Scalp access in adults

  1. .
    Last edit by Chuckie on Jan 18, '03
  2. 8 Comments

  3. by   ajwill
    Whoa! With the availability of vascular access devices, I would have a hard time supporting use of scalp vein use on an adult. Refer to the Standards of Intravenous Therapy (INS) for appropriate site selection. While I dont know of a book that says you cant do this, I also dont know of one that says its safe practice. I have seen anesthesia do that one time in 23 yrs.With the irritating nature of meds these days given IV,I'd have to say no and address this with the MD
  4. by   janine3&5
    Just curious, why wouldn't a pt like this (where you've exhausted all veins) have a PICC put in?
  5. by   Chuckie
    Last edit by Chuckie on Feb 26, '02
  6. by   ajwill
    My understanding of using scalp veins on newborns has to do with the lack of valves in newborn scalp veins. I dont think you'll get a definite answer from INS. Just remember to practice as a "prudent nurse" would. Sometimes you have to stop and put the ball back in the MD's court. What type of medications in this pt on? And could infiltration of these drugs cause tissue damage, phlebitis, or pain?
  7. by   Chuckie
    Last edit by Chuckie on Jan 17, '03
  8. by   Chuckie
    Last edit by Chuckie on Jan 17, '03
  9. by   canoehead
    I think the chances of phlebitis in the scalp and in the legs and feet eliminate them as sites for any length of time. Of course if you are between losing a life or using whatever vein looks gettable I would be all for using any access, and getting the P.C. site later.

    Would intraosseous access work for this patient? Seems like the docs need to get a reliable access point, rather than nursing risking their license with iffy peripheral sites.
  10. by   iv therapy
    Check the INS Standards. Scalp veins are appropriate for infants but I am not aware of anything that will support that in adults. I am aware that there has been an article in an Emergency Nursing Magazine supporting the use of scalp veins but I don't think you will get support from INS. You can always write them and ask.

    In our facility we would definitely not support anyone using a scalp veing on an adult