Phlebitis and a stupid idea

[ohbet]

Ive always read that venipuncture to the foot has a high rate of phlebitis,and recently , at the LTC facility where I work, phlebitis occured to someone with an IV to her foot.

Wouldnt it be a good idea to require an MD order for a foot venipuncture? Our facility doesnt require it,does yours? Is this a stupid idea?

[baseline]

Yes....a doctors order would be a great idea for a foot IV and is anywhere I have worked.

[Rena RN 2003, RN]

gotta have a dr. order to do a foot IV at our facility

[ohbet]

Wow,two replies with MD orders for foot IV,I didnt know that.Sometimes I think my facility is stuck in the medievel period

[finallyRN]

Our hospital also requires MD order for IV in the foot. When we still had our IV team they were the only one allowed to place them as well.

[cactus wren]

Yuppers, we also have to have a Md.`s order for one in the foot, and also for blood draws there, also.

[emily_mom]

Same here...gotta have a doc.

[BBFRN, BSN, PhD]

We have to have an order in our hospital, too, and a Doc or IV nurse has to place it.

[mario_ragucci]

I'd be aggrivted if someone put an IV in my foot because it would restrict my movements more than a central line (?)

[caroladybelle, BSN, RN]

Mario,

As a general rule, IV/blood draws are done in the feet when there is absolutely no place on the arms where access can be obtained and central line access is contraindicated (hx: PEs, repeated central lines w/clots or extravisation).

I have always obtained an MD order prior to drawing blood/IV start in places other than arms.

As a note, I have had at least 3 patients that had IVs in their chests/breasts due to lack of viable sites and hx of clots/phlebitis in all extremities. Scary!!!!!!

[CMERN]

Gotta have a doc order were I work... too

[BadBird, BSN, RN]

I have always worked where a doctors order was needed for IV or blood draws in the foot. Usually if they are that difficult we pester the docs for a central line.