Switching Seats

It was only a little baby 22 gauge, but it felt like I was pushing a garden hose through sand once I got through the skin. She winced in pain and let out a yelp, fighting the urge to pull her hand back from mine. She grits her teeth, sucking in air sharply with each motion of the needle.

No flash.

I look at the back of the hand, where I had carefully landmarked the tiny vein just a few seconds ago. It was obvious before, but now that I have inserted the sharp under her skin it has retreated to some unknown depth. It doesnt want to be found.

I try to ignore the woman's painful cries and continue my search for the elusive vessel. I use the tip of the needle like a probe, moving slightly to the left and upwards as I get closer... as I must be getting closer to the goal. Where the hell is that goddamn flash? I elect to insert more of the needle, reach farther underneath the skin. Another painful yelp from the patient. She is becoming less able to control pulling her hand back, and I almost lose the needle altogether.

"Just one more second ma'am, I've almost got it. Please try and stay still."

I dont have it though. There comes a point where - after inserting the needle and missing - careful correction becomes blind hunting and hoping. I have lost sight of where the vein was supposed to have been, and now I am sticking in the dark. I've crossed that line. One last time I move the needle upward and forward.

A splash of blood into the tiny chamber.

I wait. Sometimes the small needles take a long time to fill up the flash chamber. The lumen of the needle is very small, it takes time. Just wait a few more seconds, you'll see, it'll fill right up and the IV will be done. ...It shouldnt be taking this long, though. I must have gone right through the vein. One more tiny motion and it is confirmed as a small bulge grows on the woman's hand. Shit.

My preceptor raises an eyebrow. I've missed twice now, it's time for him to take over. I carefully climb over the monitor cables as we switch positions: me into the airway seat and him to the bench. I watch from the penalty box.

He assesses her arm, selects a location, and inserts the needle. Easy as pie, the flash chamber fills right up and the catheter slides without a hitch. The safety needle moves back and locks into position. ...The familiar clicking sound of a successful IV.

My preceptor lets out a little chuckle, smiling at me.

I'm never going to hear the end of it.