Backorder of butterflies...

Specialties NICU

Published

Good afternoon - in light of the critical shortage/backorder of butterfly needles, what process are you using for alternatives?
We are restricting use of them to strictly ABG/blood culture draws, and also the approach of using the most skilled person first (aka not the time for practice opportunities, as this affects our entire healthsystem's supply).

Let me know your thoughts and strategies!

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Specializes in retired LTC.

Now maybe a reason why my home-visit phlebotomist didn't have any extra butterflies!!!

She went to my antecube with one of the reg needles, and boy, she bruised me. Big time.

If they listen to me, I can pick out a nice big fat juicy straight hand vein. But noooo! They go for something they want to.

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My current unit allows the most skilled IV nurses (usually PICC nurses) to draw cultures off of regular IV catheters when they're starting our IVs; that's how we usually get cultures for fresh admits who need access and aren't getting lines.

It can be a little tricky if you're not used to it, though. The set-up is simple--you just dump your supplies like your catheter and CHG scrubber directly onto your sterile field, and make sure you scrub the site really well, as you would for an art-stick. The hardest part is getting the blood to bleed back--you usually have to stick a pretty big, juicy vein. Even then, you might have to shimmy the catheter back little by little past valves to get good, gushing blood return. We then use blunt-tip needles and syringes to suck the extra blood up out of the catheter hub before attaching the t-connector. Not as good as an art stick, but better than nothing (especially if the kid already needs an IV).

As far as ABGs, if you're really short, could the providers consider running cap gasses instead? They're pretty much equally useful for NICU purposes (mainly checking CO2, pH and bicarb, with less consideration for the PaO2).

We're out of tons of crucial items, too--tape measures, heel warmers, med lines and spiker sets, preemie formula. We even ran out of FFP a few months ago. What a dumpster fire.

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Specializes in retired LTC.

FFP???

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18 hours ago, amoLucia said:

FFP???

Yep, none for the entire hospital. It was earlier in the pandemic back when nobody was giving blood because they were afraid to go outside. We just happened to have a handful of cooling DIC kids at the time so we ended up giving a bunch of Factor VII, which was ironic because that stuff costs several thousand dollars per dose and usually requires an attending order and pre-authorization from our pharmacist.

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Specializes in retired LTC.

FFP = fresh frozen plasma???? I guess I should have been more specific :))

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Specializes in Pediatrics, Community Health, School Health.
On 11/12/2021 at 10:20 AM, adventure_rn said:

heel warmers,

We always used a diaper with warm water and wrapped it around the foot- works great!

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