Quote from apaisRN
IV ativan? yikes! That's a BIG needle they use! Seems there must be better, kinder ways. Personally I'd want analgesia, sedation and maybe some Versed for recall.
It was a free standing (hospital was across the highway) out patient oncology clinic & versed (conscious sedation) was a no-no. Matter of fact, even when we do them on inpatients in the hospital, they don't get versed. Maybe it is just our onc group, but they will usually order morphine and ativan if they premed an inpatient.
A lot of patients at the clinic did it without premeds. Ativan provides some amnesia - right? It was the best we could do under the circumstances and most of the patients tolerated it well (except for the aspiration part). Entire procedure would only take about 10-15 minutes. We would buffer the lidocaine -- try to make it not bite so much, but it still got to me
when the doc would numb the iliac crest - and you could actually HEAR the needle make a 'pit, pit, pit' sound as it made contact with the bone (especially if they were a myeloma or elderly patient with soft bones... yuk).... oh yeah, and the larger patients that needed a 7 inch spinal needle to REACH the bone -- that was not pleasant to watch.
I was the lab supv. at the time, so not sure what size IV was placed (that was the nurses deal). Many of the patients had mediports, so access was not a problem. Occasionally they would call me that the doc was ready to start and patient would need more meds.... I just remember the nurses pushing it VERY slowly.
Staging for lymphomas was the WORST because had to do bilateral aspirates for staging and the disease is not uncommon in teens (we did not see pedi onc patients). And stage IV lymphoma patients have to have another marrow done to assess treatment after they finish their course of chemo (THAT is when I wish they had the versed for the recall).