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?Routine central line placed in patients to receive vesicant chemo

Any oncology nurses out there or reps from large cancer institutes or hospitals?

Are any of your hospital routinely having central lines placed in patients who are to

receive vesicant chemo?

  Our hospital requires that vesicant chemo be administered by an I.V. therapy RN,

who must start a "clean stick" I.V. in a forearm vein, personally infuse or inject the

med, while frequently checking blood return, pt sensation, and condition of the site--

and document same.

  Our recent problem has occurred due to short-staffing and poor timing.   Patients are

being admitted later in the day and not being ready for their vesicant chemo admin until

mid-evening.   I.V therapy was not notified early and we were staffed with floats who

were not certified to admin. vesicant chem.   A committee was formed....of course, the

physicians wanted more I.V. nurses hired & trained, which the hospital refuses to do.

We suggested the patients be admitted and be ready earlier in the day when more I.V.

nurses are on...or that physicians place central lines(or order PICCs)for patients who are

to receive vesicants..  then the nurses on the  unit can administer the meds.

 The docs don't want to insert central lines for "staff convenience".  

  It might help in our discussion with them if a lot of hospitals are using central lines routinely

for vesicant chemo.   Any info is appreciated.


IV Support /Educator


Eugene, OR

Use of a CVC will reduce but
Use of a CVC will reduce but not eliminate the risk of extravasation injury from injection of vesicant chemotherapy. While I think a CVC is safer for the patient, it does not alter the level of monitoring that is required during infusion. So if the IV nurses are doing it now, they should still continue to do it if a CVC is present. In my opinion, the idea for CVCs would not change the responsibility of the IV nurses. Staff nurses do not have the drug knowledge or infusion technique skill and knowledge. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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