nursebuxom

yes you can. I have one, but it didn't happen in a day. Having good placement skill is only passing kindergarten. just a note, someone stated that they had over 200,00 iv starts to their credit. do the math. don't believe everything you read.

please tell me this is a joke.

Dawn, if you're at KU MED, you have the grand master of all IV/PICC knowledge right there at your fingertips. tap in! take a flashlight, or an otoscope, and shine the light directly on the skin. look very closely, and you'll see the veins in the glowing rim. with this method, you only get a tiny section of the vein, but you'll begin to see them with practise. I do better with feeling my way, sometimes I use the sterile cath cover to "dent" the skin and mark where I want to insert. venoscopes have a very limited use if your skills are good, but every now and then, it can give the clinician an edge on the very difficult patients. For IV team situations, the Landry Vein light is better. It costs more ($450), but it has an adaptor that will allow it to be used efficiently on pediatric patients, whereas the venoscope makes a separate unit for pedis, together totalling > $450.

good question. My husband is a nurse with fewer years of experience, and he makes more than I do because he works in a critical care position. IV and PICC are not considered "critical care". I don't care. I've done critical care and ER and PACU and MedSurg and just about everything else. I'll take less money, this, I love.

This week I had a discussion with the ID about this issue. The rules for vanc have changed it seems. They used to do a peak and trough to ensure that the level was not toxic, now the goal is to keep the level up. We draw ours one hour before hang time, and do not hang until lab results are back and if out of range, reported with orders given. Peak is drawn 30 minutes to one hour after completion of infusion. The infusion time varies with the dose ordered, but we have been told to make sure the iv will hold for the dose because if it takes too long to hang, the therapeutic benefit will be lost. We've also been told that if the site is lost during infusion (and another not immediately available), notify the pharmacy or the MD for orders on the remaining amount. Apparently, after a while, there is no point in running the remainder of the dose. Did that make sense?

I've used NS and buffered lido for starts, more importantly, I've had starts on my own veins both ways. The NS doesn't sting like the lido and it does numb the insertion site very well. I've also used NS wheals on either side of a roly poly vein to hold it in place with good results.

hell there. that's one word.

Here are my tricks - get the hips up up up! Put an upside down bedpan or a couple of pillows under the hips, just like going to the gyn, and let those butt cheeks hang down. Hold the girl open with one hand, wipe front to back and look for the wink. Put a sterile q-tip in the lady parts to mark it If you still don't see it, put your longest finger into the lady parts while holding the catheter tipalong the front wall of the lady parts, it will probably find the meatus all by itself And if you can't get it in, go up in cather size, not down, and 18 is less flexible than a 16 and will go in easier - promise!

poor patient! That doctor needs some education about portacaths for sure. Every 7 days is plenty with a sterile dressing and a biopatch.

my current facility p&p is back prime. each antibiotic does not requre its own tubing. we change tubing q 72h. secondary tubing has the same - q72h. I have worked in a facility with a 96 hour policy, they told us based on research, I never saw the research.

with the new pneumonia guidlelines, the patient is to receive the first dose of antibiotic within 4 hours of arrival. There are other such guidelines floating arount out there now too, so it would seem that you are between a rock and a hard place. I would have removed the excess from the premix bag and given the correct dose, assuming that the volume was not going to be a problem.