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Carol Olson
Second PIV 'just in case' it is needed for an emergency.
The IV Team is occasionally asked to assist with a difficult PIV insertion in the ICU if the bedside nurse cannot insert the PIV.  We have been asked to start a second PIV 'just in case' the PIV is needed.  One PIV may be all that is needed for the prescribed IV therapy, but it is the ICU's unwritten practice to have the second PIV 'just in case'.  There isn't a specific order for this.  It isn't in any policy.  I've asked the ICU nurse clinician where the order for the 'just in case' IV is and have been told that it is standard practice.  How are other nurses handling this request?  Thank you.
Having adequate numbers of

Having adequate numbers of IV catheters in any critical care patient is a desirable goal. When the patient is crashing is not the time to be finding a vein, but there is a risk associated with having multiple catheters in a patient. In my opinion, this comes under the topic of nursing judgment, but the administration of your management (especially risk management) is what counts. I think having a written protocol for an extra peripheral saline lock would be one method. Most ICU protocols I have seen call for a saline lock even though there may be no IV meds prescribed. If there are IV meds prescribed, I do not think you need to have a physician's order for the peripheral catheter. The IV meds and fluids implies the need for a catheter. The number of catheters, their size, site, etc are all within the nursing domain. 

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

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

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

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