Top shelf - esp leaving tourniquet on a few sec post push.
G
On Mar 1, 2017, at 4:03 PM, Sara Morales
<sjmorales13@xxxxxxxxx<mailto:sjmorales13@xxxxxxxxx>> wrote:
Thanks Paul. Your notes were very helpful
On Wed, Mar 1, 2017 at 3:44 PM, Paul Paquette
<dmarc-noreply@xxxxxxxxxxxxx<mailto:dmarc-noreply@xxxxxxxxxxxxx>> wrote:
I haven't had to use a vein finder & the Drs I've worked for don't like the
quality of an oral FA & find it useless in most cases so I haven't done that in
years either.
Kirsten Locke & I give a course at OPS Annual Program on IV Tips. Can't give
all the tips now but heres a couple suggestions:
If your having difficulties finding a vein:
-make sure your tourniquet is tight & not more than 3"-4" from the site you
choose to look at i.e. just above the wrist if looking at the hand, just above
the elbow for anticubital site. Often times the pts complain its too tight but
when you go to release it you find it's not tight at all. It may help to place
a towel or go around the pt's shirt sleeve were you want to apply the
tourniquet.
-Stay open minded. Everyone has their favorite location, left or right arm or
hand etc... But don't limit yourself to only those sites. I had to use a pt's
foot everytime he came in.
If you're finding small veins but they always blow or infiltrate:
-Try an "open butterfly" technique. I learned this from a nurse who
administered Chemo to Cancer pts, who consistantly have the smallest veins.
Don't attach the syringe with dye to the butterfly needle. Remove the needle
used to draw up the dye & set the syringe nearbye with tip propped up so as not
to contaminate the open end. Uncap BOTH ends of the butterfly again being
careful not to contaminate open end (I hold it up between 2 small fingers).
When you stick this "open butterfly" even into a small vein you'll notice the
"Flash" of blood in the tubing quicker & it will continue to flow to the end of
the tubing rather than stop a mm or 2 into the tubing or inside the needle
itself if the syringe was attached (no back pressure to stop it). Don't worry,
even with the tourniquet attached, the flow is slow enough to be able to grab
the open syringe & attach it to the butterfly. Draw back any remaining air in
the tubing & you're ready to push SLOWLY & release the turniquet midway thru
the push (this help to keep the vein a little more firm).
Good luck
Paul Paquette
-----Original Message-----
From: wgraham6 <wgraham6@xxxxxxxxxxxx<mailto:wgraham6@xxxxxxxxxxxx>>
To: optimal <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Sent: Wed, Mar 1, 2017 9:53 am
Subject: [optimal] Re: [optimal] AccuVein
We have a few patients a year that are extremely hard or impossible to stick.
We will get out the vein finder but usually not very helpful. So not to torture
these diabetic patients with more than my limit of sticks oral FA is a great
option. We use the Optos California and get amazing images.
BJ Graham, CRA
Bjgrahamphoto@xxxxxxxxx<mailto:Bjgrahamphoto@xxxxxxxxx>
336-469-4951<tel:(336)%20469-4951>
Sent from my Verizon HTC Smartphone
----- Reply message -----
From: "Sara Morales" <sjmorales13@xxxxxxxxx<mailto:sjmorales13@xxxxxxxxx>>
To: <optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>>
Subject: [optimal] AccuVein
Date: Wed, Mar 1, 2017 12:00 PM
Our department is looking to purchase a vein finder for those seemingly
impossible patients. I can't believe how expensive they are and need to make
sure that they actually work on the difficult patients. Easy patients are easy
and I don't need a $5,000 device for them.. Do these devices work well for the
obese, dialysis patients, severe diabetics etc.
Sara Freeman Morales, CRA, OCT C
Scheie Eye Institute
Philadelphia, PA
