netgeek

Hi There, I am starting to work some immunization clinics in a few weeks. I really dislike giving IM's as I fear I am going to tap the bone. I am wondering if you have any tips for giving an IM to people with tiny arms? We use a 1 inch needle for all ages/arm size. Thanks

ic.... As far as I know this patient didnt have a PFO, but in doing reading on them I just thought back about this incident and got scared that what if the patient had it and just didnt know it? if so the air would be harmful? The patient was in their 50's and as far as i know was relatively healthy. Thanks

anyone know anything about my above post about foramen ovales??? Thanks, I appreciate it :)

Hi, I was doing some reading in another thread about patent foramen ovales. And approx. 20% of adults have them. If air were to be injected into venous circulation on a pt with a foramen ovale couldnt it cross over into arterial circ? So now I am worried that the patient i talked about above, what if they had a patent foramen ovale? I am sure they didnt but if the pt did, if something were to happen wouldnt it happen almost immediatley? 8 hrs after and there was nothing, should i still worry? Sorry for the bother, but I got worried when I read about these foramen ovales. Thanks

One other thing. Someone in a previous post brought up something about Patent Foramen Ovale. This is something new to me, but I understand that its a hole in the heart connecting the left and ride sides. Most sources say approx. 20% of adults have this. If air is injected into the vein and then goes to the heart can the air then go through the Foramen Ovale into arterial circulation? Most sources are saying that small amounts of air (under 10cc's) isnt really going to cause much harm and judging all the posts it seems to be agreeable.... but now im worried that what if the patient i mentioned in the above post maybe by some chance had some sort of foramen ovale. If the air went into the artery it would be fairly evident right away right? I am sure that this is nothing... but I worry about these things. Thanks

I am a nursing student and I was shadowing an RN for my first day on our surgical unit. We needed to saline lock a pt's IV so they could go for shower. I asked the nurse if I could flush it and she said yes. She was the one who drew up the saline (approx. 2.5 ccs) , so I just assumed that she had ensured all the air was out of the syringe. So I went disconnected the IV Tubing and inserted the blunted syringe into the IV site in patients arm and as I was injecting the last little bit I noticed a small air bubble in the syringe (maybe 1/5th of a CC in size) and before I realize I had injected it. I got so scared! I immediatley told the nurse and she said not to worry about it. When I left shift 8hrs later the client was alright. Vitals were all stable, a little bit of tachypnea but this seemed to have started the day before and was slowly progessing. Should I worry?? Thanks

I wonder the same thing myself sometime, sometimes I forget about the A-Marker.

Thanks Daytonite!!

Daytonite.... you dont happen to have a link for that thread? I tried searching for it and could not find it. Thanks

Hi! I have a question regarding flushing IV's. Today was my second day of clinical on a surgical floor. I was assisting an RN with temporarily disconnecting an IV. She drew up 2.5 cc's of saline to flush it because she said you have to flush it when you disconnect it. I asked if I could flush it (first time) and she said yes. So we went into the room together and she handed me the syringe and she told me just to push the saline into the IV site, the only thing is that there was a pocket of air in the syringe (not too big) and I didnt realize it before it was too late. I told the nurse after we had left the room and she told me not to worry and that occasionally small amounts of air will get into the IV tubing, as long as its not too much it isnt a problem. The client was fine for the rest of the shift, he had some tachypnea near the end of the shift but this was something that started yestaurday. She just handed me the syringe, since she drew it up I assumed she got all the air out. I am king of worried. Is this going to be harmful for the client? I will ALWAYS double check to make sure from now on! Thanks

lol .... Thanks Daytonite

Ok... i cant believe i forgot the pinch the skin... it been awhile since I gave a subq and i was so nervous.. I gave the injection in the morning and for the rest of the shift the patient was fine, and I was on shift the next day and the patient was still fine. There was no bruising or abnormal skin at the site. I guess I was just worried that it may of punctured the muscle because I didnt pinch the skin... but the needle length was so small and I did do it on an angle... If it did hit the muscle, and adverse effects were to occur, something would of happened during my shift or the day after right? Thanks

Hi, I was asked to give a sub-q dose of Dalteparin to a pt. It was given once daily as a preventative measure. It was one of the very small prefilled syringes. The actual needle sharp was slightly small than that of a insulin sharp. It had been a little bit since I gave a subq injection, and I was a little nervous. When I went to give it (in the arm as per pt's request), i was nervous and forgot to pinch the skin(which I realized right after), and I also injected it at 45 degree angle because I was so used to giving insulin at that angle (I just looked up on the pfizer website and they said it can be given between 45-90 degrees). Do I have to worry about any adverse conditions developing? 24 hours later I checked the injection site and no apparent bruising/redness or discloration. Patient reports no pain. When I gave it again the day after, I made sure to pinch the skin, and I also injected at a 90 degree angle. But I am still somewhat worried about the day before. Thanks

Hi, I live in Canada and we dont EMT's or CNA's in the ER. Its mostly just the nurse. I am interested in becoming an ER nurse in the states. I have my bachelor of science in nursing. I was wondering what does the ER nurse do when there are techs and CNA's? Is the nurse on the bottom of the pack when it comes to the "hierarchy" of the ER? Thanks.

Hi I live in Canada and we dont EMT's or CNA's in the ER. Its mostly just the nurse. I am interested in becoming an ER nurse in the states. I have my bachelor of science in nursing. I was wondering what does the ER nurse do when there are techs and CNA's? Is the nurse on the bottom of the pack when it comes to the "hierarchy" of the ER? Thanks.