Painful IV starts and your hospital policy

[daisey_may]

Hi,

I am currently starting a project for my BSN that will hopefully be able to made policy at the hospital I work at.

At the hospital where I work, there is no policy about offering any pain alleviation prior to an IV start. Many of the hospitals in my area already have a policy in place. It seems that lidocaine prior to starting an IV is used in some areas of the hospital and not in other places.

Does your hospital have a policy? What do you use for pain relief and what are your feelings about using and offering it? Do you consider it a standard of care to offer pain relief prior to an IV start?

This project is in it's early, early stages of research and from discussing it to other co-workers, I've had mixed feelings about implementing a policy and I'm curious how other nurses feel about it, too.

Thanks,

Daphne

[meownsmile, BSN, RN]

I dont think ive ever had a patient complain about a hurtful IV stick. We do however have access to EMLA creme if we need to by order only. It isnt policy that we have to use something to numb the site. I think sometimes the pain level is partially the skill of the person doing the sticking.

[Jo Dirt]

yes I have heard of that before, have you had novacaine before (you know like at the dentist) just curious.

lidocaine does burn.

It makes my heart race, too.

[firstaiddave908]

I wish i had numbing cream when i had to go to the er in o5 because the nurses stuck me nine tiimes. but after the 8th stick a nurse came in and stuck me and got it on the ninth try. That was not fun at all by any means. I think hosptials should have a policy where if needed the nurses can numb up a IV site so it wont hurt for the patient.

[leslie :-D]

we use lido id.

and even if lido burns, id injections are not that invasive.

i never tell my pts to look away.

they seem to fare better when i suggest they watch me.

i tend to think the anticipation of not watching, is more anxiety provoking than watching, and being in control.

leslie

[nursemike, ASN, RN]

At our facility, peds get EMLA, but no set policy for adults. I suppose it would be available by Dr.'s order--embarassed to admit, I never thought of. It's pretty expensive, though.

I've done a blood draw on a ten-year-old and started an IV site on a 14 yr old, both without EMLA. Both were boys and said it would be okay. Most of our kids (in the epilepsy unit) are no-sticks, and usually if they need an IV, EMLA is used and the peds nurses will do it for us. God bless them! Still, the two kids I stuck were easier than most adults, and both said it only hurt a little. (If it were me, I think I'd rather just get it over with than wait around on the EMLA.)

[wooh, BSN, RN]

(If it were me, I think I'd rather just get it over with than wait around on the EMLA.)

Some of the kids start FREAKING OUT when you put the emla on because they know it means they're getting stuck. And it seems their freaking out lasts exactly the amount of time it takes for the emla to kick in and you to come in to do the stick, minus 3 minutes for them to fall asleep. Then you wake them up, and the freaking out resumes. When kids are in for a few days, I've had parents request that we not use the cream because of that. I wish we could get the cold spray back for those times when the cream isn't really the most appropriate choice. Need to ask about that when I'm next at work.

[danh3190]

On the ambulance where I work we're not allowed to use lidocaine or anything else. I've only occasionally had a patient complain or seem in any distress. Of course nobody likes being stuck, but it's not usually very traumatic, similar to getting blood drawn.

When we were learning to start them we practiced on each other. I'd received 13 sticks, actually more like mining expeditions, in the couple weeks we were learning. I didn't find it that big a deal, except for all the black and blue marks.