IV site changes

If it was a difficult insertion and the site is showing no sign of infection etc then we do consider leaving it longer.

Otherwise it 72 Hours

Where I work, it is supposed to be changed at 72 hours. However, a doc may write an order to leave it longer if it is still working and the patient is a difficult stick to begin with.

72 hours is the standard of care. Anything over 72 hours and the risk s of Phlebitis and thrombophlebitis go up. Just for information a MD can write an order to extend a PIV but, it does not take the responsibility away from the nurses if a complication occurs after the 72 hour standard of care. I know that this sounds paranoid but I teach IV Therapy classes and people do get sued for this. If I were to leave in for longer thatn 72 hours it would be only on a patient that is expectant and is a very difficult insertion. But, I would still be responsible for that decision.

Randy Ross R.N., B.S.N

IV Nurse Consultant, President & CEO

IV's Etc... LLC

Vascular Access

& Consulting

http://www.ivsetc.com (http://www.ivsetc.com)

[email protected]

Where I am currently working we dont ever change IV sites unless it goes bad- course we are PICU. About the rest of the hospital I am not sure.

rj:)

Can someone tell me a sure and accurate way to assess for Phlebitis and thrombophlebitis?? I am still in school and when I ask nurses on my clinical floor, it seems their answers differ. It is just so hard to tell if the person's skin is already "loose" or whatnot from their age, weight, condition etc. I monitor if there is pain at the site or redness, but how do I really know what I should be looking for? I am always worried that I may not pick it up and I am running IV's through and putting danger to me patient. Please any input would be extremely appreciated...

Can someone tell me a sure and accurate way to assess for Phlebitis and thrombophlebitis?? I am still in school and when I ask nurses on my clinical floor, it seems their answers differ. It is just so hard to tell if the person's skin is already "loose" or whatnot from their age, weight, condition etc. I monitor if there is pain at the site or redness, but how do I really know what I should be looking for? I am always worried that I may not pick it up and I am running IV's through and putting danger to me patient. Please any input would be extremely appreciated...

ButrflyGurl,

Do not feel bad, most nurses miss the difference between the two. With Phlebitis you will see a red streak along the vein. There is often pain associated with this streak. With Thrombophlebitis there will also be red a red streak and pain but also warmth and the track will feel very hard and tender. If you ever see Thrombophlebitis for the first time you will never forget it. I have seen many cases of both but, distinquishing the two can be difficult at first signs. This is just a small explanation and does not cover much. You can look up the terms on the net and see pictures. It is hard sometimes to distinquish the signs from the beginning of infiltration and extravastion. You are already up on many nurses keep up the good work.

Randy

Thanks Randy,

I will do some research on the web too, just nice to hear from real life experiences once in a while!

Phelebitis is inflamation of the vein, thrombophelebitis is when a thrombi or clot has formed in the inflamed vein :)

I always touch my iv sites, I've found phlebitis by touch, because it isn't always red.

We change our IV sites q96h. The policy was changed several years ago based on current literature and research. I wasn't on that committee so I can't pass on the literature they used. Also, I'm not sure if they are tracking incidences of IV proplems since them.

Our facility has a q96h protocol, also based on current literature and studies. The nearby facility still has the q72h protocol.

Have the q72h protocol.