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pwilken
introducer needle modification

Does anyone have experience with modification of an introducer needle for central line insertion--specifically arching the shaft of the introducer to create a curve prior to insertion? Is this just a one off that I have seen with a physician inserted catheter? Really interested to hear if anyone else has seen this or if it is commonly done. I have seen it with subclavian CVAD insertion.

lynncrni
Heard of it, seen it done by

Heard of it, seen it done by anesthesiologist for short PIVCs. BUT it is NEVER a good thing. The junction of where the internal end of the catheter joins the stylet is engineered with great care. The purposes are to ensure that the shoulder of the plastic catheter is a smooth transition so it will advance easily into the vein lumen. Also the design is to prevent the catheter from peeling back on itself as you make the venipuncture. This curvature of the stylet alters all of those good designs and makes for more problems. I have been doing infusion nursing for 49 years and have never seen any manufacturer include this in their instructions for use. Also this has never been included in any standards or guidelines. It is a horrible way to treat any PIVC and should NEVER be done. It sounds like you are talking about a plain introducer needle without any catheter. But this curvature could make it difficult to advance the guidewire through it, maybe diffcult to withdraw introducer from over the wire, definitely not recommended by any manufacturer or standards and should NEVER be done either. This is dangerous off label use. When it is done, and there is a serious problem that leads to a lawsuit, the liability will fall exclusively on the inserter and the manufactuer would not be named. 

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

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