I am working on updating our hospital policy on Infiltration and Extravasation. In reviewing frequency of assessing the line for patency I have come upon the INS Position Paper on Peripheral Iv Assessments.
It looks very achievable/doable until I read the part about assessing the peripheral line with an intermittent infusion of a vesicant every 5-10 minutes. So.....if we have a Vanco , K+, Phenergan etc....piggyback going this is what they recommend , am I reading that right?? below is the statement I am referring to;
d. More frequently: every 5 to 10 minutes
- Patients receiving intermittent infusions of vesicants
• The nurse should advocate for central vascular access administration of vesicant medications whenever possible. The peripheral infusion of vesicant agents should be limited to less than 30 to 60 minutes.
• In addition to visual assessment of the site, a blood return should be verified every 5 to 10 minutes during the infusion
2. Patients receiving infusions of vasoconstrictor agents
• The nurse should advocate for central vascular access administration of vasoconstrictor agents whenever possible as these agents can cause severe tissue necrosis with extravasation.
I realize this is a position statement and standards are recommndations and not mandatory but....I am also aware that these standards are used in the court of law and our choices and actions are compared to these when being reviewed.
Am I reading this wrong?? Because I feel pretty sure that we are not assesing these sites that frequently during infusion of intermittent piggybacks that are vesicant. We do certainly assess the line/site for patentcy prior to starting the medication, if any complaints, alarms etc. and then upon completion.
I am anxiously awaiting your feedback!
thanks, Gina Ward R.N, VA-BC