Specialties MICU
Published Mar 8, 2012
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 a link to good policies for this procedure?
Amanda.RN
199 Posts
Only anesthesiology was allowed to place EJs when I worked in the hospital.
Altra, BSN, RN
6,255 Posts
We place EJs. Generally 18- or 16-gauge. They are peripheral lines -- the external jugular is not a site used for central lines.
SWAT RN
7 Posts
We do it as SWAT in ours.
wanderlust99
793 Posts
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.
1018rn
16 Posts
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.
chuckz, BSN, RN
165 Posts
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.
brainkandy87
321 Posts
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.
rgroyer1RNBSN, BSN, RN
395 Posts
We do them usually a 16g but only our er and icu nurses are allowed to place them.
suiteums, MSN, RN
77 Posts
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.
Yep, boob iv. It was literally the only access on one of my pts.
Only Dr. in our er
google "ej insertion competency" the first result will return Pomona hospitals p&p posted by ena