sickle cell pt..

[timdmb]

hey evryone so i treated a sickle cell pt last night... this pt had no vein anywhere in the world... everything was sclerosed and scarred... pt had a long history of iv drug use... the er couldnt even get a line in so they put a hep lock in the internal jugular... question is can i use this line to draw labs from?... reason i ask is i was told by the outgoing nurse to just draw his labs through that line.. i tried but there was no blood return... and i couldnt fund a vein anywhere... how would u deal with this type of pt... i ended up endorsing to the next shift and forwarned them that it would be most likely that theyll need to find a resident to do a femoral draw or put in a line... i hate endorsing my labs to the next shift... do u think this is ok?

[timdmb]

so it came down to a resident doing a femoral stick, just a little update... pt ended up being dc very quickly, as was expected pt show up to various hospitals says hes in crisis... tough thing to turn away obviously, thanks for the posts and i asked about the lower extremity sticks and its in our policy and procedure the only one to stick on the lower extremity is our residents or attendings... "drunk driver vein was completely sclerosed its amazing... usually i just ask the pt if theyre users where i can go... this pt however told me up front i wont find anything... and actually asked me to go to his neck..... riiiiiight... anyways im just babbling on thanks for all the responses...