sbivrn

Hi! i am new to the forum and excited to see a forum for IV therapy nurses. I am taking the CRNI exam next week and would like some words of wisdom from those who are veretans! I have been studying for about 3 months but still feel overwhelmed! I wo...

CRNI stands for Certified Registered Nurse Infusion. To become a CRNI you must currently work in one of the nine core areas of infusion nursing, and pass the certification exam. Not all CRNI's place PICC lines. This is a national certification by the...

Interesting. I place the patient completely supine, except in cases where the patient cannot tolerate it. When making the turn at the shoulder I have the patient turn their head toward me and angle the chin down to the shoulder. This almost always wo...

Sure, but it's taken us to some neat places :)

Perhaps I have been unclear. I do not do over the wire exchange for clotted PICCs. The result would be no different than that to which I am objecting. Our two options are to use Activase to declot the picc or to pull it. Never to stick a wire into it...

Over the wire exchange of a PICC line is a totally different issue. The validity and safety of the procedure is well documented. We accomplish this quite safely at the bedside. This is also done in Radiology. You cannot compare declogging a g-tube wi...

The first couple of years post nursing school can be overwhelming. They just cannot teach you everything you need to know. so you will get quite a lot of on the job training. As bad as it seems on new grads, it's much better these days. I started out...

Just saw your question. You can certainly make a career out of vascular access nursing. It is much more than running here and there starting IVs. I am not aware of any specialty IV teams that will hire a new grad, however. Most will want a few years ...

Lots of luck to you. Love to hear about anyone making new strides in vascualr access for their institutions. You're doing a good thing!

I don't believe you'll find any articles on blood draws from midlines. I am not aware of any. We do not do blood draws. Maybe I was unclear. We check for a blood return upon insertion. Then flush really well with NS.

Yes we do use blood return as an indicator of satisfactory placement. We do not xray midlines. We typically use (on the adult patient) 4 french single lumen catheters for midlines, cut to have the tip locate in the axillae. We will flush afterwards w...

I agree with Diana. Where did the clot go if not into the patient's vascular system? This is not an INS standard of practice. This should not be let go. Many people cover a lack of knowledge with bravado! :)

I am very proud of the IV team of which I am a part. We are a part of Gaston Memorial Hospital in Gastonia, NC. There are 9 of us and 7 of us are CRNI's. We cover the hospital 24/7. We place 150-180 PICC per month. We place several hundred difficult ...

That's interesting. Do you place midlines in the same manner as PICC lines? We use the modified seldinger technique for both and don't have anymore problems with bleeding from one to the other. It usually depends on the bleeding times and whether or ...

Those are hard ones, no doubt. You are dealing with poor skin tugor, probable dehydration, and poor venous status. Just make sure you are not using a catheter that is too big. A 22 gauge catheter is plenty big for most infusions. Forget what they tol...

Wow- I've never heard of trying that. Do you mind telling which brand of picc needle is giving you the trouble threading the wire?

As an IV team member and used to nurses too afraid to give it a try, I must agree most with Mandolyn's advise. Practice, practice, practice. Request a day in Endoscopy. You'll start more IV's in one day there than you'll ever start on the floor! :)

Hypodermoclysis is a slow infusion of fluids into the subcutaneous tissue. Usually used to treat dehydration in the elderly. It is a good alternative for those little old folks who don't have accessible veins. You can infuse 3 liters of fluids throug...

We use the Bard purple power piccs exclusivley now and they are used routinely for power injections. Arrow is also coming out with a power picc very soon that we will be trialing. He's only being rambunctious if he is not using piccs designed for thi...

Your CRNI is right. We have 2-3 ampules of regular,sterile, non-bacteriostatic NS in our picc kits for use during insertions. If we need more we pull out a couple of 10cc bottles pop the tops and clean them with alcohol prior to opening our kits and ...

1. I work nights so I place piccs alone 2. we have 24 hour coverage 3. we are in process of writing policy to read our own cxr confirmations 4. We do have IRs availalbe on day shift, but only to place those we could not.