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Discussion

leaving in iv needle

Hi everyone,

I'm a nurse for around 6 years already. I started a new job as aclinic nurse. Now I ger to take blood tests and start iv's- things only the docs did at the hospital. Today an old man came in and needed an iv, I actually managed to get it in. The fluids were dripping slowly. I figured it must be because of the small iv size. After an hour and only half the bag of NS 500ml was finished. the doc said to take it out see if he could urinate better. When i took out the needle - i noticed that I left in the metal part!!!!!!!!!!!!!!!!!! What am i that stupid? I've practiced on family memebers and seen iv's done a million times,

The mans arm was swollen. I checked during the iv drip- there was no swelling . I figured that when he came back from the bathroom it went para. Did i anyhow injure him seriously?????!My neighbor is a paremedic he said that i maybe damaged a valve

Any help?

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    When i took out the needle - i noticed that I left in the metal part!!!!!!!!!!!!!!!!!!

    I'm trying to imagine how that is even possible. That would explain why the infusion was going so slowly, though.

    I figured that when he came back from the bathroom it went para.

    I don't understand this. What does "went para" mean?

    Did i anyhow injure him seriously?????!My neighbor is a paremedic he said that i maybe damaged a valve

    Any help?

    It sounds like the fluids infiltrated. If you left the needle in the catheter, then the catheter would be rigid and likely to poke through the vein wall, and you'd be infusing fluids into the tissues rather than the vein. Swelling isn't always obvious unless you're also checking the underside of the arm as well.

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    Not sure how you hooked up the fluids with the needle still in place. Either way, it sounds as though the fluid went into the tissue instead of the vein..

    Every IV cath I have used, the needle must be retracted and the cath left in place before you can hook anything up to it..Are you in the US??

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    Certainly not good practice theses days, but up until about 30 years ago that's how it was always done. Peripheral IV's consisted of a metal needle that was taped in place (no dressings or prn adapters either for the most part so they were messy and often moved around quite a bit).

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    • Expert

    OP....where are you? The IV needles in the US makes it virtually impossible to hook up fluids. It sounds like the IV infiltrated. MunoRN id right .....years ago in the US All our IV's were "butterfly" needles and yes they infiltrated. Even if you "hurt a valve" the veins will heal and the fluids will usually absorb.

    I wish you the best.

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    It is still possible to use a scalp vein needle for a short term infusion but much safer to use a standard catheter over the needle device, It is also possible on some devices to access the vein..thread the catheter with the needle in place,remove the flash plug and hook up the IV fluids...you can do this with an intima

    What happened in the above scenario is as the others have stated...you had inadvertent administration of IV fluids into the tissue, what happened was the needle punctured a hole in the vein allowing leakage of the IVF into the tissue.It most likey had nothing to with the valves which are semi lunar folds that kind of function like little doors. They can be damaged during venipucture and venipuncture should be avoided at the valve when you can palpate them. Y

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    It's not possible to leave the needle in and infuse with 'angiocaths' but it is possible with the Intima caths as Illuvit mentioned as well as Nexiva caths, you're flow would be limited due to the needle still being in the lumen but it would still work:

    view nexiva

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    • Author

    No in Israel .thankyou everyone for your advice.

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    • Author

    Thanks for posting. How do you palate a valve?

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    • Expert

    What is "palate a valve"????? Did you mean palpate the valve? You really can't......you did not harm to the patients veins. You "go through" the patients valves when you insert (cannulate) the vein. These valves are itty bitty inside the vein to keep the blood moving in the right direction...."Going through one" or "damaging" one is not a big deal they heal quickly and no "real" damage is done. Whenever you get a bruise you've damaged the vein....it heals and it gets better.

    Sometimes if a patient has a chronic illness or is a frequent IV drug abuser (using needles to inject illegal drugs) the veins from OVER USE become large and hard due to scarring of the vein from the constant injury from needle stick. Sometimes, again on a patient that has had many IV starts or the elderly, you will be able to see/feel that the vein is "firm" to the touch our is tortuous (snake like appearance) like veins on the hands of an elderly patient and "know" that will not be a good vein to start an IV.

    When you start an IV....calm down. Take a deep breath. Get all your supplies together. The more you repeat the steps the more they become second nature. I'll bet you will never to it again. Your paramedic friend is exaggerating a bit about the "damage to the valve"

    I wish you the best.

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    • Author

    Thankyou so much! I appreciate your input

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