We are preparing a class to teach our nurses how to DC fem. art. lines. The MD that volunteered to educate the staff, insists that the nurses inject a local infiltration of xylocaine to the insertion area before pulling the line. I don't feel comfortable with this and many of my fellow nurses don't either. Isn't this out of the realm of what we nurses are trained to do. I feel the MD is too cavalier about having the nurses do this. Are any other nurses being asked to do this? I realize fem lines are routinely DC'd at many institutions, and that we are behind the times a bit, but this local injection doesn't sit well with me. What is your input?
Nov 14, '98
You are not alone to feel so strongly about this unnecessary step in d/cing arterial lines. I have been a critical care nurse for 10 years now and have only needed to premedicate orally with meds in preparation for line pulling. It is imperative that patients not be numb in the groin area upon pulling a sheath so that they can alert the nurse to any pain or swelling post-pull suggesting bleeding. The patient's ability to feel and report any changes to the RN is crucial to the assessment of the groin post pull. The practice of injecting patient's with Xylo pre-pull does border on beyond our scope of practice. Please consult your policy and procedure manual or Human Resources or even your VP of nursing.
This MD is probably just thinking of everyone involved but is going a little bit overboard. Talk to him or his superiors and come to a mutual understanding that everyone can live with. Good Luck!!
Nov 16, '98
Hi, I have been an ICU nurse for 15 years. It is not a standard of practice to premedicate pts.w/ xylocaine. Since it is an unusual situation, I suggest to have the MDs do it.