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Discussion

What do you start IVs with in your OB unit?

I work L&D on the Jersey shore & we get a lot of grand multips... we use either 18G or 20G angios for our IVs... it's like practically sticking fork prongs in people, but it's our policy! :crying2: Just out of curiosity, what do you guys use?

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    I just had a repeat C in September. Policy in the hospital was 18g. The nurse that started my IV did a little numbing with lido and she put it in my right forearm. I am a TOTAL BABY about IVs, but this was a piece of cake! Thank the dear lord for lidocaine!

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    When I had my little one, the MD required a 18g-hospital required at least a 20g. Hurt like $^%^&$, and it took 4 sticks to get it (I have GREAT veins). Carried bruises around for 4 weeks, but if something had happened I'd been glad it was in.

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    18g angio cather. If it is a large patient we will use a 20g. We prefer 18g just incase a patient needs to receive blood for any reason.

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    We use 18g for all laboring moms just in case they have to go for a stat c-section or need to receive blood.

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    We don't require IV's or heplocks on every patient but when they do need an IV, it's an 18G.

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    • Guides
    I work L&D on the Jersey shore & we get a lot of grand multips... we use either 18G or 20G angios for our IVs... it's like practically sticking fork prongs in people, but it's our policy! :crying2: Just out of curiosity, what do you guys use?

    The OB hospital where I did my training at it was their policy for everyone to get at least one 18g in the forearm. You increase/decrease the flow rate by the radius to 4th power for every change in IV gauge.

    OB is a high risk practice and you never really now when a patient will go for an unscheduled C-section, have an undiagnosed placenta acreta, or some other complication. A patient isn't going to be able to tell the difference between a 20g or 18g in the forearm if it is done right. 22g/24g IVs are totally worthless on adult patients in my opinion, and should only be used as a last resort. I have stuck 16g and 14g in patients forearms and they didn't know any difference. It is more about technique and finding the right vein than anything else.

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    Gotta have a big line...surgery risk and all...they have lots of fluid on board with HUGE veins so it is an easy start.

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    We too require 18g on all our laboring pt's just in case they should have to go to surgery or need blood. But with a hard stick we will sometimes use a 20g. No extention set-surgery says they cannot bolus through them?? We do just fine. We are always short on infusion pumps so we use dial-a-flows on everyone.

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    Our policy says all laboring pts require 18g IV's. That is unless you are a VBAC. Then you are required to have a 16g IV. :dzed:

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    Holy lord! I'm now thinking twice about a VBAC with my next one......at the very least I'll be sure to ask the unit I'm delivering on what guage they plan on starting on me! :p

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    • Expert

    At the very least a 20, but an 18 is ideal. Well, ideal for the docs. Not for the patients, I'm sure. :)

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    If you ever need to push blood products in under pressure, you'll be very glad for that 18ga. I believe that is standard for OB. We only put in a 20 ga if it's impossible to put in a larger one.

    When I worked at the big city medical center where we did VBACs all the time, we were OK using an 18. I've only put in 16 ga when someone came in bleeding really badly with a previa or something like that.

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