20 Useful Tips to avoid Blowing a Vein

Are you ready to practice your venipuncture skills? Below is a list of the 20 most useful tips so you can avoid blowing a vein.

1. Feel the veins.
You can’t easily see a good vein but you will definitely feel it by palpating the area. Feel for fullness and integrity. Choose the largest vein first as you will less likely blow it especially if you are using a large bore catheter.

2. Choose the right size of catheter and if not contraindicated, go for a small one.
If you don’t need to infuse large volumes of fluid or if blood transfusion is not necessary, just use a small catheter. For adult patients, gauge 22 is usually recommended. On the other hand, gauge 22-26 IV catheters are commonly used for pediatric patients.

3. Make sure that the bevel is facing upwards so you will not blow the vein when advancing forward.
You can control the angle of insertion more when the bevel is facing upwards. You will also have easier glided point of entry as the sharp end-tip of the needle enters the skin.






4. For geriatric patients, a deeper vein is less prone to blowing.
Elderly patients usually have fragile veins like those thick veins that could be easily seen in the dorsal part of the hands. If you know that you are dealing with a fragile vein on an elderly patient, look for deeper veins that are more stabilized and less movable.

5. Always go for the straightest vein.
Venous valves are often located between the intersection of two veins and you should avoid them for a smooth IV line insertion. If you encounter venous valves upon catheter insertion, it will stop the needle from advancing forward and you might puncture the vein wall sideways.

6. Use hot packs if your patient’s arms are cold.
If your patient’s arms are cold, you need to warm them up to dilate the blood vessels. By doing this, you can make veins pop out quickly and avoid blowing them. You can use warm washcloths or blanket if you don’t have hot packs in your area.

7. Ask your patient to open and close his/her fist during vein assessment.
This will improve venous refill especially if the arm is dangling downward. Also, when you are about to do venipuncture, make sure to ask the patient to keep his/her hands and arms relaxed. Improving venous refill will enable you to see the veins clearly and assess which vein is more prone to blowing.

8. Anchor the vein.
You can do this by holding the skin and veins taut with your non-dominant hand. With this technique, you can keep a unstable vein from moving sideways as you puncture it.

9. When you are about to stick the needle, do it in a 15 to 30 degree angle.
Adjust your angle of approach accordingly if your target vein is too shallow or too deep. The common cause of blown veins is too deep angle of approach when sticking the needle.
Image shows the proper initial insertion angle for short peripheral IV catheters. Insert the catheter into the vein at a 15 to 30 angle. Source: spanamerica.com


10. Insert the catheter directly on top of the vein.
Avoid side access as it can push the vein sideways even if it’s anchored by your non-dominant hand. Inserting the vein catheter on top of the vein will also reduce the chances of going through the two vein walls.

11. Go slowly with catheter insertion to avoid double penetration.
Give yourself plenty of time in estimating the angle of approach so you can avoid jerky movements. Hit the vein slowly but steadily and make a short stroke through the skin to reach the vein quickly. Feel the catheter penetrate the vein. In some cases, you can even hear a small click-like sound and feel that you are getting a flashback.

12. Once you hit the vein and see flashback of blood in the flashback chamber, STOP advancing the catheter and drop your angle of approach.
This is necessary in avoiding puncturing the vein wall again. Drop your angle of approach as you advance the catheter a little bit more. This will prevent puncturing through the vein.

13. Pull back the needle a little bit before advancing the whole catheter.
The needle will serve as a guide wire as you push the catheter farther. You need to pull back the needle so there will be less chances of puncturing the vein again as you advance the catheter.

14. Try not to use a tourniquet in elderly patients.
Their veins are so thick but very fragile so just a little pressure from the tourniquet can blow a punctured vein. If you suspect that there is poor vein integrity but you can easily see and feel the vein on an elderly patient, try anchoring the vein and do not use a tourniquet.
However, if you can’t really palpate the vein, you can also try applying a tourniquet a little farther from your target vein.

15. Improve the vein’s fullness by using gravity.
Ask the patient to let his or her arms dangle on the side of the bed. The gravity will improve the vein’s fullness so you can palpate it more easily for venipuncture.



16. If you are dealing with very fragile veins of elderly and chemo patients, try using a BP cuff as your tourniquet.
With a BP cuff, you can control the pressure you want to apply. Start with the lowest pressure first and see if you can already make the veins appear. It is best to use the lowest pressure possible so you can prevent pressure-related venous blow.

17. Once you have a flashback, release the tourniquet first before advancing the catheter.
This is important in reducing the chances of pressure-related blowing of fragile veins. This trick works for large but weak vein walls. You must be quick in releasing the tourniquet once you have ensured that the catheter is within the vein.

18. When you have successfully inserted the catheter, pull back the needle quickly to attach the IV fluid set and start the IV infusion with the first few drops running very slowly.
Rushing into starting the IV fluid might blow the vein wall due to a sudden large volume of fluid being infused. Just let the IV infusion start slowly especially if you are working with fragile veins.

19. Don’t do “fishing”.
If you don’t get a flashback, don’t make your needle go around digging for the vein. It’s very uncomfortable for the patient and you are also increasing the chances of blowing the vein.
Whenever you don’t get a flashback, just pull back the needle a little bit and redirect it. If you still don’t get a flashback, pull the needle out and start again.

20. If available, use visualization devices.
This is a great help for patients with difficult veins so you could not risk blowing a good venous access. There are many types of vein visualization devices around like transilluminator lights and pocket ultrasound machines. These devices will illuminate vein pathways so you can track the direction of where you should insert your IV catheter.


One More Tip!

As what most senior nurses say, once in a while you will experience a “dry spell” with venipunctures. If it’s not your day, let it go and ask help from your colleagues.
You can also learn hard-to-explain IV insertion techniques by watching senior nurses do venipuncture. Always remember that there are lots of lessons to learn from other’s experiences!

Cool Health Benefits of the cucumber

Cucumber is the vegetable that belongs to the gourd family and it is originated form the North India.Cucumber is the worlds 4th most widely grown vegetable crop

Let us check some of the Health benefits of this in detail...........



1) The Water content is rich in the cucumber, so it keeps your Body Hydrated and Regulating the Body
     temperature.It is more useful in flushing out the toxins from the Body

2) Due to the Presence of Certain Minerals like Potassium, Magnesium and Vitamins B and C, It is useful in
      the Skin Care.The skin of cucumber can be used for relief to skin which was caused by the Sunburn

3) Cucumber have three lignans, it had the history of reducing the risk of many types of cancers

4) Cucumber had several minerals which will helps in regulating our Blood Pressure

5) Cucumber is an Excellent source of Dietary Fiber, which its juice is useful for the people who had Teeth
     and Gum Problems

6) Due to the High Water content and low Calorie, it is an good aid for people who are looking for Weight 
      loss

7) The Consumption of cucumbers regularly will reduce the Chronic Dissipation and the intake of  Fresh
      cucumber juice will cure the Digestive Disorders and ulcers too.

8) The seeds of cucumber are used for the treatment of Tapeworms.

9) It will help you to promote your joint Health, as it contains Rich Amount of Silica

10) The compounds named Sterols in Cucumber will helps you to reduce your Cholesterol levels

The Top 10 Health Benefits of Bitter Melons (Karela)

The Top 10 Health Benefits of Bitter Melons (Karela)

1 Diabetes - One of every ten adults suffers from this disease, and it’s becoming a bigger problem every day. One way this fruit can help is by regulating the blood sugar level. We all know when the level is too high it means bad things to come. But when you see a doctor, most will prescribe medicine to lower it. And what happens when you are all out of meds? You go and get more. This is only prolonging the problem. Controlling blood sugar level is the only way to be diabetic free with minimal damage to the entire system. When insulin receptors become ineffective or does not function as it should, it is called a down regulated insulin receptor. Using bitter melon in the diet can help reverse the insulin resistance effect. Bitter melon helps diabetics to treat insulin resistant without medication. This is an important role in prevention and treatment of type II diabetes which is also known as insulin-independent diabetes. This can also prevent further diabetic complications that are cause by chronically high sugar concentrations. This can lead to blindness, kidney diseases, stroke, heart attack, and diabetic feet. Eating bitter melons or drinking the extract or even taking the pill form in many cases can reverse the effectives of diabetes.

2 Cancer – Eating or drinking the juice from the melon can help prevent certain types of cancer. It is also known to decrease and kill leukemic cancer cells, according to the Sloan-Kettering Cancer Center. It can stop cancer cells from spreading and this can increase chances of a full recover. But the diet must be consistent for this to be in an effective way to treat this disease otherwise it will not work.

3 AIDS/HIV – The disease that brings scare to most, this is a disease that is becoming a wide spread issue. The first case which was discovered in the United States among gay men in 1981, but the disease itself has been around far longer than that. In the Belgian Congo in 1959 there was a Bantu man had died from an unknown illness which made this man the first known case for HIV. Bitter melon glycoprotein beta-momorcharin helps inhibit synthesis of macromolecules in splenocytes, embryos, and tumor cells. This protein also retards the effects of HIV by using the protein to deactivate the ribosome function in HIV infected cells by stopping protein synthesis and eventually kills the cells which are infected.

4 Antioxidant – Antioxidants help protect us, it’s a cell which prevents damage taken from free radicals. Free radicals can come from natural environmental toxins which are common. There are also those from pollution and smoking, and some byproduct from normal metabolism. It has been proven that it will boost the immune system.

5 Asthma – Very high number of positive results has come back with patients that have suffering from a chronic cough and bitter melon in this case has helped with releasing sputum that is accumulated within the respiratory tract and lungs. Many who have used bitter melon extract or eaten it regularly belief that it helps relief them of asthma.

6 Skin – Acne or wrinkle skin? The chemical or serum within a bitter melon has been known to be used for acne and wrinkles. Because of the antimicrobial and anti-inflammatory properties this can aid in acne issues.

7 Digestion – Helps with digestion of food by producing digestive enzymes.

8 Weight loss - Low calorie and carbohydrate with definitely help with dieting and also strengthen your immunity.

9 Injury or wounds – It helps with controlling the blood flow to help heal wounds faster and also prevent any infection.

10 Constipation – It works wonders on constipation without having to cause diarrhea.

10 Simple Ways to Reduce High Cholesterol

If your latest blood test report reads cholesterol level above 200 mg/dL, it’s time you think seriously about reducing cholesterol levels in your body. But why? Because cholesterol clogs your arteries and lead to heart attacks and strokes. That’s enough reason to take steps to reduce high cholesterol. How to reduce cholesterol? Simple, you’ll have to change some of your dietary habits and get your body moving not only to lose excessive weight but also to remain physically active. You also need to quit smoking! It seems so simple to read all these remedies for reducing cholesterol but you and I both know that it is not that easy! But it’s not that tough too! Nothing is impossible, remember! So lets know how you can do all this to reduce high cholesterol levels in your blood. Whatever remedies you adopt, just keep in mind that they should do one of the two things- either reduce LDL (Low-density lipoprotein or bad cholesterol) or increase HDL (High-density lipoprotein or good cholesterol) in your blood.

Natural Remedies to Reduce High Cholesterol

1. Move your body; Lose weight

Regular exercising can amazingly help in balancing your cholesterol level. Obese or not, every one should exercise. If you are overweight, losing even five to ten percent of fat can help lower LDL or the bad cholesterol to a considerable levels. In fact, physically active persons form more of HDL that is good cholesterol which keeps their heart healthy. It’s not that you have to necessarily hit the gym and work out for hours, even moderate exercises including brisk walk for 30 to 40 minutes are also sufficient. In fact, you don’t even to spend these 40 minutes at a one go. If you walk or exercise for 10 minutes for three to four times a day, that will also have the similar effect on your cholesterol. Walking is only one form of exercise, you can move your body by any means- swimming, playing, running, jogging, yoga, aerobics, cycling or even dancing.

2. Don’t get Tempted with Saturated and Trans Fats

Foods with saturated fats as well as trans fats are, no doubt tasty, but you have to avoid them. They are the main culprit when it comes to dietary cholesterol. These bad fats can only increase bad cholesterol and triglycerides in your blood. You should not get more than 7-10% of your daily calories from saturated fats. Meat and full fat dairy products have high concentrations of saturated fats while fried foods and commercially baked and cooked foods are high on transfats. When you buy these ready to eat food packages, you cannot even depend upon the labels that read ‘trans fats free.’ Reason, in United States even 0.5 gm of trans fat per serving is allowed to be labeled as trans fat free. This means when you have these so called trans fat free foods, you are having 0.5 gm of trans fats in every serving. Just imagine if you take several servings, how much trans fat are you going to consume! So instead of going by the label screaming ‘Trans free fat,’ read the ingredients list. If it even reads an item called ‘partially hydrogenated oil,’ it does contain trans fats. So better avoid it.
Here is a list of foods having high levels of saturated fats and trans that you must avoid having if you really want to reduce cholesterol levels.
• Vegetable oil
• Butter
• Margarine
• Lard
• Meat
• Full fat dairy products
• Commercially baked cookies, crackers, snack cakes
In place of saturated fats, start having healthier fats – monounstaurated fats found in olive, peanut and canola oils and polyunsaturated fats found in nuts such as almonds and walnuts.

3. Opt for Healthier Monounstaurated Fats

Many studies have been conducted that say monounstaurated fats not only lower LDL cholesterol but also help in raising the levels of good HDL cholesterol in our blood. So next time when you use an oil for salad dressings or for marinating chicken and fish as well as for roasting vegetables, use the healthier olive oil rather than any vegetable oil! A study conducted by Baylor College of Medicine found out monounsaturated fatty acids (MUFAs) in olive oil can even reduce LDL cholesterol in people with diabetes or metabolic syndrome just as efficiently as low fat diets! Some of the natural sources of monounsaturated fats such as Avocado may actually help in raising the good HDL cholesterol while reducing LDL due to its component beta-sitosterol- a plant based plant which reduces the amount of cholesterol that can be absorbed from food. However, just like nuts, avocados are high in calories so you should have them in moderation. Here is the list of foods that contain heart friendly monounstaurated fats.
• Olive oil
• Peanut oil
• Canola Oil
• Avocado
• Nuts

4. Go Even for Polyunsaturated Fats

Fat is also essential for certain bodily functions so you can’t just discard having fats. However, you can always opt for healthier ones. Just like monounsaturated fats, polyunsaturated fats too are a good option when trying to reduce high cholesterol levels. Certain nuts have high levels of polyunsaturated fats that help in keeping our blood vessels healthy. But one thing that you must keep in mind that only a handful of nuts is what is needed during a day. More than that can lead to other problems like obesity due to high calories found in nuts. Also avoid having salted or sugar coated nuts because they totally defeat the purpose of having good fat leading to good HDL cholesterol levels. Just have handful of raw nuts some of which have been listed here.
• Walnuts
• Almonds
• Hazelnuts
• Peanuts
• Pecans
• Pine nuts
• Pistachio nuts.

5. Fall in Love with Fish and its Omega-3 Fatty Acids

Fish has the best quality of omega-3 fatty acids known to lower LDL, the bad cholesterol. American Heart Institute recommends having at least two servings of fish in a week but you can have more of it if you like to. However, take care not to add saturated fats while cooking your heart friendly fish. One of the studies suggests when fish oil is taken without limiting saturated fat intake, your LDL levels may not change at all, worse it may increase! Better grill or bake your fish than frying or adding butter or vegetable oil to it! If can’t have fish, you may also have fish oil supplement but consult with your doctor first. Some of the other sources of omega-3 fatty acids are soybeans, canola, flaxseeds and walnut. However, the way your heart gets benefit from fish, it doesn’t get it any other way. Some of the fish that are great sources of omega-3 fatty acids include the following:
• Mackerel;
• Lake trout;
• Herring;
• Sardines;
• Albacore tuna;
• Salmon; and
• Halibut

6. Eat more Fiber Rich Foods to Reduce Hight Cholesterol

Researches have proved it- fibers, specially soluble fibers reduce the levels of LDL bad cholesterol. These fibers bind with intestinal bile acids that contain cholesterol and leads them out of your body. As little as 10-15 gm of soluble fiber a day can lower your bad cholesterol by upto 10%. Dried beans, oats, barley, and foods having psyllium are great sources of soluble fibers. One of the types of fibers called pectin not only lowers high cholesterol levels but also restricts you from overeating by slowing down your digestive process. Certain fruits including apples and pears are high in pectin fibers. Interestingly, foods that are high in fibers tend to be low in saturated fats, calories and cholesterol. Just take care not to add a lots of butter to your otherwise fiber rich whole grain bread. Some of the high fiber foods include:
• Oatmeals
• Apples
• Pears
• Kidney beans
• Barley
• Prunes
• Brown rice
• Grapefruits
• Black beans
• Pinto beans
• Whole grains

7. Have Foods with Plant Sterols

There is a substance found in plants called sterols or stanols. These can block the absorption of cholesterol by your body. Thus it’s a good idea to have orange juices, margarines and yogurt drinks fortified with plant sterols. Just 2 gm of plant sterol per day can reduce LDL cholesterol by more than 10%. A glass of sterol fortified orange juice daily is all you need to get this much amount of sterol.

8. Have a Shot of Red Wine Everyday

Now this is a remedy you’ll love. Drink a glass of wine everyday, preferably red wine. Many researches have supported the fact that moderately consumed alcohol everyday can raise the levels of good HDL cholesterol. Red wine made up of high fiber red grapes, in fact, have super beneficial effect on cholesterol levels. Red wines are rich in the plant compounds called saponins that are beneficial for cholesterol levels. However, it should be only one glass for women and two glasses for men per day. More than that can actually harm your whole system. American Heart Association though cautions against beginning to drink if you don’t drink as of now.

9. Don’t Forget the Green Drink- The Green Tea

While red (wine) is good, green too is beneficial for your cholesterol levels! So, don’t forget to include green tea into your daily beverages list. In fact, you can replace the sodas and other sugary or carbonated drinks with this healthier option. A study conducted in Brazil had found that people who consumed capsules having green tea extracts considerably reduced their total cholesterol.

10. Do Not Smoke

It’s tough but you have to! You have to quit smoking if you want to raise your good HDL cholesterol levels because smoking lowers levels of HDL cholesterol posing a great risk for heart disease. See what quitting of cigarette does:
• When you quit smoking, within 20 minutes, your blood pressure decreases; check for yourself!
• The risk of your heart attack decreases within 24 hours of quitting smoking.
• Within a year, there is 50% decrease in the risk of heart disease as compared to that of a smoker.
• Within 15 years, you are at par with a person who has never smoked in his life without any risk of heart disease due to smoking.

Benefits of Drinking Lukewarm Lemon Water Every Morning

Being rich in Vitamin C citric content, lemons enhance your beauty, rejuvenate your skin from within that brings a glow to your face, helps you lose weight, flushes out toxins and much more. Lukewarm lemon water serves as the perfect ‘good morning drink’ for one and all. The reasons are many.

Get Rid of Caffeine Addiction

Having a glass of lukewarm lemon water every morning can help people get rid of their addiction to caffeine. At the same time, it also boasts you up for the day as much as a cup of coffee does.

Freshness

The best remedy for your laziness, lukewarm water helps you get ready for your daily chores. Adding a little honey to it will also prove beneficial. You will observe an incomparable freshness each day.

Boosts Up Your Immune System

Rich in Vitamin C, a glass of lukewarm lemon water helps in boosting up your immune system preventing you from the normal cough and cold. Its potassium content keeps your brain fit as well as ensures that your blood pressure remains controlled.

The Best Technique to Lose Weight

Drinking a glass of lukewarm lemon water with a bit of honey each morning is the world’s best remedy to loss weight.

Cleanses the Skin

A glass of lukewarm lemon water cleanses your skin and enhances your glow. It also helps prevent wrinkle lines as well as pimples.

Have a Good Breath

It helps you get rid of bad breadth by killing the bacteria responsible for it. Stay fresh with your good breaths by using this great remedy.

Strengthens Your Liver

The citric acid in lemon water stimulates your enzyme to work efficiently. This is how it helps in secreting any toxins formed in the liver and strengthens your livers.

Makes your Brain Wiser

The potassium and magnesium contents of this citric lemon water nourishes you to handle stress and tensions easily. It also helps in developing greater concentration level and is therefore, an advisable drink for students.

Anti Cancer

A glass of lukewarm lemon water in the morning helps prevent many kinds of cancer by killing up the acid formations that may occur.

Reduces Swelling

The people who suffer from joints pain must make it a point to start their day with a glass of lukewarm lemon water. It has the ability to secrete the uric acids from your joints and provide you relief from the swelling and joints’ pain.

A glass of lukewarm water comes with a package of all good to happen. So, why not to use all this goodness by making it a point to have a glass of lukewarm lemon water each morning, before you start with your day. You must not miss the opportunity to benefit from the cleansing and healing effects that a glass of lukewarm lemon water has to offer.

Exchanging Oxygen and Carbon Dioxide

Exchanging Oxygen and Carbon Dioxide

❤ An animation of a typical human red blood cell cycle in the circulatory system. This animation occurs at real time (20 seconds of cycle) and shows the red blood cell deform as it enters capillaries, as well as changing colour as it alternates in states of oxygenation along the circulatory system

❤ To support the exchange of oxygen and carbon dioxide, about 5 to 8 liters (about 1.3 to 2.1 gallons) of air per minute are brought in and out of the lungs, and about three tenths of a liter of oxygen is transferred from the alveoli to the blood each minute, even when the person is at rest.

❤ At the same time, a similar volume of carbon dioxide moves from the blood to the alveoli and is exhaled. During exercise, it is possible to breathe in and out more than 100 liters (about 26 gallons) of air per minute and extract 3 liters (a little less than 1 gallon) of oxygen from this air per minute.

❤ The rate at which oxygen is used by the body is one measure of the rate of energy expended by the body. Breathing in and out is accomplished by respiratory muscles.

Heart Attack

• 1. Heart Attack A heart attack occurs when the flow of oxygen-rich blood is suddenly blocked to a section of heart muscle and if the flow isn't restored quickly that section of heart muscle begins to die.
• 2. Symptoms Linked with aSymptoms Linked with a Heart AttackHeart Attack ● Pain in the chest which continue for more than a few minutes ● Pain that progresses beyond the chest to the shoulder, arm and back. ● Shortness of breath Sweating, nausea, vomiting, or dizziness ● Rapid or irregular heartbeats Heartburn or abdominal pain
• 3. Heart Attack TreatmentHeart Attack Treatment Coronary angioplasty and stenting:Coronary angioplasty and stenting:This procedure opens blocked coronary arteries allowing the blood flow more freely to the heart. Coronary artery bypass surgery:Coronary artery bypass surgery: In this procedure a graft is created to bypass blocked coronary arteries using a vessel from another part of the body.