16G or 18G for IV access?

Minou · May 15, 2005

we use mostly 18g, some rn's go for 20g when they have a hard stick but I tend to think if you can get a 20g in, you can get 18g in as well.

16 G, too big !!

Minou

Littlewonder · May 30, 2005

Yuck, the bigger the gauge, the more trauma on the vein! You do not do someone a favor putting in a huge IV without need. It just increases IV related risks. Please tell me that everyone there uses lidocaine or something else to numb the site, that has got to hurt!

Our anesthesia guys prefer that we use 18g, but we often use 20's instead since so much of the literature indicates that a 20 is sufficient in non-emergent cases. In most cases, a 20g is plenty for a C/S as well (although it is almost impossible to convince anesthesia of that.)

BETSRN · May 30, 2005

Just curious to know what your protocols are in your L&D. I've only used 18G needles until now. The hospital I'm currently at requires 16G for L&D. It's been a challenge for me to use that huge needle!

A 16??Yikes. We use 18's or 20's. Our anesthesiologists told us you could (though not ideal) run blood through a 20 if need be but they prefer 18's. I have never seen blood given in L&D anyway.

SmilingBluEyes · May 30, 2005

Just curious to know what your protocols are in your L&D. I've only used 18G needles until now. The hospital I'm currently at requires 16G for L&D. It's been a challenge for me to use that huge needle!

we 18 G only. Why a 16? You can infuse blood and deliver fluids very rapidly with 20 or 18G .......we don't even stock 16g on our floor!

SmilingBluEyes · May 30, 2005

Also, today's 18g has a bore the size of the old 16g.......meaning you can do what you need to with the smaller guage needle!

SmilingBluEyes · May 30, 2005

A 16??Yikes. We use 18's or 20's. Our anesthesiologists told us you could (though not ideal) run blood through a 20 if need be but they prefer 18's. I have never seen blood given in L&D anyway.

wow you have never hung blood in L and D? You must have a very healthy and fortunate population? We on the odd occasion (due to hemorrhage) have hung blood. Don't like to, but sometimes it's necessary!

k_cole21 · May 30, 2005

I know that you can infuse blood with an 18 & a 20 so I'm sure why they have this policy. If anesthesia thinks they need a 16 for blood then they should start a 2nd IV in the event that we would need to hang blood. Also not everyone uses local when starting these IVs w/ 16g.....

Rose B · Jun 5, 2005

We use 18's here. Will use a 20 if the pt's veins aren't so great. If they end up needing surgery with the possibility of blood products anesthesia can start a new site.!

HoosierDeb · Jun 5, 2005

I am an IV Therapy nurse. Our L&D patients get an 18 or 20, usually a 20. Traumas get 18's, 16's in the field by the medics. Larger doesn't always mean better, it means greater risk for phlebitis and decreased patient comfort. The better the blood flow around the IV catheter, the better the IV.

JaneyW · Jun 5, 2005

I am an IV Therapy nurse. Our L&D patients get an 18 or 20, usually a 20. Traumas get 18's, 16's in the field by the medics. Larger doesn't always mean better, it means greater risk for phlebitis and decreased patient comfort. The better the blood flow around the IV catheter, the better the IV.

I would love to be more schooled in IV therapy. Thanks for the input. How do you choose/start an IV in order to ensure better blood flow arounf the catheter? Do you have a favorite area for L&D catheter placement? I try to find large veins somewhere on the forearm, but often end up in the hand because it is easier for me to get it on the first stick. Do you have suggestions or tips you are willing to share??? Start a new thread if you can.

Thanks!!!!

k_cole21 · Jun 6, 2005

So I finally cornered an anethesia doc and asked why we use these 16Gs @ this facility when we can run blood through an 18G or a 20G and most of the country is using 18s or 20s. Her response was blood can run faster through a 16G and she feels more comfortable with 16s. She went on to say......"if someone's bleeding out i'm going to stick a 14G in anyway"....i said EXACTLY! if they are bleeding out we have to have a 2nd site so why not let us use an 18 or a 20 for these women? She had no answer for me!

Dayray, RN · Jun 6, 2005

18's are standard sometimes ill do a 20 if the pateint has fragile veins. 16's if the patient is at high risk for bleeding and going to get C/S ie clotting disorder, PLT

Really 18's and 16's are about the same to put in. Anything you can put a 18 in you can get a 16 in it just seems harder but you'll get used to it.

The differance is that you can run fluid faster threw bigger guages and sometimes that can make all the differnace if someone bleeds or drops their presure.

You can run blood threw a 20 but a larger % of the RBCs get hemolized (are broken) becuase they try to crowd their way threw the IV and end up getting squeezed. So if you have to run blood you need to run it allot slower or you are going to get a lower impact on the crit and you are going to place some stress on the pateints kidneys to deal with all that free protine---> nitrates.

Same thing goes for 18 vs 16. The question here is how fast do you think you need to run fluid and what is the likelyhood of needing to give blood.

As for 20's I've heard some pople say that the pateints viens are "too small for an 18" but for me narrow viens are'nt hard its the ones that have flimsy fragile veins that need the 20's becuse threading in an 18 will blow them.

BetsRn I want to work in your L&D I wish I could go to work without the fear of a pateint hoseing and needing to rapid infuse gallons of RBC's and FFP.

(sorry no spell check today Im too tired) P