NO, NO, NO. Read my blog post about use of veins on the chest wall. http://www.hadawayassociates.com. This would also apply to veins in any strange location like a PIV in the shoulder. There is a pathophysiological reason for these veins to be distended and prominent, and this reason will more likely than not lead to a serious complication. Lynn
I am going to disagree with the firm negatives the other posters stated with a caveat.
Odd locations for PIVCs should never be used unless there is no other immediate option and/or there is a clinical indication as to why this location is being used. I would say though that a PIVC used in an odd location should be changed out for something more appropriate ASAP.
The fact that this is occuring in the ED is why I am saying this, better to have a high risk PIVC then an awesome PICC in a dead guy.
The ED tends to be a uique world with unique challenges that differs from most any other unit in the hospital.
I would agree with you to an extent. I was an ER nurse the first 5 years of my nursing career and I would have said exactly that. However, a PIV in a dying patient is certainly something we don't stop to assess the best access. But once stable, we need to get that line out and a better line inserted. So for the first critical hours...yes....but once stable. Do better
If the ED patient is critical without IV access, would it not be better to place an I/O? They are easy and provide immediate access, and the patient has six sites to choose from.
Carole is correct. If you can not establish a stable PIV within a very few minutes in an unstable patient, the IO is the best alternative. This will give you 24 hours to assess the patient and make the most appropriate choice about the type of VAD they actually need. For patients that are stable and in need for some type of infusion therapy, areas of joint flexion are never a good site. Putting in a PIV that is virtually guaranteed to last a very limited amount of time is a waste of time and resources and painful for the patient. Your advanced VA team should be using visualization technology to find a much more stable location in the extermiety IF a PIV is the most appropriate choice or inserting some type of CVAD if that is warranted. Lynn
NO, NO, NO. Read my blog post about use of veins on the chest wall. http://www.hadawayassociates.com. This would also apply to veins in any strange location like a PIV in the shoulder. There is a pathophysiological reason for these veins to be distended and prominent, and this reason will more likely than not lead to a serious complication. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Let me double down on Lynn's comment...NO NO NO!!!
I am going to disagree with the firm negatives the other posters stated with a caveat.
Odd locations for PIVCs should never be used unless there is no other immediate option and/or there is a clinical indication as to why this location is being used. I would say though that a PIVC used in an odd location should be changed out for something more appropriate ASAP.
The fact that this is occuring in the ED is why I am saying this, better to have a high risk PIVC then an awesome PICC in a dead guy.
The ED tends to be a uique world with unique challenges that differs from most any other unit in the hospital.
Asystole RN, BSN, CRNI, VA-BC
Vascular Access Nurse, Infusion Nurse
Asystole,
I would agree with you to an extent. I was an ER nurse the first 5 years of my nursing career and I would have said exactly that. However, a PIV in a dying patient is certainly something we don't stop to assess the best access. But once stable, we need to get that line out and a better line inserted. So for the first critical hours...yes....but once stable. Do better
If the ED patient is critical without IV access, would it not be better to place an I/O? They are easy and provide immediate access, and the patient has six sites to choose from.
Carole
Carole is correct. If you can not establish a stable PIV within a very few minutes in an unstable patient, the IO is the best alternative. This will give you 24 hours to assess the patient and make the most appropriate choice about the type of VAD they actually need. For patients that are stable and in need for some type of infusion therapy, areas of joint flexion are never a good site. Putting in a PIV that is virtually guaranteed to last a very limited amount of time is a waste of time and resources and painful for the patient. Your advanced VA team should be using visualization technology to find a much more stable location in the extermiety IF a PIV is the most appropriate choice or inserting some type of CVAD if that is warranted. Lynn
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Agree with Lynn and Carol. IO should be used in an emergent situation.
Sheila Hale, MSN, RN, CRNI, VA-BC, Austin, TX