jbtulsarn

I didn't mean to offend you about the "combat pay", I have many friends and coworkers in Iraq right now, and my first husband was active military and I only knew about "combat pay" from my previous experience as a "dependant". You are so right about the sacrifices of the military and their families, and 225 is certainly nothing to brag about. Shameful in fact. My only point was that if you have more certifications/skills, you should be compensated for them. jb

We use the big ChlorPrep for our PICCs, would love to have the small ones for our IV starts but our manager said they are too expensive, 43 cents each...jb

Almost all of us are PICC certified, we staff 24/7, we do not get any differential in pay, but I don't think our critical care areas get any special pay incentive either. In fact, we don't get time and a half for working holidays, which I think is wrong. Even the military get "combat pay" and I think we should get incentive to work in higher stress areas doing more complex/risky procedures. We use ultrasound to place about half of our PICCS, and rarely have to send someone to radiology to have one placed because we can't get the PICC in.

OK, the ONLY thing alcohol does is remove oils from the skin, it is a poor antiseptic, we use alcohol then betadine to prep our sites, and it is mostly the friction that does the work. Also, if you put the tegaderm or sorbaview or whatever your occlusive dressing is over the insertion site first, then chevron the tape from under the catheter hub and then bring the tape up parallel on each side of the catheter (not across it as this can cause irritation to the site from the pressure) on top of the occlusive dressing, and PLEASE put on an extension, DON'T insert the tubing/needleless adaptor directly to the hub of the intracath since this causes movement of the catheter which will lead to pain, leaking at the site, dislodging of the catheter. Nothing makes me madder then to see IV sites with poor dressing and securing technique and the patient has be be restuck because the weight of the tubing has pulled out the catheter. This extra time at the beginning will save time later and spare the patient another stick. jb

It is not recommended that patients with Femoral lines be up walking around, as far as bending at the hip, this is uncomfortable for the patient. Femoral lines are high risk for infection, as patient advocates we should "suggest" other access such as PICC lines and get the Femoral line out ASAP. jb