IV Gauge for CT

[EDrunnerRN]

In the ER today I had a 20 y/o "chest pain." Of course the pt received the full cardiac workup as well as a CT of the chest. Prior to taking my pt to CT the MD asked me what size IV I put in the patient and I replied 20 G. In my opinion, I felt this size IV was sufficient. However, the MD, who is newly off residency, snapped back and said I want an 18 G in this patient. I proceded to question why and he said that he could (not sure why he said he bc it is the radiologist who does this) could read the scan better. I had my doubts but let the fight rest because for one I had no time for this and two I knew it would get me no where, fast. He put in an order for the 20 G to be DC'd and an 18 G LAC placed. I spoke to a few seasoned nurses as well as rad tech's who have never heard that the size 20 or 18 G made a difference on the scan. Anyone knowledgeable in this area??

[Hagabel]

Pardon me, but...

I think you're only reading a part of the discussion. I wasn't talking about whether or not to place the IV without having a MD's written order in an emergency, as just about all ED's having medically sanctioned standing policies (ie. an institutionally prepared set of anticipatory medical orders to be used by nurses in cases of emergencies).

What the argument revolved around was, that after the MD's exam, when the doctor specifically directed an IV to be removed, then THAT is in and of itself, a medical judgement, AND thus constituted a medical order that must then be followed by nurses. Again, standing orders used in hospital policies are only to facilitate medical convenience, and do not rise to the legal level that it allows nurses to overrule or supercede a primary doctor's medical judgement. This is because regular nurses, as a matter of legality, do not ever have medical judgment as they are not medical doctors. I suggest that if any nurse has doubt, check with their institution risk management and ask specifically, when a doctor orders an IV removed, and in the nurses judgment the IV should stay; who is in the legal right.

Geez......sigh.......