We are seeing a come-back of ethyl chloride use for PIV's. I am looking for other centers who use ethyl chloride spray for analgesia. Most research papers show EMLA and LMX very effective along with the use of Buzzy. I cannot find any EBP in INS supporting the use of ethyl chloride vs the use of LMX or EMLA. Thanks in advance to those who reply.
INS Standards uses the phrase "including, but not limited to ---". So topical sprays were not intendionally omitted. I suspect there were no studies about using this product for putting in any type of VAD. Also, are these sprays labelled with venipuncture or catheter insertion? These sprays are not considered to be sterile and that is the reason many do not use them for catheter insertion. Lynn
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 see that you are asking about PIVs, but I can tell you that the effects when a nurse does not know how to use this properly can result in injury and removal of an implanted port device. I have a pic that shows 4 distinct circular skin lesions (full thickness skin injury) on the skin directly over pt's port. Everyone who saw it thought it was a chemo extravasation (he had received cisplatin the week before). Most extravasation injuries are diffuse and drift BELOW the port because of gravity. There was no erythema nor any signs below his port. PLUS I've never seen this kind of injury with cisplatin as we dilute it in alot of fluid. He was sent to the surgeon for removal. I bumped into his oncologist the next week and mentioned this. He denied they used ethyl chloride. I saw him about a month later and he said, You'll be happy to know we are no longer using ethyl chloride for our port access procedures.
With PIVs, you'll have an even larger population of nurses to educate about this product. And Lynn mentioned that it is not sterile. If you sprayed it and then used the chlorhexidine antiseptic, the anesthetic effect would have worn off by 1 minute after spraying.
I'll check with Sarah and see if she can post the pic in the gallery.