Does anyone have experience with modification of an introducer needle for central line insertion--specifically arching the shaft of the introducer to create a curve prior to insertion? Is this just a one off that I have seen with a physician inserted catheter? Really interested to hear if anyone else has seen this or if it is commonly done. I have seen it with subclavian CVAD insertion.
Heard of it, seen it done by anesthesiologist for short PIVCs. BUT it is NEVER a good thing. The junction of where the internal end of the catheter joins the stylet is engineered with great care. The purposes are to ensure that the shoulder of the plastic catheter is a smooth transition so it will advance easily into the vein lumen. Also the design is to prevent the catheter from peeling back on itself as you make the venipuncture. This curvature of the stylet alters all of those good designs and makes for more problems. I have been doing infusion nursing for 49 years and have never seen any manufacturer include this in their instructions for use. Also this has never been included in any standards or guidelines. It is a horrible way to treat any PIVC and should NEVER be done. It sounds like you are talking about a plain introducer needle without any catheter. But this curvature could make it difficult to advance the guidewire through it, maybe diffcult to withdraw introducer from over the wire, definitely not recommended by any manufacturer or standards and should NEVER be done either. This is dangerous off label use. When it is done, and there is a serious problem that leads to a lawsuit, the liability will fall exclusively on the inserter and the manufactuer would not be named.
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
I have seen the doctor modifying/bending needle a little before putting it in my hand for IV treatment.
I would NEVER sit still for that, ever!
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
I usually don't comment here but this one is a big WOW! Just because the IFU (instructions for use) doesn't say you cannot do this DOES NOT mean you can! Altering the device is definitely OFF LABEL. As Lynn commented, great care goes into manufacturing medical devices. If in doubt, contact the manufacturer. All clinicians really need to be aware of the IFU for the device being used. Many don’t even know what IFU stands for…..