[zacarias]

Hey,

When you start an IV, is it ok to see blood run up the catheter in addition to the flash chamber? Also, if I got slight blood return, not total red, but some and it was positional, should I leave it? The flushing showed no signs of infiltration, no puffy spots or anything. I would imagine that if I was able to thread the cathether in all the way (it WAS difficult though) that it should be ok...??
Zach

[siggie13]

Personally, since you can't see inside the vein to really know what is going on, if I have any problem with advancing the catheter and/or return blood flow, I pull it out and do it again. The cannula can kink; you can go thru the vein and still thread it subq and not see puffiness with the flush. Better safe than sorry.

[iluvivt]

some catheters such as the insyte autogard (usually the smaller gauges) have a special notch as part of the design that allows you to see the flashback through the catheter as well as in the flashback chamber. these designs are mostly used on smaller gauge catheters to assist the clinician in realizing that indeed you are in the vein without constantly staring at the flashback chamber. This is very helpful on pediatric pts. Generally speaking once you are in a vein and are going to thread the catheter(after you have pulled back the needle slightly) your blood return will keep coming. Sounds like you went through the vein. also just b/c a catheter flushes does not mean all is OK,this is particular;y true in areas where there is a lot of tissue (i.e.at or near the ACF).A catheter properly placed is easy to thread. Once in a while I start an IV and I know I am in and I do not get a flashback. This has happenned with pts that are in cardiac arrest,on vassopresors or other emergent states.I would say it is really a rare occurance.So when in doubt....take it out.....or seek out someone with excellent IV knowledge hope this helps