geriatric patient

NicuGal, MSN, RN · Aug 12, 2003

Does she have a central line? We get an order to draw off the line when they are that old. We have done venous sticks on them too....we use EMLA cream.

nurseiam · Aug 12, 2003

She is on her second broviac after several Picc lines so there is an order for NO labs to b drawn from it. Do you use the EMLA in the NICU? I've used it on peds. I know that she is a ped patient but there are only a few of us that know this.......

NicuGal, MSN, RN · Aug 12, 2003

Yes...we even use it on the heels, but we sometimes have to warm them as the EMLA can cause heelsticks to not bleed so well.

I hear you on how many lines some kids go thru...it is so sad!

Have they considered just doing one art stick for all the labs...that another thing we have done.

nurseiam · Aug 13, 2003

I think that it is more of getting others including new nurses to critically think about what they are about to do. They do a heel stick because that is the way it would be done for most other pts without a drawing line. I was just thinking at that age her heals must be callised and hard as a rock!! The poor thing! I would like something concrete to take in there and say"Hey lets not punish this baby......."

Long Term Care Columnist / Guide · Aug 13, 2003

Uhhhhh......excuse me, but how did this thread get titled "Geriatric patient" when it's about a sick infant????? :confused:

NicuGal, MSN, RN · Aug 13, 2003

That is what they call long-termers...the geriatric neonate LOL

Pediatric Critical Care Columnist · Aug 13, 2003

I work PICU and I can tell you that practice differs greatly from facility to facility. In Winnipeg, we would draw from the line if possible ( and we had lots of CVCs we weren't permitted to draw from). If the kid was big enough or was an easy stick, we'd do a venipuncture. Failing that, the lab would come and do a capillary sample. They used heels for babes under two months, then moved on to fingers or toes. The fingerpoke method can be used on anyone. It isn't really any different from a heel stick, warming the digit being the key. I also like to put a little smear of Vaseline on the site before I poke, which helps put the blood into the microtainer and not running down their hand.

Long Term Care Columnist / Guide · Aug 13, 2003

Thanks, NicuGal! I learn something new every day on this BB:kiss

cswain12000 · Aug 15, 2003

I have a friend who has twin daughters born at 23.4 weeks and they are now ten years old. They both weighed just over a pound at birth. The hospital they were at used finger/heel/toe sticks for labs unless the pt had an art line. At ten years old--they still have no feeling in their finger tips, and scars on their heels. I don't know of any way around some of this though when you have an old timer in the NICU. At my hospital we use a combination of venipuncture-(even on the tinies) and heel sticks. We will use art lines for as long as we can in the early days when we are doing numerous labs. We never use PICC lines, but we will use broviacs and UVC's. cindy:)