Do you remove occluded or infiltrated IV right away or wait until new start done?

remove it, if an emergency arises you need a new one. No good giving drugs through an access that doesn't work, drugs infiltrating may cause a lot more problems. Sometimes we find in the UK access was put in and not always a necessary thing so decisions was made individually to whether insert or not. Things change and access can be inserted if required

Sometimes if we have an IV infiltrate while giving a certain medication (dopamine, etc), we have to leave the IV in so that we can give a medication to help stop the damage caused by the drug. If it was just a maintenance IV, I will generally d/c it before starting a new one. If the IV just won't flush, I will play with it a little bit before removing it because sometimes if you tear down the dressing and readjust the IV it will work. Sometimes the tip of the catheter gets up against the wall of a vein or it gets a little bit kinked and if you move it slightly while flushing, it will become patent again.

Please explain what ECMO means? Today is the first time I have seen that. Thanks.

ECMO stands for Extracorporeal Membrane Oxygenation. It's similar to the cardio-pulmonary bypass used during open-heart surgery. In babies it's used to let the lungs or heart rest and heal after respiratory or cardiac failure. The reason you can't pull an IV is that the patient is heavily heparinized (to avoid thrombus formation in the circuit), so they will bleed and bleed badly. No IV starts, no fingersticks for blood sugars or other labs, and at least at my institution, if you lose your Foley, too bad. You leave it out.

Ou,t out, out right away - and access at another site as soon as possible

Leave the site in until a new one is started.

If you place a band on the arm above a newly d/c'd site it will bruise, or bleed depending on what was wrong with it.

I pull out the old before starting a new one. But... if it is only painful because of the psychological aspect of having an IV, I will leave it in until a new site is started. Sometimes IV sites can be painful for a day or two before going bad, and you can use it in an emergency situation until IO or another peripheral is started. If it has gone bad -infiltrated or phlebotic, d/c it! You also need to follow your hospitals policies and procedures for guidance. Good job questioning practice. Sometimes questioning practice can bring about a change!

at the hospital I am a patient, if it is infiltrated then they pull it and put warm compresses on the area. then they get new access as soon as possible.

If IV is bad take it out, it can't be used,and it may be uncomfortable or painful for patient:bugeyes:. If it is infiltrated putting something in the line could cause patient more harm. If it is occluded trying to put something in line can dislodge a clot and cause harm. I would think that you would leave a line in until you have a new line, only if it is day to rotate site (every 3 days where I work).

i does not hurt to leave the infiltrated iv in. it is actually a good idea if you are not sure if the medication that is being given through the line may cause extravasation. you may need to give a neutralizing medication under the skin to prevent severe damage. this especially true with chemotherapy and other vesicants. if the line is only normal saline get it out and get a warm compress on it. if it is a vinca alkaloid give the appropriate neutralizer and get a warm compress on it. if it is alkylating agent or antibiotic vesicant give the appropriate nuetralizer and get a cold compress on it.

each institution has it own policy but research has shown the above to be the most effective way of dealing with this matter

chris

NEVER flush an occluded iv. you can dislodge the clot and cause serious complications.

chris

The only time I would leave the bad IV in before I started a new one is if I was going to start the new site IMMEDIATELY. The rationale for this is that if you have to use the same arm to start the IV ( I prefer to use the opposite arm but this is sometimes not possible) when you put the tourniquet on the arm where you just removed the IV then it may start bleeding from the site because it has not had time to seal off. Otherwise I remove it right away.

I'm a newbie but may can give reasons for my facility. I was taught that if the IV is infiltrated policy is to leave it in...reason being is that if what was infuisng or being pushed is something that causes irritation or tissue death such as K, then the existing IV site must be used to dilute...example...we have a protocl to follow for IV infiltrates....if it causes harm to the patient...IV vanco or K we must first infuse 10cc NS to the infiltrate, then call IV team who then comes and asses and treats the infiltrate. If, however, the IV site is occluded or the area is reddened, we can pull it.....I cant remember what it is the IV team uses for vanco infiltrates..just know that it MUST be treated and DOCUMENTED!!!!!! We had an IV team at my facility and the nurses varied on what they wanted us to do...if it ws red I pulled it...one IV nurse said not to...reason is that they must start a new IV above the one that was occluded...makes sense, but they should be able to see where the old one was!?? hope it sheds a little light and makes a little sense.