Our IV team has discovered PIV being placed in superficial veins of the chest. It seems we have a few ER nurses who are placing the IV's in veins that are visable in the upper chest and most recently on the lateral side of the chest below the axilla. I am very concerned with this practice as we find these IV's on the inpatient wards during our rounds. I am of the belief that in an emergency it would be preferred to place on EJ or central line. Does anyone have any litature that I could present to the staff that would state why this is not a safe practice.
Go to my website listed below. Click on Clinical Articles from the home page. Look for one titled Peripheral Catheters in Atypical Locations. This should provide some information for you. It was published in the Catheter Connection column of JAVA a few years ago. You are quite correct to be concerned.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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
In doing some research today, I found an article that addresses a 18 g catheter placed in the chest/shoulder area. Thought you might like to know this reference:
Detecting an infiltrated intravenous catheter using indigo carmine: a novel method.
Department of Anesthesiology, Duke University, Duke University Medical Center, Durham, North Carolina, US
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
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