Dumb Question?

  1. Ok, I have a dumb question I think, for all of you....

    Why can't IVP meds be given down an Art Line?
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  2. 11 Comments

  3. by   maolin
    Think of where the blood is traveling... what's "downstream" from the A-line insertion site? If you gave an IVP in the A-line, the med would be traveling distally into the hand's capillary bed. Intravenous meds are pushed in veins so they travel into systemic circulation, further diluted in large volume of blood and then distributed throughout the body. You don't want that phenergan dose concentrated in the hand - you want it going the other way to get where it needs to be so your pt won't puke.

    HTH.
  4. by   WeakAnkles
    So, you're saying it stays localized in the hand, and never makes it systemically? Would it cause necrosis of tissue then?

    This came up in our unit with a new grad making this mistake recently, and I never thought about it before. I feel stupid asking about it now, since I have worked in units for years, without giving it thought before.
    Last edit by WeakAnkles on Nov 18, '07
  5. by   maolin
    I suppose some, maybe even all the med, could end up in systemic circulation after circulating from the radial artery>hand's cap bed>venous circulation, but it would be taking the long way around and could be VERY dangerous... necrosis, thrombus..

    Point is, IV meds go into veins, not arteries. A lines should only be used for monitoring BP & for blood draws (ABG's).

    A tough lesson for this new grad. I hope there was no harm to the pt.
  6. by   WeakAnkles
    I don't think there was any harm. I heard about it after the fact though. Thanks for the explanation, helped me think it through more.
  7. by   Dinith88
    Quote from WeakAnkles

    This came up in our unit with a new grad making this mistake recently,.
    OUch. HOw the heck did she do that? Disconnect the a-line, or? Seems it'd be a bloody mess and a little tricky compared to just pushing through an iv-port?
  8. by   TopherSRN
    Quote from Dinith88
    OUch. HOw the heck did she do that? Disconnect the a-line, or? Seems it'd be a bloody mess and a little tricky compared to just pushing through an iv-port?

    Ever hard flush an A-line or IABP? Ever push thru a CVP line? Same way, just connect at the stopcock.
  9. by   Dinith88
    Quote from TopherSRN
    Ever hard flush an A-line or IABP? Ever push thru a CVP line? Same way, just connect at the stopcock.
    yes i suppose... It's just that we dont typically have 3-way ports/stop-cocks on a-lines(why would it be set up that way?...).

    I'm sure the nurse was sweating bullets... no harm done...good lesson learned...
  10. by   Bethy-lynn
    yes i suppose... It's just that we dont typically have 3-way ports/stop-cocks on a-lines(why would it be set up that way?...).
    Our a-line kits have a 3-way attatched to them right out of the package, most likely for blood draws if a vamp is not available (like when they come back from cath lab or OR, where they don't typically furnish vamps).
  11. by   Myxel67
    Quote from Bethy-lynn
    Our a-line kits have a 3-way attatched to them right out of the package, most likely for blood draws if a vamp is not available (like when they come back from cath lab or OR, where they don't typically furnish vamps).

    Same here
  12. by   cardiacRN2006
    Quote from Bethy-lynn
    Our a-line kits have a 3-way attatched to them right out of the package, most likely for blood draws if a vamp is not available (like when they come back from cath lab or OR, where they don't typically furnish vamps).

    So do ours.

    I saw a nurse take a flush out of the a-line port and then use it for a IV flush. While not technically wrong, it still made me cringe a little. I can see someone getting confused in the process.
  13. by   gradcare
    WHa tabout the implications of arterial embolis in the radial /femoral artery (or more probable downstream in the capillarys)??

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