Hi, how long can I infuse a continuous vesicant through a short peripherial IV before needing a midline or CVC?
How long can I infuse a intermittent vesicant through a short peripherial Iv before needing a midline or CVC?
the INS has a position Paper on this, you can go to there website and look for the category Position Statements and locate the one titled Non cytotoxic Vesicant administration.
But.... a continuous vesicant should only be given via peripheral in the emergency situation then converted over to a central line. Intermittent vessicant infusion only recommended for short term, less than 6 days. However, in all situations you have to take into consideration many other factors with the pt, diagnosis, plan of care, pts venous status etc....
Gina Ward R.N., VA-BC
T here are no recommendations for the times you are asking about. Length of time for these infusions is not the only cause of extravasation injury. A short PIV in the hand, wrist, or ACF has a much higher rate of infiltration/extravasation due to joint movement and this can happen with a few hours. The nature of the vesicant plays a role. INS has a list coded by red and yellow or those with the greatest risk and those that are weaker vesicants. Infusion of calcium chloride is very different risk than an infusion of vancomycin. Frequency of site assessment and patency assessment is another factor. An awake, well oriented patient that can immediately report discomfort is different than a comatose patient. Finally PIV and midline would be in one category as both are peripheral veins. So your choice would be PIV or midline versus a CVAD. Midline and CVAD are not in the same category of VADs.
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