Expert: Dr Ian Jackson - please note UK based - 3/18/2008

Question
This may be a little peripheral to what you do, but I have now had three bad experiences with either conscious or deep sedation because they could not get an IV in.  (I've had blood clots and phlebitis in the past so they can't use my hand.)  My last resort was a PICC line and radiologists couldn't access that either.  I spent a very painful hour in the radiology department while they tried to place it but couldn't advance the wire.  They finally got in an IV at the crook of my elbow with an ultrasound but I'm now totally phobic about any tests that require IV sedation because the insertion is so traumatic.  (Not to mention the residual pain, bruising, etc., usually leave me with limited use of my arm for a month or so.)  Is there some specialist I can ask for next time who won't put me through this?

Answer
Hi Kim
Sorry to hear about your problems.
Anaesthetists are the only ones who have extensive experience at this - and to be frank only those who have been doing the job for at least a couple of years. There is a new plaster Rapydan that apparently provide local anaesthesia for the procedure and warms the area up so it is more likely that a vein can be found. I have no experience of these other than tryiong one on my hand and was impressed with the pain relief it provided.
Otherwise you need to actively warm your limbs (e.g. under a warming blanket) before people try to stick a needle in.
Kind regards
Dr Ian Jackson