Do you consider an infiltrated IV a medical emergency

[guest1074618]

Left the ER for outpatient...today we had a patients IV infiltrate normal saline. The tech called me and let me know the infusion was stopped, IV removed and a compress applied. Pt in no distress. I was behind schedule and working with a patient so I let them know I’d be down in a minute to eval. My non nurse manager is hemming me up for not dropping everything and running down to that “medical emergency” .

??? lawd I ain’t know that was an emergency like that LOL

[HandsOffMySteth]

39 minutes ago, Horseshoe said:

Should be hypdermoclysis?

hypodermoclysis

?

[KatieMI, BSN, MSN, RN]

Honestly, do not know should I cry or laugh out loud after reading in. Although I once had a NM who called facility-wide "biohazard code" after seeing a coumadin pill wrapper being dropped on floor.

[Horseshoe, BSN, RN]

21 hours ago, juniper222 said:

hypodermoclysis

?

??

Touché!

[nursej22, MSN, RN]

2 hours ago, juniper222 said:

hypodermoclysis

?

D'oh! I knew something didn't look right.

I remember a veteran nurse instructor teaching about this. And I think they do it pretty routinely for cats.

[KatieMI, BSN, MSN, RN]

15 minutes ago, nursej22 said:

D'oh! I knew something didn't look right.

I remember a veteran nurse instructor teaching about this. And I think they do it pretty routinely for cats.

Hypodermoclysis is alive and well in hospice care and in chronic outpatient care when IV placement is not possible for some reason.

[Tenebrae, BSN, RN]

The only time I would consider it a medical emergency is if the patient needed an urgent IV medication and had no IV access eg patient in cardiac arrest etc

Your scenario. No, not a medical emergency

Perhaps it needs to be said by the highers ups its not for non medically trained people to be making judgements on what constitutes an emergency

[KatieMI, BSN, MSN, RN]

18 hours ago, Tenebrae said:

Perhaps it needs to be said by the highers ups its not for non medically trained people to be making judgements on what constitutes an emergency

After what there will be yet another round of dog and pony show about so-called "teamwork". There's no place for "I" here, every opinion counts, it is all about the patient, everyone is soooo important, etc., etc.

Looks like the place the OP works already has the sensor of the concentration of idiots/sq. foot in dangerous zone and beeping on high frequencies, so the rest of staff needs the time to do the actual job, not to listen to yet another lecture about much ado about nothing.

P.S. I have nothing against teamwork but not when 66.6666667% of team members do not know what they are doing. That's not teamwork. It is pure abuse for the remaining 33.333333%

[HandsOffMySteth]

3 hours ago, Tenebrae said:

The only time I would consider it a medical emergency is if the patient needed an urgent IV medication and had no IV access eg patient in cardiac arrest etc

Your scenario. No, not a medical emergency

Perhaps it needs to be said by the highers ups its not for non medically trained people to be making judgements on what constitutes an emergency

The medical emergency is that manager's lack of knowledge.

[Tenebrae, BSN, RN]

15 hours ago, juniper222 said:

The medical emergency is that manager's lack of knowledge.

Yup

[Tenebrae, BSN, RN]

16 hours ago, KatieMI said:

After what there will be yet another round of dog and pony show about so-called "teamwork". There's no place for "I" here, every opinion counts, it is all about the patient, everyone is soooo important, etc., etc.

I have no issue with team work, I have had a situation where a ward clerk was demanding that I attend to something, while I was halfway through another issue that I couldnt leave. I politely said "I need to finish this, I will be with you in approx 3-4 minutes" and repeated the same thing when the ward clerk tried to push the issue.

No non medically trained person is going to dictate to me how I care for my patients. Hell, I'll go against a medically trained person if I believe they are putting my patient at risk. I had a patient who was end of life, the doctor and I had arranged to get some palliative meds, in both oral and subQ charted. I advised the clinical manager that I would take the oncall over the weekend and on my days off so we had a clear clinical plan in place. This sorted, I went on to days off figuring we had it all sorted. I got a call from my senior CNA who apologised for ringing but the clinical manager had told her to fax the GP and ask them to cancel the charting of the subQ meds.

The clinical manager had not documented anything in the patients notes, and the doctors reaction when I rang was 'no one is going to dictate how I look after my patients" and the charted med order was left with both oral and subQ which ironically we did need over the weekend and had we not had the meds already charted it would have been a nightmare trying to get stuff sorted. I also documented the hell out of my actions including clinical rationale to ensure no one could challenge it

I dont ever want to be that sort of nurse that is "I'm clinical, you arent your opinion doesnt matter" however the welfare of my patients comes first and I will politely and firmly if needed make that clear

Disclaimer. Given that sometimes stuff is clear in my head and doesnt translate well to text, I hope this makes sense

[JFfromCA]

Little knowledge is a dangerous thing.

[Waiting for Retirement]

Closest thing I ever had to an "emergency" with an IV infiltrate was when I was still at bedside; I'd gotten report on a patient with a slow-running NS IVF, no issues. Then I saw the patient on my first go-through, within about the first half hour of my shift, and she had a MASSIVE and I do mean MASSIVE infiltrate. She had very loose "old lady" skin that thankfully was elastic enough to hold onto that bag of fluids pumped into her arm and hadn't yet allowed it to burst out. I pulled it out, watched the steady stream of NS pouring onto the towel I put under her arm, and grabbed the charge nurse. NO WAY did that get like that in the 30 minutes I'd had her before I got to her room, that had been going on through the last 12-hour shift and there's NO WAY that site had been checked in many hours. That created an incident report and a call to the doc if my memory is correct, but that was really very extreme.