Step 14: Choose a vein

Guidelines:

• Use veins on top of the hand, top of the forearm, or inside the elbow.  Veins inside the elbow are large but hard to reach by yourself.  It is easier to reach the smaller veins on top of your hand.
• Feel veins to see how big they are and in which direction they go.
• If necessary, use veins in your ankles or feet.
• Choose veins that are straight.
• Once you have chosen a vein, stick the vein at its spot that is farthest from the heart.  If that spot does not work, the part of the vein above it (closer to the heart) may still be available to stick.
• Keep your arm straight if you are using a vein on the inside of your elbow.
• Don’t use the same vein and the same spot for every infusion.  You want to give your veins time to heal.  Rotate your use of veins.  For example, use a vein on the back of your hand, then one on top of your forearm, then one inside your elbow.
• If you cannot find a vein to use, try one of these tips to make the veins stand out more:
  • Soak the arm in warm water for five minutes to make the veins get bigger.  You can also run warm water over the forearm and hand before starting.
  • Wrap a warm towel over the forearm or hand before starting.
  • Gently massage the area over the chosen site.  Do not slap the skin.
  • Hang the arm down and slowly open and close the fist.
  • Put the tourniquet on while the arm is hanging down.  Slowly pump the fist and then bring the arm back up.
• If you regularly have trouble finding a vein, begin an exercise program to build up your veins.  One exercise is to squeeze a sponge ball in each hand.  Start with 10 squeezes daily and build up to 50 squeezes per hand daily.
• If your veins roll, apply a second tourniquet below the site you are going to stick.  You can also use your thumb and another finger to stretch the skin over the vein.  You may need another person to do this.
• If you have trouble getting the needle through your skin, rub your skin with a cream every day to keep it soft.

Caution: Never use veins on the underside of your wrist.  They are too close to the nerves and arteries.

Figure 4-16  Sites for infusion.