Butterflies

[FineAgain]

Recently we have had an influx of transfers -- mostly from small outlying hospitals -- who arrive with a 24ga butterfly that is infusing fluids. We always have to restart them as it is against our policy. Butterflies are not meant to be used as an IV, unless I missed something?

I have also found that the patients complain of pain at the IV site. I also feel I should mention that the IVs are usually wrapped in half a mile of tape with gauze over it. Wondering if this is so I don't notice it is a butterfly??!!

Thoughts, comments?

[Kyrshamarks, BSN, RN]

At one Hospital I worked at, we switched to an IV cath that had wings just like a butterfly. I know they are still in use at facilities. Are you sure that the cath is not that?

[iluvivt, BSN, RN]

I think people are getting confused. There are many IV catheters that are designed with wings that are catheter over needle devices (CON). The wings can serve two functions..they can assist with insertion if they easily fold up and give you something to grip on to. That is why they have pebble like dots on the bottom of the wings. The second purpose is that they can be used to easily stabilize and secure the catheter after insertion. The Intima is a typical example with the needle being pulled after access into the vein of course. What is left in the vein is plastic cannula often made of vialon. The next type of butterfly is the true butterfly, which is just a needle with an extension set attached and often used for blood drawing and one time infusions. I always name the type of device by brand name that I insert inot a vein and only use the term butterfly if I am actually using a non-catheter needle device.

Make sure you know hat you are looking at and there is nothing inherently wrong with a small catheter unless you need a larger one for a specific reason. Use the shortest smallest cannula that will meet your patient's needs. For routine IV therapy a 22 gauge that is working well and is asymptomatic,preferably not at an area of flexion is perfectly acceptable and follows current standards of care for reducing compilations and preserving veins.