wanted to revisit this topic becasue---As a team we have reduced central line days and CLABSI but are beginning to notice a need for something else in some of our patients.
The standareds say we can only infuse nonvesicant nonirritant drugs (those with a pH greater than 5 or less than 9 and an osmolality lessthan 600). Yet we do this in peripheral veins for 3-4 days each time we start a peripheral cannula in smaller vessels of the forearms and hands. These sites are for shorter duration and assessment is easier for the staff nurse. I also realize that often these sites don't make it to more than 48 hours without complication. We are often awaiting culutres that will determine length of treatment parenterally versus PO and sometimes are blessed with a patient or two with pretty good peripheral access. What about the patient in this scenario that has poor to no access or the patient in the ED that needs a CT angio of the chest to rule out a PE? Would we or could we be looking at a patient that might benefit from a 3-4 inch length of catheter placed above antecubital for a 3-5 day length of stay to infuse irritant drugs? If the need is to be prolonged then action could be taken to place a PICC or other device as needed. We expect peripheral veins of the forearms to hold up to these therapies. Just looking for some discussion on this topic.... include the patient that is needing just 24-48h more of IVAB and has lost his last good IV site in your thinking.