of a millimeter in diameter, into about an inch (25 mm) of a vein without encountering any valves in the vein, or any twists or turns in the vein. If you move, the needle will miss. The good news is, if you hold still, the insertion may not even hurt.
5. Ask about anesthetic, especially for a child.
Numbing the skin can make getting an IV easier, especially for a child. The problem with anesthetics for IV sites has always been that getting the anesthetic to make the insertion of the IV needle painless required the insertion of a hypodermic needle to give the medication. A relatively new system known as the J-tip, however, squirts lidocaine through the skin without a needle with a "push" from a small cannister of carbon dioxide. Topical coolants, however, usually are not helpful.
And if receiving fluids and medications intravenously is a chronic problem for either adults or children, seek out a hospital with high-tech capacities. Some hospitals are equipped with ultrasound devices that can be used by nurses to place intravenous therapy lines painlessly with a single stick. This is particularly helpful for people who receive chemotherapy or parenteral nutrition.
If you embrace these tips, you still won't love IV lines — but you'll probably be able to stop dreading their insertion.
- Hartstein BH, Barry JD. Mitigation of pain during intravenous catheter placement using a topical skin coolant in the emergency department. Emerg Med J. 2008 May.25(5):257-61
- Weiner SG, Sarff AR, Esener DE, Shroff SD, Budhram GR, Switkowski KM, Mostofi MB, Barus RW, Coute RA, Darvish AH. Single-operator Ultrasound-guided Intravenous Line Placement by Emergency Nurses Reduces the Need for Physician Intervention in Patients with Difficult-to-establish Intravenous Access. J Emerg Med. 2012 Oct 25. pii: S0736-4679(12)01087-6. doi: 10.1016/j.jemermed.2012.08.021. [Epub ahead of print]
- Photo courtesy of thirteenofclubs on Flickr: www.flickr.com/photos/thirteenofclubs/5458070010
- Photo courtesy of tamakisono on Flickr: www.flickr.com/photos/tamakisono/8407942171