Question about IV therapy....

  1. We were having a discussion at work this evening about IV sites and infiltration. I seemed to be the only one of this opinion....

    The patient had 2 IV sites. One was on the anterior forearm just above the wrist and was saline locked. The other site was up the arm near the antecubital space and had running IV fluids. The site near the AC space infiltrated significantly. D/C with cannula intact. The nurse taking care of this patient is a fairly new RN and asked me if she could use the saline lock site for running IV fluids. I said no. I always thought that if an IV site goes bad (and especially infiltrates) that any vein distal to the site couldn't be used. All the other nurses thought I was crazy. I could have swore that somewhere along my schooling or nursing career I was taught that. Can anyone help me out on this? Do I need to go eat a helping of humble pie for my co-workers? Thanks for any help.
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  2. 11 Comments

  3. by   baseline
    It makes sense that if the cath below the infiltration is in the same vein, it will con't to infiltrate the proximal site.
  4. by   cactus wren
    That`s what I was taught,too...that`s why you`re supposed to start low, and work up...What was wrong with other arm?? I would of just started a new iv there...would of left SL in, just"in case"
  5. by   vaughanmk
    I agree. I've been in the same situation and couldn't get a good IV started below the site. I'd move on to the other arm. That one is gone for a few days.
  6. by   WashYaHands
    I always thought that if an IV site goes bad (and especially infiltrates) that any vein distal to the site couldn't be used.
    I was taught this too.

    Linda
  7. by   deespoohbear
    Anybody have any links that I can print stuff off so I can take it to work? Thanks. I knew I wasn't crazy....:chuckle
  8. by   veetach
    was the bad IV in the same vein as the heplock?? if so then I wouldnt use it, but if one was medial and one was more lateral on the arm, then I would use it.

    we were also taught to never use an IV distal to one that has infiltrated, but then there is the real world.....
  9. by   LilgirlRN
    I stuck a man near the AC once, but it blew, had a dialysis shint in the other arm so I couldn't use it. So went below where I had stuck before, near the wrist. Turned the fluids on and I swear they came out the original site. Have only seen that once, was freaky.
  10. by   veetach
    OH! LilgirlRN, I saw that happen just 2 weeks ago, it freaks you out doesnt it??? LOL
  11. by   deespoohbear
    Originally posted by cactus wren
    That`s what I was taught,too...that`s why you`re supposed to start low, and work up...What was wrong with other arm?? I would of just started a new iv there...would of left SL in, just"in case"
    The pt is a hard stick and the RN taking care of her didn't want to have to restick her if it really wasn't necessary. Eventually, one of the nurses was able to get an IV site in the opposite arm but it went bad after about an hour. My vote is for a midline or a PICC. She is just one day post-op after major bowel surgery so she will be there for a few days.

    Thanks for all the postings. I know now there are others who are in agreement with me.
  12. by   Brownms46
    I think I found a good site for you to print off stuff. It's a Baxter site...and it also can be used for CEUs. The courses are free and you can print off the certificate immediately.

    http://www.baxter.com/doctors/iv_the...ion/index.html

    Just click where it says "click here"...and then scroll down until you see..Essentials of IV Therapy


    An Online Home Study Continuing Education
    Course for Nursing and Pharmacy Professionals

    Edited to say: Totally Free! Be ready to print off your certificate, because if you close the page before you print it off..you have to take the test all over again to get back to the certificate page. The only thing you have to type in, is your name as to how you wish it to be on the certificate. At least that is how I remember it. Each course counts for about 1.5 CEUs...I think. For those of you in Texas...I used this to renew my Texas license with no problems.
    Last edit by Brownms46 on Mar 3, '03
  13. by   deespoohbear
    Thanks. I will look that site up later....

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