Why cannot give IV medication via artery? - page 4

by suizzz

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Hi, I'm new here, please help me to answer the above question. It's looks like stupid question but it bothers my mind.:banghead: I have been searching the answer from internet but I unable to get a good answer. :zzzzz What I... Read More


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    Quote from Otessa
    Just found that out today. This doesn't sound like a common practice though.....
    No, it is not very common at all.
  2. 0
    One reason you don't want to give an IV med through an arterial access is that it kind of "slams" into the patient via the arterial route. If the patient is in a special procedure, the artery that is accessed is part of a sterile field. You would have to reach over into the field to give the med, or ask the doctor to give it, slowing down the procedure.
  3. 0
    arterial damage arterial pseudoaneurysms may form at injection sites, which can rupture, potentially resulting in hemorrhage, distal ischemia, and gangrene. inadvertent intra-arterial injection can also result in endarteritis and thrombosis, with ultimately similar consequences.[2]
  4. 0
    Moved to Nursing and Patient Medications.
  5. 1
    first of all, we need to go back to our basic a&p...the substance in the vein is heading to the heart, then out into circulation after liver filtration. substances in an artery are heading right to the organ/tissue to where it leads. just thinking on this basic understanding of a&p a person can answer this using critical thinking.

    2. giving iv medication arterially can damage artery and necrotic because artery will spasm after injection.

    arteries and veins are amazing in that they can handle substance that would normally destroy regular tissue but can be carried through a vessell without doing any damage at all. it's late and my brain is not functioning at it's best so i cannot recall specific drug names, but someone else may know of some. you know, those kind of meds that you need to be positive you are in the vein and you push, then aspirate, push, then aspirate while giving it because if even a little gets out of the vessel it will eat up the tissue.

    but yes, the arteries have muscular tissue that veins do not and can spasm, which can lead to pain, vessel constriction and possibly causing the needle to be pulled from the vessel which would lead to a major hematoma due to the arterial pressure.

    two of the nicus i have worked in split the tpn through the umbilical arterial and umbilical venous lines

    just trying to use some critical thinking here, but could this be because premies still have fetal circulation, which is not the same as an adult? i do not know this for sure, but if things are still being given via the umbilical arteries and vein then fetal circulation must still be intact?
    quote from woodenpug
    i had once worked with a population of patients who used i.v. access for recreational purposes.

    i asked many questions, such as why insulin needles (they call them orange caps). i even asked "why not use an artery?", since you have so few veins left? the answer - i don't think it would be as much fun if my hand got high.

    only someone who uses iv access for recreational use could come up with an answer like that :chuckle

    actually they were right on the mark and seem to have a better understanding of blood flow than you do.
    some chemos are given that way.

    again, just using basic a&p and critical thinking (and no that is not sarcasm), but i deduce that this is done because the toxic chemo would be able to skip going through general circulation and hit directly at the tumor/cancer with full strength, thus doing less damage to all the other organs it would otherwise have had to pass through in order to even make it to the tumor, if it ever did, if given iv. course, this may be done rarely as it could be difficult to access an artery that leads directly to the tumor, and additionally if arteries are unstable, high risk for infection, etc and chemo needs to be done over a long period of time.

    so to sum it all up, when injecting a med into an artery you are only supplying that med to the area of the body that recieves it's blood supply from that artery. if you give a med into the femoral artery then the leg, the brachial artery then the arm, the carotid woo crap right into the brain bet that wouldn't be good lol....wait a sec, just realized this, if a med is not given in a vein but only an artery, it will never make it to general circulation (thus never getting to it's point of action) because it will never get into the heart, hmm, cool, i like when two and two come together!

    very good question op, and i like the way you think, this is what will make you an awesome nurse, if you don't know something you don't just say, "well that must just be the way it is" without trying to understand the why of it! you don't really know something until you know the why of it right down to the very root of it.
    lindarn likes this.
  6. 0
    To the question about running tpn into a UAC, this is something that we will not do in our NICU unless in an emergency where no other access is available.

    In terms of a neonates circulation, in an ideal situation it is not different from an adults. The uac is no different than a central artline in an adult except where its inserted. The umbilical arteries are connected to the descending aorta. The catheter in a UAC ideally ends in the high position in the aorta between t6 or t9 or the low position at around L4 in the descending aorta.

    Once a child is born they no longer have fetal circulation because you change the pressure of the whole system when you cut the umbilical cord from the placenta and kiddo takes their first breaths ,it makes the path of least resistance through the lungs and not to bypass then through the ductus or foramen ovale. So in response to neonates having fetal circulation the answer is technically no because there is no placenta providing oxygen, their lungs are. So the aorta is carrying (in an ideal situation) oxygenated blood from the lungs ( provided they are working well) away from the heart just like in an adult.

    Where a premature infants circulation might differ is that the may have patent ductus or a foramen oval or many other heart defects that causes shunting of blood similar to fetal circulation or immature lungs that lower the oxygenation of the blood within the artery. But in terms of running meds into the aorta of a neonate, not the best route due to the same reasons listed by many other posters. Also UACS aren't used for more than 7 days at a time so you really wouldn't want to be relying on it for any long term infusions.
  7. 0
    Quote from Backtoyou2011
    To the question about running tpn into a UAC, this is something that we will not do in our NICU unless in an emergency where no other access is available.

    In terms of a neonates circulation, in an ideal situation it is not different from an adults. The uac is no different than a central artline in an adult except where its inserted. The umbilical arteries are connected to the descending aorta. The catheter in a UAC ideally ends in the high position in the aorta between t6 or t9 or the low position at around L4 in the descending aorta.

    Once a child is born they no longer have fetal circulation because you change the pressure of the whole system when you cut the umbilical cord from the placenta and kiddo takes their first breaths ,it makes the path of least resistance through the lungs and not to bypass then through the ductus or foramen ovale. So in response to neonates having fetal circulation the answer is technically no because there is no placenta providing oxygen, their lungs are. So the aorta is carrying (in an ideal situation) oxygenated blood from the lungs ( provided they are working well) away from the heart just like in an adult.

    Where a premature infants circulation might differ is that the may have patent ductus or a foramen oval or many other heart defects that causes shunting of blood similar to fetal circulation or immature lungs that lower the oxygenation of the blood within the artery. But in terms of running meds into the aorta of a neonate, not the best route due to the same reasons listed by many other posters. Also UACS aren't used for more than 7 days at a time so you really wouldn't want to be relying on it for any long term infusions.
    Thank you for clearing that up! I understand that fetal circulation/cutting the cord/change of pressure and all that jazz, but I was thinking that if fluids and other substances were still being infused through the cord then the change of pressure with the cutting of the cord would not have happened and thus fetal circulation would stay intact.

    So let me think here...you would give anything via the umbilical artery because that is flowing out of the cord away from the body, the med would be given via the umbilical vein which is headed to the liver and vena cava thus it will be filtered and reach general circulation?
  8. 1
    Correct, kind of. Once you separate babe from mom the umbilical arteries are no longer connected to the umbilical vein ( no placenta anymore).

    So a Med infused into the Cather will distribute via the descending aorta. I think what maybe confusing you is the difference between a UAc and a UVC. To be clear an umbilical arterial catheter is separate from an umbilical venous catheter. So if a baby were to have both (not likely but for explanation sake) we'd have fluids going through the UVC because you're right it circulates meds better an it's safer. The uac would be hooked to a transducer and only be used for abgs and other labs and monitoring pressure. Hope I made sense kind of tired, lol!
    Pets to People likes this.


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