Utilizing I.V.'s in the foot or lower leg?

  1. I am so frustrated with patients whose arms are bruised, swollen, weeping, and pricked 50 times (over 4-5 days.) and the doc wont put in a central line and we can't find an iv site on either arm, and there's 5 or 6 great veins showing in the feet. What is your experience? Can you use the feet and legs on non-diabetic patients at your facility? If the pt. is DNR would it make a difference? If the patients' temp is 103 and has 4-5 iv antibiotics ordered?
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  2. 11 Comments

  3. by   NS_RN
    Yup...we do it all the time when necessary. As long as they are not diabetic.
  4. by   cactus wren
    HAve to get a doctor`s order, then we do...also do lab draws from feet...with an order,also
  5. by   emily_mom
    My daughter had one at 14 months in her foot, and it was terrible. They wouldn't let her walk for four days, and by the time the catheter fell out it was completely mangled. Never again will I allow that.....

    Adults....we have to have doc's order.

    Kristy
  6. by   sjoe
    When I worked on an IV team, this always took a doc's order. Too many potential complications with lessened circulation in legs and feet, as contrasted to arms and hands. Strokes and amputations are no fun.
  7. by   fab4fan
    When I worked in Peds, we used foot veins on babies that were not walking. It was at our discretion; we did not need a doctor's order.
  8. by   Mattigan
    I work Peds and use foot veins in babies not walking or standing on their own all the time. If they can stand or walk I only use it as last resort for fluids or meds and as soon as crisis is over I change it out. A few hours on IVF usually lets a vein pop out that you couldn't feel before.

    Oh, we don't need a physician's order. On babies I prefer scalp veins unless they need an oxyhood or something similiar. They last much longer and usually easy to stick even if the baby is chubby.
    Last edit by Mattigan on Feb 5, '03
  9. by   neneRN
    I put a line in the foot once in a while if that's all they've got. You'd be surprised at the number of pts who have huge veins in their feet (no problem using an 18) when they have not a single vein in the upper extremities. I wouldn't do it on a diabetic though. We do have to have a doctor's order although in the ER we generally just stick it in- the docs don't mind.
    Another spot that I've discovered is the shoulder, a couple of inches above the axilla. Recently, we had an unresponsive pt needing immediate access-several nurses had tried, two docs had unsuccessful bilat EJ attempts and unsuccessful central line attempt. I was able to get a 20 in this area on the first (lucky)shot. I am generally able to use this site before resorting to the feet.
  10. by   frannybee
    We used feet a lot in neuro ITU when arms and heads were covered and tangled in 4 million different lines. Doctors still do the cannulation here, so doctors order is n/a
  11. by   emily_mom
    My daughter was walking (more like running), and the IV was unnecessary as when she pulled it out they didn't reinsert it anyway. Doc said she didn't even need it....which makes me wonder if they had consent in the first place. Had IV's in hand before w/ no problems.

    FYI...she was having tubes in on a Monday and doc admitted her on Friday...*****?? IV totally uncalled for....only wish I knew then what I know now.
  12. by   Darlene K.
    We do it all the time on the peds that aren't walking - don't need a doctors order. I prefer the hand if at all possible.
  13. by   ?burntout
    It is against hospital policy here for adults to have an IV in the lower extremities. Only exception of course is peds or nursery.
    It is either upper extremities or central line. We have docs that refuse a CV line alot until we tell them to come stick the patient themselves.
    On occasion, anesthesia will come and attempt to place a peripheral line...this happens very seldom.

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