Poll results: Bevel up or Bevel down when inserting IVs

A week ago, I posted a poll on my blog about inserting a peripheral IV catheter, bevel up or bevel down. Here’s the result as of 11.23.2010.

The poll showed, inserting bevel up is the technique used by 92.11% of the blog readers who took the poll. It is also the common practice and the common insertion method taught in many IV insertions classes and training programs. A twitter colleague  @TorontoEmerg ask: What does the literature say? The Infusion Nurses Society’s latest textbook ” Infusion Nursing: An Evidence based approach” third edition states ” with the bevel up…” (chapter 23 pg. 460).  Several other textbooks, like Nursing interventions & clinical skills by Elkins, Perry and Potter 2007 edition states bevel up.  In addition, several comments from nursing colleagues on twitter and face book have stated they use  “bevel up”.

As far as pediatric patients, a long time colleague and friend Lynn Hadaway posted this reply on Face book:

“For peds the bevel length can be designed shorter and with a slightly greater angle so make it easier to cannulate small vessels. This would be a C size bevel. Most have a B size bevel. There is huge amounts of engineering to make a bevel.”

While majority use “bevel up”, 5.26% use “bevel down”. I’d be curious to find out why that technique works for them.  One twitter reply from @portapatti stated:  “I use bevel down.when pt has high bp. I’ve had blood shoot back at me if you r alittle getting in.”  Then @podmedic commented: “I wonder what the people who chose “Neither” do? Sideways?” I agree, it would be interesting to find out what the 2.63% who use neither do?

Thanks to  everyone who participated, read and visited my blog.  Of course, this is an unscientific poll but I appreciate your participation. This was fun and hopefully it made you stop and think. As always, feel free to post your questions or comments here.

One thought on “Poll results: Bevel up or Bevel down when inserting IVs

  1. I first learned “bevel up” when I was a pharmacy tech working in the IV room. If “bevel down” was used it would often “core” the membrane of the IV port or top of the vacuum bottle, introducing floaties in the fluid, and leaving a membrane that wouldn’t self seal.

    I’m not sure if that translates to human skin, but it sure makes sense to me.

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