Re: CVC's and # of Lumens
I
may be speaking out of league/term here as an ED nurse but:
The general argument/consensus I've come to see is:
* The number of lumens inserted is directly proportional to the ability/confidence/availability of such CVCs to be inserted sucessfuly. As un-popular as I may sound - I'm fairly certain that
most physicians aren't blind to what their patients needs are when they insert CVCs. Meaning: they don't
purposely insert less lines than they
could have just because
they can...
As 'miniscule' as 'one extra lumen/port' might seem - it is not as 'miniscule' when the procedure is being attempted. An analogy I'd like to draw is one that we as nurses come across everyday - will that peripheral vein accomodate an 18g Vs 20g? A 20g Vs 22g? etc.
* Every extra port/lumen is yet another source/route of infection.
* Medical science isn't like mathematics i.e. 2+2 doesn't always equal 4. Right now we may think "we need access now!" ... and twenty minutes later we end up having patient deteriorate to the point of requiring pressors and other concurrent drips".
* Last, but certainly not the least - cost/need is always a factor. You may have a patient with great, tree trunk veins ... but that doesn't mean you stick 'em with an 18/16 g when a 20/22 g will suffice, right? Each extra lumen adds onto the total cost. I guess this ties in with point #2 above.
cheers,
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