Do RN's insert EJ's at your hospital

[Five&Two Will Do]

Hello all. We are working with the PICC placement nurses to develop a competency for EJ insertions. I wonder what size catheters, length included, taht you have seen used for this. Does anybody have a link to good policies for this procedure?

[Amanda.RN]

Only anesthesiology was allowed to place EJs when I worked in the hospital.

[Altra, BSN, RN]

We place EJs. Generally 18- or 16-gauge. They are peripheral lines -- the external jugular is not a site used for central lines.

[SWAT RN]

We do it as SWAT in ours.

[wanderlust99]

I've never seen a nurse do it in the ICU. If I can't get a line and they don't want to put a central line in I just ask the doc to please place an EJ.

ER nurses though, sometimes I see them put IVs in the chest, haven't seen EJ though by a nurse.

But it is a peripheral...so you still have to treat it like a PIV.

[1018rn]

I have on occasion, mostly due to my prehospital experience, and most times the other nurses looked at me like I was crazy. In small hospitals without someone available for emergent central ir PICC line insetion, it is invaluable, usually easy and quick. A regular 16 or 14 gauge needle works well.

[chuckz, BSN, RN]

When I worked in the MICU we didn't place them, only peripherally. I work in the ER now and yes, we do put in EJ's. Seriously, I'll place a line anywhere I can to get access in certain situations. I've placed them in toes, calves, upper chest, shoulders and just about anywhere else I can think of.

EJ's are used as a last resort though. I just keep it in the back of my mind that I can get one in if I need it.

[brainkandy87]

Yup, we can place EJ's. I nearly always use an 18g. I've only had one pt who I used a small gauge on and that was because I seriously doubted an 18 would fit without occluding the vein. I do them in the ER and did them when I worked on the floor. Most of the floor nurses won't do them (thank god.. most of them are bad enough at putting an IV in the arm), but there's only a handful of ER nurses that don't do them.

[rgroyer1RNBSN, BSN, RN]

We do them usually a 16g but only our er and icu nurses are allowed to place them.

[suiteums, MSN, RN]

In the beginning i threw 18's in everybody! In the words of my preceptor, "no need to be mean and inflict unnecessary pain. We can give blood with a 22 of we had to." 20 is my go to for reg peripheral unless my PT is unstable, then the 18's.

[suiteums, MSN, RN]

Yep, boob iv. It was literally the only access on one of my pts.

[suiteums, MSN, RN]

Only Dr. in our er

[suiteums, MSN, RN]

google "ej insertion competency" the first result will return Pomona hospitals p&p posted by ena