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sbmosher
pressors thru PIVs

I recently received (and accidently :( ) deleted an article regarding a rethinking of the requirement for a central line for pressors. Can some let me know where this came from and where I can find it? I also seem to recall another separate article regarding the (not) need for central line with 3% NaCl. Help is appreciated. Thanks!

lynncrni
 I have seen similar articles

 I have seen similar articles but I do not believe you can have a blanket policy that applies the same thing to all patients. Safety of all vesicant s through a PIV depends on many factors - sites in areas of joint flexion, use of handboards, use of engineered catheter stabilization devices, concentration of vesicant infusion, rates of infusion, length of time required. All of these factors plus many more must be considered. So some patients may require a CVAD while others might be safe with a PIV for a vesicant infusion. Accordiing to INS, vesicant infusions longer than 30-60 minutes require consideration of a CVAD. Also, vesicant infusion through a PIV requires site assessment including blood aspiration every 5 to 10 minutes. Do you have the nursing staff to accomplish this? 3% NaCl is a vesicant due to its extreme hypertonicity. Lynn 

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

sbmosher
Thanks for your reply. I am

Thanks for your reply. I am aware of the vesicant nature of these meds and solutions. Our institution's present policy advocates for central access, however in light of recent publications our intensivists are questioning the necessity sighting risk vs benefit. I was hoping to locate the most recent publications regarding this for reference. I will need to dive into my old emails. Thanks again.

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