does any nurse do EJ's in the ER

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I am looking for any nurse that do EJ's in the ER. I am trying to see what kind of policy if any that any one might have

Specializes in Emergency, Cath Lab.

We do them in our ED as well. We observe 1 (or more if you would like), than are observed doing 3 and signed off by another RN. They can be a life saver (literally) with a patient who is a difficult stick. Lol, just make sure there's no pulse and then poke! ;-)

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Specializes in ED staff.

Never done an EJ though some I work with say we can. Have no idea what the policy is. I've started thousands of IV's some in weird places... a boob for example, shoulder, feet, ankles, fingers.

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Specializes in Emergency Dept, M/S.

Like LilgirlRN, I've started IV's in many places besides arms, but we're not permitted by our state to start EJ's, though the paramedic students are permitted. It's really a skill I would like to have, and have been present for the insertion of more than I can count. It does seem silly not to let RN's be checked off on the skill.

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Specializes in ED/ICU.

Hi CWhite,

an EJ is an external jugular point of access to start an IV, usually used on a pt who has nothing else in the way of veins and usually in an emergency situation. Another option is an IO, which is an intraosseus stick. This goes directly into the bone (sounds gross) the paramedics used to have an older version of this but now there is a "new and improved" version which apparently does not hurt very much (in the training video the doc does it on himself).

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Hi CWhite,

an EJ is an external jugular point of access to start an IV, usually used on a pt who has nothing else in the way of veins and usually in an emergency situation. Another option is an IO, which is an intraosseus stick. This goes directly into the bone (sounds gross) the paramedics used to have an older version of this but now there is a "new and improved" version which apparently does not hurt very much (in the training video the doc does it on himself).

Through the military I've been taught to do EJ's, Femorals, & IO's-using the FAST IO (is this the "new & improved" version you're referring to?) It is quite easy to use & the only discomfort felt by the volunteers was when the NS flush was pushed. Type in FAST IO into You Tube search to see how this differs from the Tibia IO paramedics do.

Not sure what the EJ policy is here in this state (I'll have to ask a friend). I've just gotten used to separating what I can do in the military from what I can do in the civilian sector, until I'm told/taught it's within my scope.

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Specializes in ED/ICU.

To CGMedic..Yes I am referring to the rapid IO. The old ones were brutal. We started using some lido with the initial infusion if the pt is awake and that seems to help. I worked with BUDS medics in ICU in the San Diego Naval Hospital. I was shocked initially at how much responsibility they gave you guys. It was against state laws, but of course it was a federal facility. I developed a great respect for the medics I worked with (who would take a full assignment in a very high acuity ICU just like myself). I have kept in touch with a few over the years, the are both FNPs now.

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Specializes in ED/trauma.

we do IOs & ABGs regularly at my job. We also do sq route for fluids now. And if we get certified we can do PICCs routinely, but no EJs. I have also started ivs in all kinds of weird places, (& the boob is a great place-very vascular if they are large) don't tend to last too long though.

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Specializes in ED/ICU.

Wow I love trauma...saline in the boob...if it did last long could be quite lucrative:)

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Specializes in ED/trauma.

yeah, but then you'd have to do it in the other one...dont wanna be lopsided ya know!

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

I did a boob IV back when I was a tech ... got in trouble for that one! My NM said, "You can only put IVs in extremities!" She about fell over laughing when I mumbled, "It was big enough to be an extremity ..."

That patient came back recently, and we reminisced over the boob IV. :) Luckily that patient has a port in her chest now! :D Still a boob IV, in a way. LOL

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Specializes in ED/ICU.

LOL...I know....my definition of a "pendulous breast" is one that a pt could carry her chart under. I have actually found a TV remote control under a pt's breast and also a doughnut...but I guess that's a whole'nother thread!

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Specializes in ER, telemetry.

Techs are allowed to start EJs in my ER, but not nurses. New protocol within the last year of so. Before that, nurses did it too.

Only techs are allowed to do IOs too.

Oh well....

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