For some IV drugs the drug book says to give them in a large vein. What large vein's are they talking about. And once you know what large vein they are refering to, what do you do if you have an IV going in a small vein? Do you DC that small vein IV and find a large vein and start the IV there?
Oct 19, '07
Some drugs are very irritating to veins. The smaller the vein, the better the chance of irritation and complications such as blown IV, phlebitis. It is up to the nurses judgement, along with any hospital policy or best practice standard, to decide to start an IV in a larger vein. Theoretically, the IV should be started in a large vein, in a non-bending area to start with - not those little hand veins that some nurses like to use. Of course there are those LOP (little old people) that you couldn't find a large vein on them if you removed all their skin and could see inside them. Some drugs you can dilute with lots of saline and still be safe. Other times you may have to call the doc and tell him that you can't give the drug with the available IV site, you are unable to get a better site, and please consider a PICC or TLC.
Oct 19, '07
a midline or picc line would be your larger veins.
but even w/a midline or peripheral, i dilute like crazy and push very, very slowly.
(i never use hand veins)