Qs: needles, 'real' world

Karen · Aug 10, 2010

You can use a tb syringe with a filter needle (unless the type you have come with needle already attached) I would use a filter needle just in case. A 3ml syringe has 1/2 ml markings so that is accurate as well.

It would be best not to use the arm with the picc so if other sites were available use those. If I had to pick between a picc line and an injured arm I would pick the picc arm but there are many sq and im sites it is best to go to an area away from lines or injuries.

I only turn off the iv pump when I have to flush due to incompatibility or if there is a potent med in the line that you need to disconnect the iv at the lowest point. You actually have more control over flow when you are timing the injection with the iv fluids running. Depending on the rate and location of the port you could inject the med in the line and when you turn the pump back on it flows in at that rate. For example if I turn off the normal saline running at 100ml per hour, inject the digoxin over 5 minutes (but is only 0.5ml of fluid), when I turn the IV fluids back on the entire dose of digoxin is in the tubing and it immediately flows into the patient

glovedgoddess · Aug 11, 2010

Yes the TB syringes that we have, have needles already attached and are NOT removable. So these nurses do not use filter needles at all for these types of injections

Asystole RN · Aug 11, 2010

qs from day shift:
1) in the 'real' nursing world is it a common thing that nurses draw up sc shots of morphine (for example) in a tb-heparin syringe out of an ampoule? i used a 3ml syringe with filter needle and than attached a 25g (5/8'') needle to the syringe. i was only giving 0.5ml (5mg) of morphine -> ampoule supple is 10mg/ml. the rn told me that she normally uses a tb syringe, it's more precise for a sml amount and the needle is smaller. she said some nurses even use insulin syringes! okay so...is a filter needle not always necessary (are we not that worried about glass getting into the small syringes)? and would any of you recommend using tb and insulin syringes for sml amounts of med for sc injection?
never seen mso4 come in an ampoule but the meds i do give from ampoules i alwaays use a filter needle. if i do not have anything smaller than a 3ml syringe i will use it. you can get pretty precise with a 3ml syringe, at least in the 0.05ml range. if you have a multi dose vialof something then i would recommend the tb syringe for sq injections.
2) also if giving an sc or im, can you give injections into an arm with a picc? i guess it would be better to choose the arm that is free of ivs, but lets make this interesting and say that the pt has a picc in the right arm, a cast on the left arm and lower abd dressings (). so would you use the thigh or the upper back (for sc)? or just go ahead and use the arm with the picc?
if there were no other accessible areas for a suitable sq or im injection then use the arm. i would use the thigh first or better yet, try to get the route changed to iv.
3) in 'real' world are there any nurses that actually stop the iv pump when giving an iv push med? or even clamp/kink the line when administering it? i believe the rationale for stopping it is to be in complete control of how fast the med is being push thru the line. if the line is running with an existing solution than that will affect the time the med is administered. but it seems to me that every nurse i have asked has said no they do not stop or kink line and just let it run (of course if its compatible) and push it through. that seems like less of a hassle because than theres no forgetting to turn pump back on and such. if so many nurses do this, than it must not be a harm...right?
thank you lovely ppl! :)

copied from my post from the thread qs! bubbles, ivs etc

https://allnurses.com/nursing-student-assistance/qs-bubbles-ivs-495290.html#post4454576

"an infusion does not necessarily mean pump with safety lock and one way valve.

there are dial-a-flows that require gravity pressure and simple straight drips, monitoring flow by counting drips.

most tubing has a loop in it, where the excess tubing hangs off the bed before meeting the patient, heavier solutes in the medication tend to settle in these loops and again, a constant infusion is a very poor "flush". for example, watch how blood cells settle in the loop when the tubing gets backflow into it. if you ever infuse or push something with color you will see how it will tend to settle in these loops.

depending upon the type of catheter, cvc or piv, the locations, patency, gauge and patient position will all effect which has the least pressure, the bag or the patient.

for example, hang a straight bag of saline without a one way valve (most hospital tubing does not have a one way valve) into a 22g in the hand with it dangling off to the side. push 10ml of saline into the unclamped tubing and watch the drip chamber...you will see that 10ml of saline just pushed upstream.

these basic principles do not take into account specific situations, they are rather general safe practice principles designed to be habits of safe practice."