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Internal jugular IV

Critical   (12,624 Views | 16 Replies)

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IVRUS has 32 years experience as a BSN, RN and specializes in Vascular Access.

1,026 Posts; 20,780 Profile Views

Although it's just semantics...an IJ catheter is, by definition, a central venous catheter, whether it's with a 3 inch 18ga catheter or a 9FR introducer and everything in between. Treat it as such.

Also, it makes no sense to leave a catheter in the IJ (or other orifice for that matter) for four days if it's not being used or cared for appropriately. There's no reason an RN can't take it out using appropriate technique.

Sorry, but this is just not true. A catheter placed in the jugular vein is ONLY a central line if its tip terminates in the superior vena cava (SVC) !! A 3 inch 18 gauge IV catheter is a peripheral IV! Also, Muno, it is a standard to use a petroleum based ointment on all sites over three inches. The case you refer to was an abstract, and it appears to be related to something that occurred upon insertion. Share the entire study if you have it. And, using a petroleum product at the site is important and is in the standards, whether you choose to acknowledge them or not, is you choice and your liability, should an AE occur.

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VANurse2010 has 6 years experience.

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Sorry, but this is just not true. A catheter placed in the jugular vein is ONLY a central line if its tip terminates in the superior vena cava (SVC) !! A 3 inch 18 gauge IV catheter is a peripheral IV! Also, Muno, it is a standard to use a petroleum based ointment on all sites over three inches. The case you refer to was an abstract, and it appears to be related to something that occurred upon insertion. Share the entire study if you have it. And, using a petroleum product at the site is important and is in the standards, whether you choose to acknowledge them or not, is you choice and your liability, should an AE occur.

The petroleum ointment hasn't been a standard any place I've ever worked.

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IVRUS has 32 years experience as a BSN, RN and specializes in Vascular Access.

1,026 Posts; 20,780 Profile Views

The petroleum ointment hasn't been a standard any place I've ever worked.

I do believe that is because many hospitals have NO clue about INS, much less their standards.

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57 Posts; 2,591 Profile Views

The INS Standard #44 states that the removal of a non-tunnelled CVAD should include cautions to avoid air embolism. Digital pressure should be applied until hemostatsis is achieved by using manual compression and/or other adjunct approaches such as hemostatic pads, patches, or powders that are designed to potentiate clot formation. The nurse should apply petroleum-based ointment... to seal the skin catheter track.

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1 Follower; 1,319 Posts; 12,524 Profile Views

Just a couple of points. Any occlusive dressing over an IJ site (tegaderm etc.) is sufficient to prevent the theoretic entrainment of air. Vaseline, if used, needs to not interfere with the tape that also becomes a requirement if tegaderm isn't used. Also, it's easier to see an intact

occlusive dressing than it is to confirm the Vaseline is sufficiently covering the hole in the skin, IME.

It isn't the amount of air that may theoretically be entrained in the 1/4 second it takes to remove the line. Unless there is an ASD or PFO, a little air into the heart and lungs is negligible. The concern is an ongoing "trickle" of air that might occur should there be a patent tract between the vein and skin, which in most patients, is pretty unlikely.

There are no valves in veins above the SVC.

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