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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

    Considering infusion nursing

    Feel free to PM me, and I'd be happy to speak with you on the phone...
  2. IVRUS

    Considering infusion nursing

    What is it about Med/Surg do you hate? If it's the fact that they have many different types of IV catheters and IV medications, then Infusion nursing is not for you. Infusion nursing is sooo much more than just being a "Good Stick" , it's about knowing where to stick, how to stick, and why you shouldn't stick. It's about knowing you IV catheters inside and out and why one deserves preferential treatment or placement over the others. It's about care and maintenance and having the knowledge base to see optimal patient outcomes given the situation that presents itself. Infusion Therapy is a specialty, and like other specialties, you should have a passion for it.
  3. IVRUS

    CLABSI - Multiple lumens vs Y sites

    WOW!, 6 lumens.. Is the patient that much of a sick puppy??? First of all, like you, I know that the more lumens means more manipulation, and an increase in CRBSI's. But, also remember that this is an ADD-ON device. According to INS, add on devices are a no-no, as this too causes an increase in infection. Filters, manual flow control devices (Dial-a-flows) or elongated tubing should be part of an integral set, and add on devices prohibited. Secondly, I too would be worried about compatibility issues. AND, last, but not least, the catheter you said that this patient has is known to HAVE THE HIGHEST INFECTION RATES OF ALL C-LINES. All of these things bring me to the need to evaluate the situation more closely...I am so glad that you are there to advocate for this patient.
  4. 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?
  5. 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."
  6. IVRUS

    Flo Valley Fall 2015

    Wow, burning bridges already and you're not even a Nursing student yet!! Smh
  7. 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
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. 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.
  13. IVRUS

    Did you get much training when you started infusion nursing?

    OM Gosh... "sticking" someone is a minuscule part of a Vascular Access Nurses responsibilities. I believe that you should have a good year or two on Med Surg and then have a proficiency with Vascular Access care and maintenance before you even consider this specialty. INS states that you should have 1600 hr of IV therapy responsibilities in the previous two years to sit for the CRNI exam. Feel free to PM me for further questions
  14. 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?
  15. 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.
  16. IVRUS

    Question about priming tubing

    Sarhat, That is an absolute crazy policy. So, are you saying that there is air in the administration set, and you are using a syringe to flush that, and whatever IVAB is left into the patient? The increased manipulation alone is scary!

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