Quote from mattsmom81
I have done femoral sticks in a code situation and am comfortable doing arterial sticks for labs and ABG's, have done so for years. Hospital policies and our NPA's dictate our do's and don'ts, but I have found in a code situation things can run a bit different...LOL!
Starting a femoral line venous or arterial line, or an arterial line anywhere is NOT in my scope of practice as a staff nurse in my hospital and state. Some ER nurses DO start external jugular venous lines in dire circumstances (trauma, code, etc). I imagine in a few settings a nurse might be trained to do such things under a physician/s radiologist's supervision, but central line venous placement and lines in arteries are generally a doctor's domain.
So, why were you needing to stick a femoral artery in a code? And did the patient have a pulse while you were doing it? If the pt was pulsless, it was a BIG error to go digging blind into someone's groin...And if there WERE a pulse, it would seem other access (for abg's??) might have been gotten. The only time i've seen femoral sticks during a code was to obtain abg's on a pt we werent able to obtain from the radial..(and the fem stick was done by a cardiologist....
And any nurse that goes jammin a needle after someone's jugular is just asking to get in trouble. Nurses doing any central sticks (in a code, trauma, or whatever) are WAY out of nursing scope... If you nick a carotid (especially during a code!) you can kiss the patient good bye...and what were the doc's doing while you were sticking femoral arteries and jugular veins?? Were the doc/doc's just standing around while the nurse was poking a central vessel??? And if a nurse is running a code without a doc present, she would be stupid to go sticking central vessels (imo).
I'm willing to bet that you've never been formally 'trained' to do these sticks (femoral artery, jugular vein, etc)...so why would you be asked or expected to in a code (you said you've done it lots of times??)..?
Also, In controlled situations (in the cath-lab, where cardiologists stick femoral arteries all the time) under the best/oportune environment, people get retro-bleeds ALOT...In an uncontrolled situation/code, where a pt's pulse is thready at best, a fem. stick is SO dangerous and can easily cause retro bleeds or cause limb paralysis (a big nerve (sciatic or vagus??) runs just-lateral to femoral arteries and can be 'run-through' very easily)
I dont disagree that after seeing it done a bazillion times, a nurse could probably do these sticks no problem...but still...
I'm not saying i dont beleive you...I'm just a little taken aback that your hospital allows nurses to do this stuff...code or no code.