Arterial Sticks...for Routine Labs

[ChristineN, BSN, RN]

Hey all. I'm a pediatric acute care nurse. I was at work yesterday and was shocked to find out that alot of the residents do arterial sticks for routine labwork. I had 3 different residents tell me that not only do they do it on a regular basis, but they think it causes less pain to the child, is less sticks, and takes less time. I was shocked!! I was also shocked to see alot of the other staff thought this practice is normal. I work acute care, so we aren't talking about STAT labs, or a code situation.

Anyone else seen this practice? I'm thinking about buying a translumenator light for vein sticks.

[mamamerlee, LPN]

I remember that they did this over 30 years ago - mostly femoral sticks. I am surprised that it is still the standard, but the arteries are larger and easier to hit.

[Phlavyah]

I'm not a nurse yet, but I have had it done to me before and I could not believe how painful it was...

[wooh, BSN, RN]

We'll do capillary sticks (finger/heel) but I've never seen anyone claim an actual arterial stick is less painful, that's just plain stupid.

[dscrn]

I'd say...line up the residents. and let everyone of them experience an arterial stick...I know in the nsy, if they were doing abg,s they would sometimes use the arterial stick for other labs, also...

[Psqrd]

I was a phlebotomist before I was an RN...I have one word for this practice..LAZY!

As I know that most of these sticks are brachial or femoral..if they clot off or damage the artery do they have a plan for re-vascularizing the limb...if this was my child trust me that heads would roll if I found out about it.

P2

[ChristineN, BSN, RN]

I was a phlebotomist before I was an RN...I have one word for this practice..LAZY!

As I know that most of these sticks are brachial or femoral..if they clot off or damage the artery do they have a plan for re-vascularizing the limb...if this was my child trust me that heads would roll if I found out about it.

P2

I agree, it seems very lazy to me too. The residents said that they might have to do a vein stick 4 or 5 times to get blood, but let them do an art stick and they can get it on the first try. The scary thing is the facility I work at does not train RN's on sticks or IV's so most of my co-workers don't know enough to know how to to vein sticks to counter the doctors. I'm sure no child that's old enough to know better would say it doesn't hurt, or is the same as a little vein poke.

[ChristineN, BSN, RN]

I'd say...line up the residents. and let everyone of them experience an arterial stick...I know in the nsy, if they were doing abg,s they would sometimes use the arterial stick for other labs, also...

Yes, want to ask them if I can "practice" art sticks...on them.

[wooh, BSN, RN]

The residents said that they might have to do a vein stick 4 or 5 times to get blood, but let them do an art stick and they can get it on the first try.

On a really dehydrated kid (or a Kawasaki's or a frequent flyer) I can see it taking 4 or 5 times to get an IV, but a blood draw is not that difficult. Not to mention, if you can't get a good vein, you can do a heel stick (on a little one) or a finger stick and drip it into a bullet. Either would be a lot less torture on the poor kids (not to mention, a lot safer.)

[ChristineN, BSN, RN]

On a really dehydrated kid (or a Kawasaki's or a frequent flyer) I can see it taking 4 or 5 times to get an IV, but a blood draw is not that difficult. Not to mention, if you can't get a good vein, you can do a heel stick (on a little one) or a finger stick and drip it into a bullet. Either would be a lot less torture on the poor kids (not to mention, a lot safer.)

I absolutely agree. The problem is that alot of times when the residents do the sticks, they do "blind" vein sticks (ie "I think there should be something here") They also do not use a translumenator on the little ones, which I think would help. I am not a great stick (worked adolescent previously, so not great at the little ones at all), but I am willing to try in order to keep my kiddos from getting art sticks!!