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IVRUS BSN, RN

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

IVRUS's Latest Activity

  1. IVRUS

    Tricky portocath

    IMPLANTED PORTS are sutured into a subcutaneous pocket. If these sutures broke, the port will travel under the skin and be hard to pin down. The MD should go in and fix this problem. Now lack of blood return could mean that the IV catheter has been severed from the ports body. This given the situation, would not be uncommon. Do not use this port. It must be surgically fixed. The lack of blood return also could be from fibrin buildup, so just how recently was it placed, and is the patient hypercoagulable?
  2. IVRUS

    Flo Valley Fall 2015

    I don't know who you are, or what the issue is, but if you read the first two posts, this person seemingly was frustrated because over several days without a response to her OP, she came back. So, it needed to be pointed out that in order to get the responses she/he desired, then specifics were needed. How is that problematic? Arrogance is not the issue here. It is however, problematic when one merely imparts information and he/she gets slammed for it.. "Indeed, no good deed goes unpunished."
  3. IVRUS

    Flo Valley Fall 2015

    Wow, burning bridges already and you're not even a Nursing student yet!! Smh
  4. IVRUS

    New to Infusion

    I'd start by joining your local chapter of Infusion Nurses Society (INS). Getting involved with IV therapy and having fellow nurses to network and assist you in your journey is important. Go to their website and find your local chapter. www.ins1.org
  5. IVRUS

    IV Vaso-Vagal HELP

    Please remember that Vasovagal reaction is manifested by VASOCONSTRICTION. Your entire peripheral system shunts blood to the vital organs, as you are likely to faint. When vessels constrict, short of time and warm compresses, US will help greatly getting to those deeper vessels for cannulation.
  6. IVRUS

    Removing the PICC line where there is a DVT?

    As long as you have a PICC that ONLY has involvement with a Thrombus, then research shows that it is important to savage it and lyse the clot with a 4-6 hr infusion. But, if it is thrombosed and infected, it must be removed.
  7. IVRUS

    Dual Lumen Midlines and Drug Compatibility

    Mikey, We know that you don't have the blood flow in your arms versus the central vascular system. Therefore, IMO, it is NOT wise to give two incompatible medications at the same time into an IV catheter which does NOT have the needed blood flow to dissipate the medications. Studies regarding this aren't available to my knowledge, so I would just say NO.
  8. IVRUS

    Flagyl compatibility with D51/2NS

    It can be confusing, but Gahart's guide to IV medications state that Flagyl is compatible with NS, D5W and LR.
  9. 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.
  10. 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.
  11. IVRUS

    Normal saline bag.

    So, Are you a pharmacist and are doing these preparations for nursing staff under a Laminar Flow Hood in a Compounding Room? I am sorry, but I was under the impression that you were a nurse doing this on the floor, or at bedside.
  12. 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.
  13. IVRUS

    IV Fluids Infiltrated w/o pain?

    Most of the time, pain isn't felt with IV fluids as long as the IVF is isotonic, or near isotonic. Pain is often associated with extravasations.. or when a Vesicant or an Irritant medication comes into the tissues. Also, depending on your patient's age, they have a reduced sensitivity with age.
  14. 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.
  15. 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.
  16. I don't know why you need a research article if a complications is known to have a direct correlation to the cause. I guess that someone figured this out a long, long time ago, but how would having their research change your practice? If you know that Alopecia can be the result of someone who constantly pulls their hair out, do you need an article to verify this?
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