Nurses Helping Nurses
allnurses Network: Central | Jobs | Books | Newsletter
allnurses: A Nursing Community for Nurses
Home General News Blogs Articles Students Region Specialty Degrees F.A.Q.
Pain Management Nursing /

Help with Starting a subcutaneous PCA



Did You Know?
allnurses is the largest community for nurses on the web. We now have over 387,987 members! Join today to network with other nurses, laugh, share, and much more.

Jan 14, 2009 09:19 PM

Help with Starting a subcutaneous PCA


I hope these are not stupid questions but here goes hehe:

When starting a subcutaneous infusion, can you use both a regular IV catheter and the butterfly IV catheter?

At our facility we have both the BD Insyte Autoguard IV start catheter and the BD Safety Intima (butterfly). Keep in mind that we do not have a specific policy for subcutaneous infusions but only a broad infusion policy from our pharmacy. We have an end of life resident at our facility and we are having some difficulty controlling her pain (she is currently on fentanyl patch 175mcg and roxanol 1m qhour prn). The idea for SUBQ PCA came up and I want to have as much information as possible before we cross this bridge with the IDT.

My second question is that comes from the literature that I have read when priming a subcutaneous infusion. You cannot prime the Autoguard until you retract the needle and you cannot prime the Safety Intima until you unscrew and pull the needle with the safety device. How do you prime these sets with either IVF such as NS or morphine sulfate if you are doing SUBQ PCA infusions? Is it ok to have some air in the line prior to attaching the IV tubing with the Safety Intima butterfly catheter before starting the infusion?

I've started tons of peripheral IV's in frail and elderly residents. Is it more or less difficulty than that?

Thank you! Any information would be appreciated.


Share

Search Tags
None
Top

 
Advertisement
Sponsored Links
 
Reply
5 Comments
No. 1
from morte
Old Jan 15, 2009, 01:46 AM

Default Re: Help with Starting a subcutaneous PCA
what you need is a Huber needle, a needle that has a 90' bend....commonly used to access ports, also used for subcutaneous access....good luck
Top

1 Reader Gave Kudos
 
No. 2
from KarangRN
Old Jan 15, 2009, 02:09 AM

Default Re: Help with Starting a subcutaneous PCA
Thank you, its been a while since we've had someone with with a portacath but I know we have some huber needles in our IV cart.
Top
 
No. 3
from morte
Old Jan 15, 2009, 02:23 AM

Default Re: Help with Starting a subcutaneous PCA
i think they come in different lengths....if the patient is very thin, you prob want the shortest you can get, good luck
Top
 
No. 4
from shrinky
Old Jan 20, 2009, 10:05 AM

Default Re: Help with Starting a subcutaneous PCA
They are really easier to start than an IV but the needle we have used is made specifically for use with subq infusion devices and we usually get them from the infusion company that mixes our drugs and supplies the infusion pump. They are very thin, tiny needles that you can insert into the thigh or abdomen and I've used them in the arm for infusion. How are you getting the meds and are you using a pump for the PCA infusion? We have usually changed the site every three days but that may be the policy of our infusion company. The needles have an adhesive around the wings to help hold them in place as well as a tegaderm over the needle to secure it to the site. Is the patient able to push the button to request the med or will this be a continuous infusion? Hope this helps.
Top
 
No. 5
from KarangRN
Old Jan 20, 2009, 02:53 PM

Default Re: Help with Starting a subcutaneous PCA
The plan is for continuous infusion.

At this point we have the resident on around the clock routine Roxanol and Ativan in addition Fentanyl patch increased to 200mcg and it seems to be keeping her a lot more comfortable. I'm having our pharmacy order those SQ needles in case we do go down that road I'll be ready and have the equipment available.
Top
 
Reply




Thread Tools


Who's Online
354 members
2,960 guests
3,314

8

Australian surgeons successfully separate conjoined twins

40

Disruptive behavior by doctors, nurses persists a year...

31

Woman sues after police tackle her in ER during premature...

5

Beyond The Last Lecture -For Randy & Jai Pausch nurses...

15

WHO: Give at-risk groups anti-flu drugs early

21

Nursing, medical schools should work together, experts say

6

Army nurse honored after 100th birthday

37

Pandemic seems to be leveling off, expert says

7

Patients happier when hospital staff discuss adverse events

9

Cleveland RN says disability did not stop career switch



1

Society Needs Care Too

11

Why am I doing this, anyway?

2

Nurse Heal Thyself

8

My Papa, why I am the nurse I am today.

17

I made it through

11

An angel's gaze

14

A Sister Never Forgets

16

Ruby's Marbles

37

What Do Operating Room Nurses Do?

14

My Little Old Jedi

20

I love this job......

23

"I hear voices"

19

Preventing FRUTI (Foley Related Urinary Tract Infection) in...

24

Error and Attitude

10

It's Just a Shower





Currently Reading This Page: 1 (0 members & 1 guests)

Interested in the hottest topics of the week? Subscribe to the Nurse-zine Newsletter.
Enter email address: