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IVRUS 18,829 Views

Joined: Dec 16, '04; Posts: 1,099 (42% Liked) ; Likes: 1,070

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  • Jul 5

    Quote from morte
    actually, i was under the impression you shouldn't use a prefilled NS syringe....that if you put it down someone may confuse it with plain NS.....an unmarked 10 ml syringe would be the better choice, drawing up saline then med.....if the dilaudid is in prefilled syringes instead of vials there is a problem. there is no way i would do it you instructors way unless there was no other way to do it.....

    Why would you put it down???
    Once you draw up the medication.. GIVE IT.
    And whose to say that a 10cc syringe filled with NSS and dilaudid won't be confused for just saline as well... Therefore, DO NOT lay the syringe down.. You drew it up, now give it. If for some weird reason you must lay it down.. Label the syringe so there is NO confusion!

  • Jun 12

    I disagree... If I could live in any state, I would quickly move back to Texas. Low cost of living, short winters, and beautiful weather over all.

  • May 23

    Quote from Daisy4RN
    Immediately stop all "gun free zones", you are just making those places sitting ducks.
    Use school funds for metal detectors instead of putting it in admin pockets or other wasteful expenditures, prioritize the funds.
    Better ID of bullies with appropriate punishment/intervention of bully only (no punishment for the one who was bullied)
    Check facts and have a plan prior to protests (merely protesting stopping school shootings will not stop school shootings)
    I believe in upholding the 2nd amendment while at the same time having appropriate gun (owning) controls, we need to be able to have an adult conversation about where this ends up without screaming at each other.
    Know and understand the facts, do your own research instead of just listening to news people or politicians, they are bias
    Get back to teaching our kids how to deal with life, the ups/downs etc, stop with the everyone gets a ribbon mentality, kids don't learn that way, guns have been around a long long time and this has not happened until (relatively) recently, its not the guns, its the people/society that has changed
    And, most importantly we need to hold those who commit crimes accountable, stop with the stupid defenses, no excuses, you commit crimes, you pay. And don't blame parents unless there is very clear cut evidence that they were somehow also actively involved, this will not stop any shooter (anyone who could commit such a heinous crime will not care that their parents will be sent to jail etc)


    I am so sorry to those who have been personally hurt by these crimes and hope we, as a country, can come together to try to stop these evil people.
    Thank-you OLD DUDE for opening this very important discussion!
    THANK YOU, THANK YOU... Love this, and you are so right on!

  • May 23

    Quote from Daisy4RN
    Immediately stop all "gun free zones", you are just making those places sitting ducks.
    Use school funds for metal detectors instead of putting it in admin pockets or other wasteful expenditures, prioritize the funds.
    Better ID of bullies with appropriate punishment/intervention of bully only (no punishment for the one who was bullied)
    Check facts and have a plan prior to protests (merely protesting stopping school shootings will not stop school shootings)
    I believe in upholding the 2nd amendment while at the same time having appropriate gun (owning) controls, we need to be able to have an adult conversation about where this ends up without screaming at each other.
    Know and understand the facts, do your own research instead of just listening to news people or politicians, they are bias
    Get back to teaching our kids how to deal with life, the ups/downs etc, stop with the everyone gets a ribbon mentality, kids don't learn that way, guns have been around a long long time and this has not happened until (relatively) recently, its not the guns, its the people/society that has changed
    And, most importantly we need to hold those who commit crimes accountable, stop with the stupid defenses, no excuses, you commit crimes, you pay. And don't blame parents unless there is very clear cut evidence that they were somehow also actively involved, this will not stop any shooter (anyone who could commit such a heinous crime will not care that their parents will be sent to jail etc)


    I am so sorry to those who have been personally hurt by these crimes and hope we, as a country, can come together to try to stop these evil people.
    Thank-you OLD DUDE for opening this very important discussion!
    THANK YOU, THANK YOU... Love this, and you are so right on!

  • May 14

    There are PICC instructional companies like BARD, who will provide the class, and U.S. is the standard of care, meaning if PICC's are to be placed, it should be using Ultrasound. Most people find the most problematic part of the journey to be the precepting. It takes numerous insertions before one is even comfortable with the process, and many more before competency is achieved.
    Or, you could find a local Vascular Access company and sign on with them, and they usually will train you.

  • May 11

    One should NEVER reinfuse a drawn waste which has been disconnected from the IV catheter. That puts the patient at too much risk. IMO, Nurses drawing from lines should use the MIXING method: Attach a 10 cc NS syringe and flush the line; Leaving empty the syringe attached, pull back 5 cc of blood, reinfuse, pull back another 5 cc, reinfuse, do this 4-5 times, with the 5th time being your specimen. This mixing method greatly reduces the chances of iatrogenic anemia, and one doesn't have to worry about the blood clotting.

  • May 8

    Quote from TriciaJ
    I don't wear gloves for injections, either. Applying counter-pressure to the injection site with the alcohol swab before removing the needle seals it up fairly well. I think gloves are over-used and often used as substitutes for handwashing, which they shouldn't be.
    Tricia,
    One IS USUALLY exposed to bodily secretions when performing a SQ or IM injections, and gloves should be worn. In addition, alcohol promotes bleeding and it burns, so I wouldn't use it to "seal" the site s/p injection.

  • Apr 25

    Quote from Ironprostate
    you metioned that small catherter is more preferred for irritating medication. But when it comes to ChemoTheraphy, does it go same? As far as Im concerened, The first route of CTx is central line like Chemoport or Hickman Cath. or C-line. But sometime, CTx medication was injected via peripehral line. And at that time, facility regulations are that never given the CTx via peripehral line smaller than 22G. hmm.. I was told that bigger size cathterter prevent vein from chance of extravasation. So what rational is beneath this?. thank you for your kindness.
    As Wuzzie said appropriately, it is all about blood flow. You always want to choose the smallest IV catheter to do the job, all-the-while allowing for adequate blood flow around said IV catheter. Ideally, I do not like my IV catheters to take up more than 33% of the vein, but sometimes I don't get what I want!! Bigger IV catheters cause more damage to the smooth inner lining of the blood vessel, the Tunica Intima. This damage starts the process of phlebitis and thrombosis. But, another factor one must also consider is the pH of the medication or solution and the Osmolarity. INS standards state that the pH should NOT be extreme and the Osmolarity should NOT be greater than 900, or one does too much damage to the vein, if it is via short peripheral IV catheter. Now if any one of the four Central IV catheters is in place, than any osmolarity or pH works as the blood flow in the central vein (SVC) is approx 10 times greater than that that is in the arms.

  • Apr 25

    Quote from Ironprostate
    you metioned that small catherter is more preferred for irritating medication. But when it comes to ChemoTheraphy, does it go same? As far as Im concerened, The first route of CTx is central line like Chemoport or Hickman Cath. or C-line. But sometime, CTx medication was injected via peripehral line. And at that time, facility regulations are that never given the CTx via peripehral line smaller than 22G. hmm.. I was told that bigger size cathterter prevent vein from chance of extravasation. So what rational is beneath this?. thank you for your kindness.
    As Wuzzie said appropriately, it is all about blood flow. You always want to choose the smallest IV catheter to do the job, all-the-while allowing for adequate blood flow around said IV catheter. Ideally, I do not like my IV catheters to take up more than 33% of the vein, but sometimes I don't get what I want!! Bigger IV catheters cause more damage to the smooth inner lining of the blood vessel, the Tunica Intima. This damage starts the process of phlebitis and thrombosis. But, another factor one must also consider is the pH of the medication or solution and the Osmolarity. INS standards state that the pH should NOT be extreme and the Osmolarity should NOT be greater than 900, or one does too much damage to the vein, if it is via short peripheral IV catheter. Now if any one of the four Central IV catheters is in place, than any osmolarity or pH works as the blood flow in the central vein (SVC) is approx 10 times greater than that that is in the arms.

  • Apr 25

    Quote from Ironprostate
    you metioned that small catherter is more preferred for irritating medication. But when it comes to ChemoTheraphy, does it go same? As far as Im concerened, The first route of CTx is central line like Chemoport or Hickman Cath. or C-line. But sometime, CTx medication was injected via peripehral line. And at that time, facility regulations are that never given the CTx via peripehral line smaller than 22G. hmm.. I was told that bigger size cathterter prevent vein from chance of extravasation. So what rational is beneath this?. thank you for your kindness.
    As Wuzzie said appropriately, it is all about blood flow. You always want to choose the smallest IV catheter to do the job, all-the-while allowing for adequate blood flow around said IV catheter. Ideally, I do not like my IV catheters to take up more than 33% of the vein, but sometimes I don't get what I want!! Bigger IV catheters cause more damage to the smooth inner lining of the blood vessel, the Tunica Intima. This damage starts the process of phlebitis and thrombosis. But, another factor one must also consider is the pH of the medication or solution and the Osmolarity. INS standards state that the pH should NOT be extreme and the Osmolarity should NOT be greater than 900, or one does too much damage to the vein, if it is via short peripheral IV catheter. Now if any one of the four Central IV catheters is in place, than any osmolarity or pH works as the blood flow in the central vein (SVC) is approx 10 times greater than that that is in the arms.

  • Apr 25

    Quote from Ironprostate
    you metioned that small catherter is more preferred for irritating medication. But when it comes to ChemoTheraphy, does it go same? As far as Im concerened, The first route of CTx is central line like Chemoport or Hickman Cath. or C-line. But sometime, CTx medication was injected via peripehral line. And at that time, facility regulations are that never given the CTx via peripehral line smaller than 22G. hmm.. I was told that bigger size cathterter prevent vein from chance of extravasation. So what rational is beneath this?. thank you for your kindness.
    As Wuzzie said appropriately, it is all about blood flow. You always want to choose the smallest IV catheter to do the job, all-the-while allowing for adequate blood flow around said IV catheter. Ideally, I do not like my IV catheters to take up more than 33% of the vein, but sometimes I don't get what I want!! Bigger IV catheters cause more damage to the smooth inner lining of the blood vessel, the Tunica Intima. This damage starts the process of phlebitis and thrombosis. But, another factor one must also consider is the pH of the medication or solution and the Osmolarity. INS standards state that the pH should NOT be extreme and the Osmolarity should NOT be greater than 900, or one does too much damage to the vein, if it is via short peripheral IV catheter. Now if any one of the four Central IV catheters is in place, than any osmolarity or pH works as the blood flow in the central vein (SVC) is approx 10 times greater than that that is in the arms.

  • Apr 17

    The concept of a "virgin line" or not being able to give the drug the way you discussed is only applicable if the reason you are needing to switch sites is because of infection. If the first line became infected, yes everything is pitched, and a new set up should be established.

  • Apr 17

    Ivana, Usually the reason patients have two IV catheters in at once is either to administer incompatible meds or to use the other one if the first one fails. I would definitely move the medication to the patent line.

  • Apr 16

    Yes, but when a pharmacy tech draws up the medication, he/she will attach the empty vial to the syringe so that the pharmacist who does the final checking can sign off that it truly was the drug ordered. So that there is another check in the system.

  • Apr 16

    Yes, but when a pharmacy tech draws up the medication, he/she will attach the empty vial to the syringe so that the pharmacist who does the final checking can sign off that it truly was the drug ordered. So that there is another check in the system.


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