what is the consensus regarding IV size and placement? go big within reason, 18g in the AC, or small and distal 20g below the AC?
what is the flow difference between these two? time for a liter to flow through a 16, vs. 18 vs. a 20? i know some CT contrast can't go into a 20 (head CT? do to the slower speed?)
during a recent ACLS class the instructor noted the increased speed and accuracy of dropping (drilling) in an IO vs. an IV and alluded to trauma situations going to the IO route over IV. how long can an IO remain in place? and what gauge are they? big i assume.
I usually go for the 18, 20g if they are elderly with fragile veins, but had to do a 24g the other night on an elderly woman. Anything smaller than a 20g and I don't even try to draw labs when I start it. 9 times out of 10 it will be hemolyzed anyway, so I worry about the IV and fluids, and the lab comes and does their draw.
Just the other day the blood bank said they could run blood through a 22 or 24, but since it has to be so slow, they'll split the unit. My other hospital always said no way, 20g was the absolute smallest, and even then they would split it. Of course trauma pts always got two 16's, or an EJ if we couldn't get anything.
Weird how blood banks differ. I even worry about hemolysis with a 20. Those cells are easily damaged.
RedSox33RN
1,483 Posts
I usually go for the 18, 20g if they are elderly with fragile veins, but had to do a 24g the other night on an elderly woman. Anything smaller than a 20g and I don't even try to draw labs when I start it. 9 times out of 10 it will be hemolyzed anyway, so I worry about the IV and fluids, and the lab comes and does their draw.
Just the other day the blood bank said they could run blood through a 22 or 24, but since it has to be so slow, they'll split the unit. My other hospital always said no way, 20g was the absolute smallest, and even then they would split it. Of course trauma pts always got two 16's, or an EJ if we couldn't get anything.
Weird how blood banks differ. I even worry about hemolysis with a 20. Those cells are easily damaged.