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negitive blood return on a working IV

What rational do I use to prove that an IV is working even though I cant get blood return (excluding a chemo patient)

I feel that when you put the syringe on the hub or extension the suction collapses the vein and you can not get a blood return even when the IV is fully functional.

Our population of patients (veterans) are mostly hard sticks and I have had nurses remove IVs because of no blood return.

I have lowered the bag and shown the nurse when blood comes back.

Your feedback is appreciated!

and Happy Belated IV Nurses Day to all,


Peripheral or central venous

Peripheral or central venous catheter?? In a PIV, you can collapse the vein wall over the catheter lumen and occlude the backflow. This is common with large syringes. So use a 3 or 5 ml syringe or try the other methods like lowering the fluid container. You can also flush the catheter while palpating the site to see if there is any new edema. It is important to remember that there are numerous drugs that are dangerous vesicants, and this is not limited to chemotherapy. So a blood return is a major part of the site assessment. You could also try placing a tourniquet in the arm well above the PIV site while aspirating. 


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

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

PIV, thanks
PIV, thanks

Cheryl Ferraro, RN

At our hospital we use the

At our hospital we use the touniquet test to determine patency of PIV when no blood return can be obtained. This is of course assuming that the PIV  rates  0/0 on the infiltration/phlebitis scale

Close clamp on IV and remove IV bag from pump.

Place tourniquet 2-3 inches above end of catheter to occlude vein

Open IV line to safe rate depending on IV fluid and pt status

If IV is in vein, it will NOT drip

If IV is infiltrated it will continue to drip and should be removed

Hope this helps.

Jayne Wixon, RN,CRNI

MCMH Ellsworth,ME

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