Reply please

So he would have been upset with my buddy the RN-EMT who wouldn.t have thought twice about a 20 ga?

I don't think you were remotely out of line. A 22 was a completely appropriate choice.

We use mostly 24 gauge PIVs on pts up to 3-4 years old. On a fat 2y/o, You should be able to place a 22 or 20(AC), however threading them can be a problem. The shorter length usually works out better. In peds, we always use the smallest one that will get the job done!:)

Thanks for the replies. I really appreciate it.

Sarah

ha! We put in whatever we think will work. Sometimes 22G works better because the cannula is less flexible. You're the nurse, you're the one to guage it. If 22 doesn't work, you could always try 24G. remember a dehydrated kid is always going to be harder to start than any other kid

2 questions

Why did he need an IV? Scarlet fever is caused by Strep, give Him PCN and send him home.

also I guess the Doc wouldn't like the 20g I put in infants either. Never let a doctor rake you over the coals for something like that. Give him the cathter and tell him to do it himself if he is so perfect:roll

Thanks for your replies....I really appreciate the support and friendship from all nurses.

Many thanks!

Sarah

i work in an er dept.

we had a ped pt. who was 2 yrs. of age. he came to us from another facility with no iv access and was being sent in for fever / ? allergic reaction.

anyway, o/a to our er the pt. looks red from the top of his head down to his pelvis area, febrile, irritable, htn, tachy, .... our pediatrician walks in and says in his european accent "...stupid, stupid, stupid, that isn't hives that is scarlet fever, get an iv in him". he is vocalizing his displeasure about the dr. who sent the child to us.

this little guy wasn't little for a 2 yr. old. a nurse attempted a 22 insyte to his mc and had good flow but was unable to thread. i attempted a 22 insyte to mc and had great flow as well but was unable to thread cannula. the pediatrician, raked me over the coals :uhoh21: for using a 22 and said, no child should have a 22, use a 24 only. what is your opinions? the first nurse said i have been nursing for 30 yrs. and that pt. could use a 22. myself, i atempted the 22 insyte because the site looked really well and the 24 insytes are so short.

constructive opinions please....

thanks,

sarah

i don't see what his problem was with a 22.....i've started 22's on kids younger than that. i've also started 24's on kids older than that; it all depends on the vein and how big the kid is. on chubby/bigger kids i go with a larger one usually (such as a 22 v. 24) because 24's are shorter and there's a greater chance of infiltration with them.

he shouldn't have griped at you for using a 22, but it's my guess (and i'm not defending his rude behavior) that he was p*ssed at the transferring facility for sending a child in such a condition without an iv and took it out on you......

Never let a doctor rake you over the coals for something like that. Give him the cathter and tell him to do it himself if he is so perfect:roll

:yeahthat: