I went to visit my friend at the hospital because she just gave birth to her baby. She had many complications and had many IV punctures on both her arms, plus an IV already in. Because I'm such a curious person I decided to look at her IV site. When I looked, her IV catheter was half way out and sort of curved. I called the nurse and told her to come look at it. She came in and looked at it and just pushed it back in and put some more tape on it. I was surprised by this because I thought that it could cause an infection after the catheter was half way out for who knows how long. Plus she did not have a tegaderm on her IV site, just a bunch of tape all over. I guess it's how they do it at that hospital, but I have only seen IV's get covered with tegaderms and not just tape, with all that tape it kind of made it hard to see the IV site clearly. So I asked the nurse if reinserting a catheter that was already half way out could not lead to an infection, and she said not as long as it didn't come out all the way. Is this correct?

It is not ideal practice. Not only from the infection control arena, but pushing the flimsy plastic catheter back into the skin could make the IV no longer patent, and infiltrate.

So don't do it. And if for some reason one can do it (and I am not sure that this is the case anywhere) you need to check patency before one just sort of assumes that it is in the right place.

Very, very poor practice.

Very poor practice. While the majority of the IV lines that I place end up with nearly all of the catheter in the vein, I've had more than a few where the catheter had maybe 1/3 of the length in. Those lines are very problematic and require frequent checks to be sure that it hasn't extravasated. If one of my usual IVs happened to move 1/2 way out, no big problem... aside from the infection-stuff already discussed. If it's one of the ones that are just barely in the vein, well... no chance of reliably getting that catheter back into that vein as we just normally don't use guidewires and I can't say that I've ever heard of that technique being used in the placement of peripheral IV lines, even if it's to find a way to get a larger bore line into a relatively small vein.

So, no, don't do that.

Sometimes it's warranted, like on a patient who is a very hard stick or has multiple lines in the ICU and who has a low albumin so you don't want to be puncturing the skin or they'll weep. If you clean the site and very carefully assess it, you might be able to save it. However, you need to assess whether it's still patent by drawing back and gently flushing. Not ideal but sometimes you have to make it work when you have 27 drips and all your central lines are full. In this instance though, probably not. You should site a new one in a young, healthy patient.

I went to visit my friend at the hospital because she just gave birth to her baby. She had many complications and had many IV punctures on both her arms, plus an IV already in. Because I'm such a curious person I decided to look at her IV site. When I looked, her IV catheter was half way out and sort of curved. I called the nurse and told her to come look at it. She came in and looked at it and just pushed it back in and put some more tape on it. I was surprised by this because I thought that it could cause an infection after the catheter was half way out for who knows how long. Plus she did not have a tegaderm on her IV site, just a bunch of tape all over. I guess it's how they do it at that hospital, but I have only seen IV's get covered with tegaderms and not just tape, with all that tape it kind of made it hard to see the IV site clearly. So I asked the nurse if reinserting a catheter that was already half way out could not lead to an infection, and she said not as long as it didn't come out all the way. Is this correct?

I would have started a new IV. You said your friend has already had several complications so I would want to make sure I had a good IV site in case she needed some medication STAT.

That's the same thing I told her. I would have started a new IV'S as well. Plus the nurse didn't even check if she was still in the vein.

I thought about that. The nurse didn't check if it was still patent. She didn't draw any blood back not did she flush it either. I told my friend to keep an eye on her IV'S because I was afraid that if it did not go back in the vein that it would infiltrate.

So if you're a nurse, you know the answer. I'm curious as to why you asked it here?

That's the same thing I told her. I would have started a new IV'S as well. Plus the nurse didn't even check if she was still in the vein.

So if you're a nurse, you know the answer. I'm curious as to why you asked it here?

Oh no, I'm not a nurse yet LOL (I wish). I'm a nursing student. what I meant by that was that if I was in clinical and had a situation like that I would have started a new IV instead of pushing it back in. I just was not 100% sure if I was correct in the way that I was thinking, so I wanted to check with some actual nurses to see if what this nurse did was okay or not.

It depends. Sometimes we have IVs that are halfway out and leave them halfway out because advancing it further will mean the vein will blow. I don't think I would have pushed it back in but I would have reinforced it and checked it. The no tegaderm is weird but some older nurses don't use them initially and instead tape it and then put one on.

I grab chlorhexadine, uncover, assess, clean, attempt reinsertion, check for patency, recover if it's good. I don't see a point in sticking a patient more times if the already established IV can be saved (safely).

Wouldn't the IV infiltrate at thst point?

Wouldn't the IV infiltrate at thst point?

Not necessarily, if it's still in the vessel. If it's in the vein and you advance it, it's just going to go further into the vein. If it's come out far enough and goes into the tissues, then yes it will infiltrate. Each one has to be assessed independently.