Do RN's insert EJ's at your hospital - page 2

Hello all. We are working with the PICC placement nurses to develop a competency for EJ insertions. I wonder what size catheters, length included, taht you have seen used for this. Does anybody have... Read More

  1. Visit  Altra profile page
    0
    We place EJs. Generally 18- or 16-gauge. They are peripheral lines -- the external jugular is not a site used for central lines.
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  3. Visit  SWAT RN profile page
    0
    We do it as SWAT in ours.
  4. Visit  wanderlust99 profile page
    0
    I've never seen a nurse do it in the ICU. If I can't get a line and they don't want to put a central line in I just ask the doc to please place an EJ.

    ER nurses though, sometimes I see them put IVs in the chest, haven't seen EJ though by a nurse.

    But it is a peripheral...so you still have to treat it like a PIV.
  5. Visit  1018rn profile page
    1
    I have on occasion, mostly due to my prehospital experience, and most times the other nurses looked at me like I was crazy. In small hospitals without someone available for emergent central ir PICC line insetion, it is invaluable, usually easy and quick. A regular 16 or 14 gauge needle works well.
    JonMikel likes this.
  6. Visit  chuckz profile page
    0
    When I worked in the MICU we didn't place them, only peripherally. I work in the ER now and yes, we do put in EJ's. Seriously, I'll place a line anywhere I can to get access in certain situations. I've placed them in toes, calves, upper chest, shoulders and just about anywhere else I can think of.

    EJ's are used as a last resort though. I just keep it in the back of my mind that I can get one in if I need it.
  7. Visit  brainkandy87 profile page
    0
    Yup, we can place EJ's. I nearly always use an 18g. I've only had one pt who I used a small gauge on and that was because I seriously doubted an 18 would fit without occluding the vein. I do them in the ER and did them when I worked on the floor. Most of the floor nurses won't do them (thank god.. most of them are bad enough at putting an IV in the arm), but there's only a handful of ER nurses that don't do them.
  8. Visit  rgroyer1RNBSN profile page
    0
    We do them usually a 16g but only our er and icu nurses are allowed to place them.
  9. Visit  suiteums profile page
    1
    In the beginning i threw 18's in everybody! In the words of my preceptor, "no need to be mean and inflict unnecessary pain. We can give blood with a 22 of we had to." 20 is my go to for reg peripheral unless my PT is unstable, then the 18's.
    Janey496 likes this.
  10. Visit  suiteums profile page
    2
    Yep, boob iv. It was literally the only access on one of my pts.
    sallyrnrrt and Greenclip like this.
  11. Visit  suiteums profile page
    0
    Only Dr. in our er
  12. Visit  suiteums profile page
    0
    google "ej insertion competency" the first result will return Pomona hospitals p&p posted by ena
  13. Visit  Greenclip profile page
    0
    At our hospital, RNs can place peripherals only in the BLEs. Having said that, it is a very large teaching hospital with no shortage of MDs, NPs, PAs, etc.
    In ICU we only place 18g or 20g. If someone comes up from the OR or ED with a 16g, we are very happy especially if it's in the forearm and not the AC! Some transfers from the floor will have a 22g in place, or sometimes in a patient with difficult access who needs 2 peripherals (and everyone in ICU needs 2) a nurse from the IV team will use a 22g. That's it.
  14. Visit  nycsurg profile page
    1
    Quote from suiteums
    In the beginning i threw 18's in everybody! In the words of my preceptor, "no need to be mean and inflict unnecessary pain. We can give blood with a 22 of we had to." 20 is my go to for reg peripheral unless my PT is unstable, then the 18's.
    This is very wrong. A 22g IV has like 1/4th the flow rate of an 18g. You also cannot use a 22g for powered injection for certain CT scan protocols. I mean sure, if the patient is entirely stable, and not preop, and not going to need a CT scan, a 22 is fine. But any patient that could possibly go to the OR, anyone who might suddenly become sick, deserves at least 1 large iv. Doing the right thing for the patient sometimes involves sticking them with a great big IV. The worst thing in the world is when the patient is crashing, and you realize that the patient came up from the ED with only a 24g iv in the finger.
    sallyrnrrt likes this.


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