Dumb Question?

Specialties MICU

Published

Ok, I have a dumb question I think, for all of you....

Why can't IVP meds be given down an Art Line?

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Specializes in IMC, ICU, Telemetry.

Think of where the blood is traveling... what's "downstream" from the A-line insertion site? If you gave an IVP in the A-line, the med would be traveling distally into the hand's capillary bed. Intravenous meds are pushed in veins so they travel into systemic circulation, further diluted in large volume of blood and then distributed throughout the body. You don't want that phenergan dose concentrated in the hand - you want it going the other way to get where it needs to be so your pt won't puke.

HTH.

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So, you're saying it stays localized in the hand, and never makes it systemically? Would it cause necrosis of tissue then?

This came up in our unit with a new grad making this mistake recently, and I never thought about it before. I feel stupid asking about it now, since I have worked in units for years, without giving it thought before.

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Specializes in IMC, ICU, Telemetry.

I suppose some, maybe even all the med, could end up in systemic circulation after circulating from the radial artery>hand's cap bed>venous circulation, but it would be taking the long way around and could be VERY dangerous... necrosis, thrombus..

Point is, IV meds go into veins, not arteries. A lines should only be used for monitoring BP & for blood draws (ABG's).

A tough lesson for this new grad. I hope there was no harm to the pt.

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I don't think there was any harm. I heard about it after the fact though. Thanks for the explanation, helped me think it through more.

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Specializes in CCU/CVU/ICU.

This came up in our unit with a new grad making this mistake recently,.

OUch. HOw the heck did she do that? Disconnect the a-line, or? Seems it'd be a bloody mess and a little tricky compared to just pushing through an iv-port?

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OUch. HOw the heck did she do that? Disconnect the a-line, or? Seems it'd be a bloody mess and a little tricky compared to just pushing through an iv-port?

Ever hard flush an A-line or IABP? Ever push thru a CVP line? Same way, just connect at the stopcock.

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Specializes in CCU/CVU/ICU.
Ever hard flush an A-line or IABP? Ever push thru a CVP line? Same way, just connect at the stopcock.

yes i suppose... It's just that we dont typically have 3-way ports/stop-cocks on a-lines(why would it be set up that way?...).

I'm sure the nurse was sweating bullets... no harm done...good lesson learned...

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Specializes in ICU.

yes i suppose... It's just that we dont typically have 3-way ports/stop-cocks on a-lines(why would it be set up that way?...).

Our a-line kits have a 3-way attatched to them right out of the package, most likely for blood draws if a vamp is not available (like when they come back from cath lab or OR, where they don't typically furnish vamps).

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Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.
Our a-line kits have a 3-way attatched to them right out of the package, most likely for blood draws if a vamp is not available (like when they come back from cath lab or OR, where they don't typically furnish vamps).

Same here

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Specializes in Cardiac.
Our a-line kits have a 3-way attatched to them right out of the package, most likely for blood draws if a vamp is not available (like when they come back from cath lab or OR, where they don't typically furnish vamps).

So do ours.

I saw a nurse take a flush out of the a-line port and then use it for a IV flush. While not technically wrong, it still made me cringe a little. I can see someone getting confused in the process.

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Specializes in gen icu/ neuro icu/ trauma icu/hdu.

WHa tabout the implications of arterial embolis in the radial /femoral artery (or more probable downstream in the capillarys)??

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