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. by   Altra
    We place EJs. Generally 18- or 16-gauge. They are peripheral lines -- the external jugular is not a site used for central lines.
  2. by   SWAT RN
    We do it as SWAT in ours.
  3. by   wanderlust99
    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.
  4. by   1018rn
    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.
  5. by   chuckz
    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.
  6. by   brainkandy87
    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.
  7. by   rgroyer1RNBSN
    We do them usually a 16g but only our er and icu nurses are allowed to place them.
  8. by   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.
  9. by   suiteums
    Yep, boob iv. It was literally the only access on one of my pts.
  10. by   suiteums
    Only Dr. in our er
  11. by   suiteums
    google "ej insertion competency" the first result will return Pomona hospitals p&p posted by ena
  12. by   Greenclip
    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.
  13. by   nycsurg
    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.

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