Vascular Access

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IVRUS has 32 years experience as a BSN, RN and specializes in Vascular Access.

IVRUS's Latest Activity

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  1. IVRUS

    PICC: aspirate blood before every infusion?

    YES, YES, AND YES! Each time, Every time! Now, once you assess and have patency with NSS, then you don't need to assess it again if you are heparinizing the line after your saline flush, but a brisk, free-flowing blood return the color and consisten...
  2. IVRUS

    port accessing tips.

    Heparin Flush will prevent fibrin build-up. Keeping a line open with Saline only is doable, but one should be flushing at greater intervals if that is what you are using. In hospital settings, they usually use Saline only as they are manipulating an...
  3. IVRUS

    Heparin Flush

    Infusion Nurses Society (INS) reviews in its standards, that Heparin Flush, if it is to be used on Non-Valved IV catheters should be the lowest concentration available. In hospitals, most IV catheters are being used sooo frequently, that Heparin flu...
  4. IVRUS

    ER registered nurse

    I would contact BARD. They often provide PICC "certification" classes.
  5. IVRUS

    PICC: aspirate blood before every infusion?

    A curos cap is a good idea, but if it is not your policy to use them, then scrub, scrub , scrub that needleless connector each and every time before you enter it.
  6. This is a total NO-NO. Shaving causes microabrasions and possible staph infections. If you must, clip the hair.
  7. IVRUS

    PICC: aspirate blood before every infusion?

    So, let's say that you are giving an IVAB. Med is due at 0600. At 0555, you do all your checks on the IV catheter/drsg, you check the saline syringe, and you do a good, vigorous scrub of the needleless connector. You hook up your saline syringe, flus...
  8. IVRUS

    sterile technique question for implanted port accessing

    That is why you are PALPATING initially with non-sterile gloves on, so that you only have to stabilize the port's body with one hand, while accessing it with the other hand. Yes, with sterile gloves on, you technically can touch the port, but I'd on...
  9. IVRUS

    Help! Struggling with IV placement in hand

    Well, Your process doesn't appear problematic, but how is your tourniquet placement? If you are placing the line on a geriatric pt, you may very well have difficulty being successful if you tourniquet is too tight. Elderly patients require loose to...
  10. IVRUS

    TPN infusing when to change PICC drsg?

    Any issues/complications, real or imagined, must come under the PRN dressing change tab. If you think you are seeing redness under at the site, that is a time when you MUST perform a sterile dressing change to assess and identify the next step in pa...
  11. IVRUS

    PICC dressing change with 3M Tegaderm with CHG

    https://multimedia.3m.com/mws/media/993615O/picc-cvc-chg-device-application-guide.pdf Maybe their website instructions can help
  12. IVRUS

    Best practice for locking a central line with heparin.

    Kristine, What is the concentration that you are using to "lock" the PICC line? Standards, and many Policies have you locking catheters with the lowest concentration, namely 10 units/mL. With this concentration, there is no need to withdraw th...
  13. IVRUS

    How do I get IV experience?

    I would try to find a Post Acute / LTC facility which takes complex patients. We have a couple in my area that take vents/trachs, and they do tons of IV therapy. Given that you are such a new RN, I seriously would discourage you from trying to bran...
  14. IVRUS

    port accessing tips.

    Were you actually ACCESSING an implanted port, or truly de-ACCESSING? Upon accessing, some ports are easier to access if the patient is sitting up; this is especially true if the pt is a large chested female.
  15. First of all Karen, this conclusion, imo, is nonsensical. Yes, having a central line in increases the chance of large vessel thrombosis, but the benefit of having it is so much better than the inherent risk. Bloodstream infections can occur with a...