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IVRUS

IVRUS

Clinical Infusion Specialist
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  1. IVRUS

    IV iron infiltrated

    If you are speaking to IV Venofer, it has a high pH and can be very irritating to the tissues. Ideally, this is not a medication I would want to infuse into a short term, less than 3 inch IV catheter. But in a world where ideals aren't always seen in practice, MONITOR, MONITOR... and have a policy in place before you infusion it, so you know how to handle it if it goes into the tissue.
  2. IVRUS

    Blood transfusion and IV cannula.

    AU, you are correct. Most 20 gauge 1 inch IV catheters have flow rates of 60 to 65 mls A MINUTE. 60 ml x 60 minutes is 3600 mls/ hr. Milliliters per hour will vary of course, depending on gauge of the IV catheter.
  3. IVRUS

    Normal saline bag.

    I don't understand why in the world you are doing this. If you are giving a drug and you want it diluted in a diluent, and you have a 250 bag, why draw out 50?? Use the 250ml bag. Each manipulation you do increases the chance of bacterial contamination. There are NO preservatives in these bags. I'd stop this process immediately.
  4. IVRUS

    Drawing labs from CVCs

    Research into this topic has "not established the length of time for stopping fluid flow" according to Infusion Nurses Society (INS). One study suggested a wait time of 10 minutes before drawing your blood sample (when drawing from a CVAD). When drawing from a short term, less than 3 inch IV catheter, stop your infusion for at least 2 minutes prior to the lab draw. Then, waste 1 to 2 mls.
  5. IVRUS

    Would you hang these IVs?

    If the patient has a pH of 7.50, he/she is already Alkalotic. The Lactate Ion converts in the Liver to Bicarbonate. If this person has already tipped the 1:20 ratio of Acid vs Base, giving Lactated Ringers just exacerbates the problem.
  6. IVRUS

    Quick Head to toe?

    I love to see what others have found useful, as it greatly helps my students too.. can you sent it to ptec1@hotmail.com?
  7. IVRUS

    PICC line list for patients

    I understand that in many Hospital settings, a CHG daily bath is part of the central line protocol. But, outside of the hospital walls, I don't know one institution, or home care agency that has that as a policy. Also, many Infectious Disease Doc's DO NOT want you doing lab draws from any central line due to increase infection risks. That being said, patients must know that there will be a sterile dressing placed on top of the IV catheter and that dressing must remain, C/D/I. Also, they need to alert you if the line gets tugged on, and they never should push it back in. Showers for every patient requires you as the nurse to adequately protect the line each and every time. Alcohol caps for the end of the needleless connector are single dose items. Because PICC's are one type of Central line, all types of medications can infuse through them. Let me know if you have questions.
  8. IVRUS

    Question about priming tubing

    A secondary medication, when attached to a primary tubing, may hang for 96 hrs if backprimed and NOT disconnected. The secondary medication which is dis-connected from the primary, is to be changed q 24. All the manipulation of connecting and dis-connecting introduces bacteria, and therefore, that tubing should be changed q 24. If the tubing remain connected and one is merely backpriming and changing the small minbag, then changing q 96 becomes best practice.
  9. IVRUS

    heparin drips and lab draws

    Infusion Nurses Society standards state that an infusion, should be STOPPED prior to drawing labs for at least TWO minutes. Many IV pumps, when put on hold, will beep after two minutes, so that might help. Also, it isn't best practice to draw coag studies from a lumen that has had Heparin drip, or locking solution in it. A peripheral VP is best. One study showed that if you must draw from said lumen, a 25 cc of waste should be obtained, for accurate results.
  10. IVRUS

    IV pump basics

    Yes, The secondary must hang higher, and remember that a secondary set is for use with a primary that has a pressure sensitive back check valve. Secondary sets don't hang by themselves, and they should remain attached, (as long as compatibility is acceptable) to give it the 96 hr dwell time. As Muno said, backpriming is the best route. If you disconnect the secondary set from the primary, then you should change that tubing q 24.
  11. IVRUS

    IV therapy/infusion clinic

    I disagree Annie. My love has been IV nursing for 28 years, or since 1990. In 1999, Life happened, and I went back to Hospital nursing for 4 years, and then came back to IV therapy. IV therapy is a specialty and one that has been my bread and butter, and I love it. Now, Working in an Infusion Clinic is a bit different than going around placing PICC's or Midlines and Declotting IV catheters, or Educating on IV therapy. Everyone eventually finds their niche in nursing, so it all depends on what brings you pleasure, as I see my role NOT as a Job that I have to go to every day, but as an opportunity to provide the best care with IVT possible.
  12. IVRUS

    Picc line accidentally pulled out 5 cm.

    This is ONLY acceptable in the few hours or a day after placement. Doing an exchange is not an acceptable practice once the catheter has been dwelling for some time.
  13. IVRUS

    Picc line accidentally pulled out 5 cm.

    Yes.. As Wuzzie said, THIS IS A NO-NO!! Once sterile field is broken, one can NEVER push a catheter back in.
  14. IVRUS

    New to OR- Barnes vs Mercy in St Louis

    Having worked at both hospitals, I prefer Barnes. Yes, it is huge, but it has so many experienced and knowledgeable team players, of which, you will be one should you make that choice.
  15. IVRUS

    PICC Nurse in 2 months?

    PICC placement is ohhh, soooo much more than a task to be performed. Yes, it may be scary, but as ILUVIVT wrote, it takes a while before you are truly comfortable with the process. And since Ultrasound is the only way these lines should be placed, it may take 6 months or more, depending on volume of pts, before you feel you have a grasp on placing them. That is okay. Ask many questions, and work with your preceptor and one day, you'll look back and wonder what you were so fearful about.
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