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How do YOU feel about scalp IVs?

NICU   (5,819 Views 21 Comments)

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I know 99% of parents hate them. How do you feel about starting them there?

I was asked to start a peripheral line on an old timer that had nada. I looked at her scalp and there were tons of huge veins! I asked the nurse why she didnt' try there as even a blind GN could have hit those and she said she hated to start IVs there.

I think they're best. They last longer, secure easy, more comfortable for the baby. I'd want it in the scalp first if it was my child.

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nicumom specializes in NICU.

40 Posts; 1,496 Profile Views

As a parent of a 26 weeker and a 27 weeker I hated them. Seeing an IV in my kids head was awful.

As a nicu nurse now I love them. I agree they look awful, but are better for the baby. We never really do them on our unit though because it freaks the parents out

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prmenrs has 42 years experience as a RN and specializes in NICU, Infection Control.

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I like them. @ my current hospital, they are rarely, if ever, used. Careful explanations help: it's not in their head, it's in their scalp, no, it doesn't hurt more (or less) than an IV somewhere else, their hands are free this way...anything you can tell them that helps the parents understand that choice.

Once had a family that thought the scalp IV was causing, or @ least exacerbating, the baby's IVH! We had to give a little anatomy lesson, and I'm still not sure they were convinced.

I think you should use them if necessary, but only after all other options are used, and the parents get an explanation.

They can be oh so tempting....

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2,399 Posts; 11,557 Profile Views

I think it should be the first place you try to an IV. How many times have you and another nurse stuck the tiny veins in a kid's feet and hands and have them blow. Now, if you have a big old head vein why do we have to worry about freaking out the parents? Aren't you sparing the pt by going for the scalp vein first?

I think if we make it a policy and educate the parents, they wouldn't get freaked out thinking it's in their brain and see that all the other kids have them too.

And I've had my own kids with hand IVs . One couldn't suck his thumb as was his habit to go to sleep and the other beat her face red with hers. In retrospect, I would have told the nurse wher to "stick it".

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SteveNNP has 9 years experience as a MSN, NP and specializes in Neonatal ICU (Cardiothoracic).

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I love them..... I'm always being told by other nurses to "start low" blah blah....Then they come and get me after the kid's been stuck 4 times, and I stick the head and get it on the first try. I try to make it part of my admit teaching. I introduce the possibility of needing to access a scalp vein along with all the other "unknowns" of NICU. I find this cuts down on parental anxiety if they know ahead of time. Personally I look at the head first, since scalp veins have no valves, are easy to see, and are easier to secure. You'll also pick up on infiltration easier, since there isn't much tissue between the skull and the skin.

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BittyBabyGrower is a MSN, RN and specializes in NICU, PICU, educator.

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On big kids, the first place I go! And for a kid on prostaglandins without central access...it is a must! We tell parents right up front that we use scalp veins frequently. Why stick a kid 10 times before going for the head?

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CT Pixie has 10 years experience as a BSN, RN.

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I'm not a NICU nurse..or even a licensed nurse (yet) but being the Mom of two NICU babies, I loved them. I didn't like seeing my wee little ones with needles in their heads, but I much rathered seeing that then seeing my little one rip the IV out of their hands/arms and feet. And actually my girls tolerated them better than the others in other areas that had been placed. Even though my girls were tiny they were in constant motion and were always getting the IV lines in their hand/foot stuck on the other, pulling them out etc.

AND there are no visiable scars from the scalp IV's like there are in my girls hands and feet..

My girls NICU nurses explained to me first what they "might" have to do and what it involved. When they actually had to do it they called me at home to "warn" me that it had to be done and the IV was now in the scalp instead of the hand/foot.

Ok enough of my babble, I'm sure you are all wanting opinions of NICU nurses..not me :lol2: and my kids experiences. Just wanted to add my :twocents: but also wanted to commend all you NICU nurses for jobs well done! I loved my girls nurses and I always remember to send cards/goodies on my daughters birthdays to the nurses in the hospitals they were at to thank them, yet again, for all their wonderful care and compassion.

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LilPeanut has 8 years experience as a MSN, RN, NP and specializes in NICU/Neonatal transport.

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I like them, but they scare me sometimes - If they infiltrate or there is extravasation of meds, it's in a dangerous place.

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2,399 Posts; 11,557 Profile Views

I like them, but they scare me sometimes - If they infiltrate or there is extravasation of meds, it's in a dangerous place.

Don't you feel that it is easier to detect an infiltrate in a scalp IV than a fat arm or taped up foot?

Now that I think of it, all the bad infiltrates I've seen have been in hand IVs. Food for thought. ;)

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tutored specializes in MICU/SICU.

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I like them, but they scare me sometimes - If they infiltrate or there is extravasation of meds, it's in a dangerous place.

I'm a nearly-finished nursing student, so this questions I"m asking is not a "challenge" - it's a genuine curious question to this response - why do you feel the scalp is a "dangerous place" if there's extravasation of meds??? Wouldn't the blood-brain barrier, along with various levels of skin, fascia, bone, and still more fascia, protect what's underneath? :confused:

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LilPeanut has 8 years experience as a MSN, RN, NP and specializes in NICU/Neonatal transport.

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*LOL* I guess we don't have too many fat arms, and there's not much tape on our IVs - just the tegaderm.

What concerns me is that sometimes the infiltrates are not exactly where you would expect them to be, since scalp veins aren't directional.

I guess what I'm also thinking is of the times when other IVs have infiltrated, you get extravasation of TPN or bicarb, and that's bad on a limb, but on a head *shudder*

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