lidocaine for IV starts?

[NativeTexan]

We are curious if any of you out there use lidocaine to start IV's in the ER? We don't, but often have pt's show up that really get hacked when we don't do that for them. Any thoughts?

[TraumaNurseRN]

Having just spent 30 days in the hospital and probably having 25 iv starts, it's one thing to have 22 or 20 in the forearm. A 20 in the back of the hand is a differrent story, and a few minutes drawing up and giving the lido was much appreciated. The savings in time due to the ease with which the line went in made up for the time spent on the lido.

wow that many IV starts....

[NotReady4PrimeTime, RN]

wow that many IV starts....

I had 14 attempts in the same night back in 1981. The first IV, put in by my GP, was a 20, and the anesthetist who was going to do my epidural didn't like it, said it wasn't big enough if he had to push fluids, so he took it out. THEN he started trying to place another one. After 12 failed attempts on both forearms and ACs (with 16!!) he gave in and put an 18 in the back of my left hand. He said he had wanted to leave my hands free because I was planning to breastfeed after my C-section. And then he missed the epidural.

[emmycRN]

I recently started a new job in a department where using lido is the policy. I can tell you that it makes a big difference because my patients always tell me it was the best IV stick they've ever had. I think it actually make the stick easier becuase if you have to "look" for the vein with the needle the patient doesn't feel a thing.

[Iam46yearsold]

I agree, Lido is the best and easiest way.

[swsh10]

I think its a case -to- case basis; if it's an emergency, or if a pt is in a lot of pain or distress, I don't gather they'd care one way or another. In our pre-op area, I usually give the pt a choice, and warn them beforehand that if they were a difficult start and I used lido, I may not see their veins anymore. (I'm good at just doing it one time) . I think the method in IV starting is more important - for instance I take time in finding the vein most appropriate for the procedure; if I do not see or feel a vein, I look for a second opinion / I do jot dig for the vein (which some nurses I observed do, therein I think lies the reason for pain). Some of my pts like lido, some don't. This is an interesting thread, particularly the info on ID NS and lido buffered with bicarb - learned something new. I've had a few pts come in with emla cream already applied on the sites they think the IV is going onto. We used to have the ethyl chloride spray (which worked wonders), but our hosp phased it out because one of the surgeons claimed it was causing thermal burns on some of his pts (any thoughts on that?).

[swsh10]

And oh, I've also had a few pts with mediports who request lido ID over the mediport site before I access their sites (they have it done at the Dr's offices). Any comments on this as well?