7 Posts
Hi IVRUS, that's what I've always said and what I've always followed but the physician/surgeon completely disagrees and says it's useable. Since there are no other nurses, I alone must advocate for me and the pt. I just wanted to make sure I'm justified in "digging in my heels" with this issue or if there was some other protocols if flow studies have shown correct placement (and how long those flow studies are good for). Thanks for the input!
1,049 Posts
Hey Blu... What you've "always" thought is completely correct!!! Dig in your heels, and cite that this IS Infusion Nurses Society (INS) standards and if you were called into a court of law, your license would be questioned, not the MD.
Flow studies are good to make sure the line is open, but if it is, why aren't you obtaining a brisk blood return? I would hook on a 5 or 3 cc syringe as both of these exert less aspiration pressure with withdraw and slowly, pull back after you ensure patency of flushing with your 10cc syringe. ALso do a direct connect (minus the needleless connector)
And, what happened when Cathflo was instilled?
7 Posts
Thanks for the tip! When I instilled the Cathflo the first time and waited the appropriate amount of time, blood return was still absent. When I went to instill it the second time per the protocol, the pt became very nervous and refused. We have been through this so many times, I'm afraid that without heparin or infusions of some sort, it has perhaps clotted or has a sheath formation (which is what the flow study showed previously but the radiologist was able to get blood return at the time).
IVRUS, BSN, RN
1,049 Posts
Standards of practice say that a clinician MUST obtain a blood return, which is the color and consistency of whole blood from every IV catheter or you have a NON-functioning IV catheter and it should NOT be used to administer any medication until the problem is resolved.