the critical thinking of IV

luvin it · Oct 30, 2004

As I remeber our country nurse connect the catheter with the IV tube before stick the pt. befor the poke the nurse will let the med run and expell th air in the tube and CATHETER. last week when I saw what happen at hospital, a nurse poke the pt hand vein using butterfly catheter firstly, when the blood return, she connect the tube, so the air insider the tube will definitly go into the pt body even if the amount is too small to fatal.
what is your procedure and sequence to start IV?

what you are questioning is right to question. This was probably not life threatening, but, could have been better. Starting w/ a butterfly is a way of establishing a saline/heparin lock. The tubing should have been primed w/ solution prior to infusion. Infusion initiated should not be direct antibiotix

flaerman · Oct 30, 2004

Hi,

I work in a very busy 31 bed ER, here we start IV's on about 80-90% of our patients(all abd pain workups, chest pain, pedi febrile seizures, kidney stones,

MI's and CVA's etc will require an IV access, bloodwork, usually some type of IVF or meds). Basically what I do is to find and access the vein with the IV catheter, hold pressure over the vein, disconnect the needle and place a pigtail tubing on the catheter hub, back flow blood to the end of the pigtail and attach the vacutainer to draw blood, once blood done release the tourniquet, cap the tail if only used as a heplock or if IVF's are ordered then just attach the(already primed)IV tubing hub to hub onto the pigtail and open the roller clamp to infuse the fluids. On peds we start the IV, attach the pigtail and then usually attach a syringe for drawing the blood(esp on babies and young children) since we are drawing less blood and using smaller catheters too, then either flush or run fluids depending on the order. Hope this helps..... flaerman :balloons:

bfx · Nov 1, 2004

If the pt does not need to be drawn the blood, do u still use the pigtail tube and syring to back the blood to the end of the tube?

:uhoh3: :balloons:

Hi,
I work in a very busy 31 bed ER, here we start IV's on about 80-90% of our patients(all abd pain workups, chest pain, pedi febrile seizures, kidney stones,
MI's and CVA's etc will require an IV access, bloodwork, usually some type of IVF or meds). Basically what I do is to find and access the vein with the IV catheter, hold pressure over the vein, disconnect the needle and place a pigtail tubing on the catheter hub, back flow blood to the end of the pigtail and attach the vacutainer to draw blood, once blood done release the tourniquet, cap the tail if only used as a heplock or if IVF's are ordered then just attach the(already primed)IV tubing hub to hub onto the pigtail and open the roller clamp to infuse the fluids. On peds we start the IV, attach the pigtail and then usually attach a syringe for drawing the blood(esp on babies and young children) since we are drawing less blood and using smaller catheters too, then either flush or run fluids depending on the order. Hope this helps..... flaerman :balloons:

luvin it · Nov 1, 2004

No, you don't. I read the previous post and noticed that it kinda went into left field. The new angio-cath. shows a back flash w/ u access the vein, @ that point, I do use a pig-tail attached to a 3cc syringe w/ 2 cc NS flushed into it. Don't leave any air in it.(does this make any sense?). After I get the flash of blood into the cath. thread the remaining cath inot the vein. Then I disconnect the neddle part of the cath and attach the pig tail. Then I pull back to verify blood return,flush that back in and tape the site.

In the hospital we use the pigtail to make it easier to attach Iv fluids and adminster IVP's.

It would be better to find a reputable person/setting to learn and practice starting IV"S. Sometime hosptials also have details in the procedure manuel to explain the way THEY want it done. It's best to check if any questions. That would also clear up the actions of others that you question.

flaerman · Nov 2, 2004

My post was not in left field, and we don't attach syringes to the pigtails unless we are drawing blood via syringe(Pedi pt's), yes I do get a blood return when inserting the catheter, but pigtails are used and all blood is then drawn via vacutainers from the the pigtails, then it is either flushed or IVF hooked up. I work in busy ER where we draw all of our lab bloods and send them to the lab with the exception of point of care testing which we do in our stat lab(cardiac enzymes, CHF and SOB indicators, and I-Stats). If labs labs are not need but say IVF or IV meds are ordered then we still start the IV and place a pigtail on it. I have seen too IV's without pigtails come out due to sloppy or poor taping/securing procedures done. Our pigtails allow for a second port on the IV at the hub as well as at the end of the pigtails(comes in handy when pushing Adenocard IV slam for rapid heart-rates....)

flaerman :rotfl: