Labs and vasopressors..new icu nurse needs advice - page 4

by icu26RN

What do you do if your pt has a picc line or central line and you need to get AM labs from the line but they are on high doses of levophed or any other vasopressor? Are you supposed to put all IV fluids on hold while you draw... Read More


  1. 0
    Quote from dorimar
    Can someone please explain how a pedal aline is ok, but not a brachial?????? In my 24 years of nursing I have never seen a pedal aline, and rightly so.... I think? Someone????

    same here--never have seen it. It sounds strange. Assuming its an adult, does this patient have some weird anatomy that makes brachial A line impossible? Trauma?
  2. 0
    I've had a few pedal A-lines. When you need a line, you need a line. We let our residents stick twice and then either an attending or one of the nurses with the A-Line cert do it.

    We RARELY have RT do our gases. They do them a lot in ER and on the floors, but in our ICU- we do them. And if the pt is a hard venous stick- we do our AM labs (or any labs) arterial if we have to. We have a large population of control-freak Type-A nurses on the unit- so we do most stuff ourselves. I'm pretty sure we'd put in our own CVCs if we could!
  3. 0
    I know this is really old...

    But I have seen a handful of pedals and at least 2 brachials. Are they really that bad? Our anesthesia CC docs put alines in on any pt with a vaso active drip.
  4. 1
    Quote from icu26RN
    Thanks everyone for all your responses . I definitely wish we had more a-lines in our icu, it would make things so much easier. I find that a lot of patients in our unit that are on multiple pressors do not have a-lines!!! I am not sure why and I will definitely try to advocate for one if possible.
    sorry to say this, but at my last job was told that the reason we don't get more art lines is medicare has strict standards and won't pay.
    I am happy to say that we had a new group of hospitalists that came in and but a quick end to this. They had attitude of "well of COURSE they need an art line, they are on pressors" LOVE LOVE LOVED it
    Five&Two Will Do likes this.
  5. 0
    Quote from funkywoman
    sorry to say this, but at my last job was told that the reason we don't get more art lines is medicare has strict standards and won't pay.
    I am happy to say that we had a new group of hospitalists that came in and but a quick end to this. They had attitude of "well of COURSE they need an art line, they are on pressors" LOVE LOVE LOVED it
    Medicare? An administration should not be allowed to dictate what is medically acceptable. It should be a standard of practice to have transduced blood pressures for anyone sick enough for pressors! I like the way your docs sound.
  6. 0
    In the ICU department I work in, all admitted patients, whether overnight post-op, short term, long term, on or off inotropes; everyone has an arterial line. Never ever interrupt your inotropes, except to wean them down, it's too risky for the patient. We always draw our blood for lab tests off the arterial line, unless it isn't aspirating. In this case, we draw off the central line or picc line if available, failing that, we do a peripheral stick.
  7. 0
    Quote from Five&Two Will Do
    Medicare? An administration should not be allowed to dictate what is medically acceptable. It should be a standard of practice to have transduced blood pressures for anyone sick enough for pressors! I like the way your docs sound.
    thanks, I really miss that place, had to relocate due to husbands job, in the market now and looking, wish me luck
  8. 0
    Quote from funkywoman
    thanks, I really miss that place, had to relocate due to husbands job, in the market now and looking, wish me luck
    Good luck and I highly recommend you find a VA!
  9. 0
    Quote from MLB55
    I know this is really old...

    But I have seen a handful of pedals and at least 2 brachials. Are they really that bad? Our anesthesia CC docs put alines in on any pt with a vaso active drip.
    I have seen pedals used in both the NICU and the PICU...granted the kiddo needs to be pretty sedated to keep them from kicking it out, don't see why it would be an issue on an adult though...
  10. 0
    Quote from icu26RN
    What do you do if your pt has a picc line or central line and you need to get AM labs from the line but they are on high doses of levophed or any other vasopressor? Are you supposed to put all IV fluids on hold while you draw labs so they dont dilute the lab sample.. what if your pt is very sensitive to the vasopressor and drops their pressure right away? But what if you leave the pressors on will it mess up the lab results? Please help..I need advice.

    I just started in the ICU 3 days ago (MICU/SICU). My preceptor just talked about this. Some of the lab techs will say it's policy to turn off the IV drips for a bit before they draw labs. She said absolutely not in the case of pressors. Keep those running!!


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