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czajka carol
Access technique of bevel down

Was wondering about people's opinion on the "The Vascular Guy"'s video about the "new" technique of inserting PIV's/spinning PIV bevel down.  I have been having discussions with my team about this technique.  Physiologically, I can not grasp the concept of bevel down, as I was taught that there was greater difficulty with insertion and higher risk of damaging the vessel. I can understand the spinning technique when you thread the catheter off the needle.  I have had some increased success of threading difficult catheters with this technique (the needle is not involved).  I have many questions that his video does not answer.

I am not sure what you mean

I am not sure what you mean by spinning technique. Bevel down for venipuncture is definitely not new as it has been around for decades, although not supported by evidence. Here is the theory behind it and there is some validity to it. Take a look at the bevel cut of the stylet some time. Notice the angle and length of that bevel. For small diameter veins, a long bevel could penetrate the back wall of the vein before the catheter tip is inside the vein lumen. Most small gauge short PIVCs now have a much shorter and steeper bevel on the stylet so that you avoid this problem. I don't think bevel down would cause more vein damage although there could be more discomfort from venipuncture or a greater chance for a skin plug to be cut out but no evidence about this, just my speculation. 

Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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