Are any of you aware of any studies conducted with regards to U/S Guided IV insertions and increase DVTs or infiltrations.
Do any of you use U/S in order to place IVs? Have you noticed a trend in increased complications with ultrasound vs other methods? Any response would be greatly appreciated.
I did notice increased rates of infiltration when I started PIVs with U/S. I would have brisk blood return and PIV flushed easily without swelling then bedside nurses calling within a couple of hours due to the PIV infiltrating. I came to the assumption that it was probably due to my PIV catheter being just inside the vein and thus with patient mobility it was sliding out of the vein easier. I have found 22g ONC that are 1 3/4in long, since starting to use these this problem has disappeared.
Hope this helps,
Rose
Rose Galyan RN, BSN, CRNI
Speciality Practice Nurse
Vascular Access Team
Indiana University Hospital Bloomington
[email protected]
Robbin George RN VA-BC
BBraun, The reference number is 4252520-02.
Hope this helps.
Rose
Rose Galyan RN, BSN, CRNI
Speciality Practice Nurse
Vascular Access Team
Indiana University Hospital Bloomington
[email protected]
I have always thought part of the problem with increased phlebitis and/or infiltrations following US insertion of PIV is related to the technique required. Skin traction to anchor the vein is one of the most important methods to cause the catheter to advance smoothly into the straight vein and avoid contact with the vein wall. One hand to hold the probe and one hand to hold the catheter does not allow one hand to hold skin traction. What clever ideas have you used to overcome this issue? Using 2 people, or others? I know we are talking about veins that are deeper in subcutaneous tissue, but these are still not deep veins in the same sense as anatomical descriptions. When I say a deep vein, I am referring to those that are located under the muscle. So my understanding from this discussion is that you are using superficial veins that are deeper in subcutaneous tissue due to obesity or other problems. Please correct me if you are actually using deep veins under the muscle. Thanks, Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
You are correct. I am referring to the veins deeper in the subcutaneous tissue, not those under the muscle. I am right handed. I held the ultrasound probe in my left hand and traction distal to the site with the flattened pinky of my right hand (easier to show that to describe) while accessing using the more angled technique that I described in my last note. This approach requires that the probe be moved a bit proximal to the intended insertion site so that the image shows up where you expect the needle to enter the vein. With this technique it seemed to enter the vein at an angle similar to starting the piv without ultrasound assistance. This worked best for me, however it still seems logical that using a vein deeper in the subcutaneous tissue holds more potential for complications than the more superficial ones that are generally used not requiring ultrasound assistance.
Monica