While you're learning to insert catheters, choose only those patients with healthy veins and good skin turgor. Minimize the number of venipuncture attempts to avoid damaging the nerves located close to superficial veins. Don't make repeated attempts to insert the catheter. This trauma can lead to reflex sympathetic dystrophy, a syndrome of post-traumatic pain, autonomic dysfunction, and progressive tissue atrophy. By using skin traction during venipuncture and catheter advancement, you can decrease trauma to the vein wall.
Veins lie in loose superficial connective tissue.
When the catheter is threaded into the vein without skin traction, the vein will move or roll and create more contact between the catheter and vein wall. This contact disrupts the vein's endothelial lining and causes phlebitis and thrombosis. Pull the skin downward below the venipuncture site with the thumb of your nondominant hand. Many use the one-handed technique, which allows one hand to hold traction while your other hand holds and advances the catheter. After venipuncture, use the index finger of your dominant hand to push the catheter off the needle stylet and into the vein while the other fingers hold the stylet in place.