[optimal] Re: When to remove needle
- From: "Sanchez, Andres" <sancheza6@xxxxxxxxxxx>
- To: "'optimal@xxxxxxxxxxxxx'" <optimal@xxxxxxxxxxxxx>
- Date: Thu, 9 Jun 2011 16:55:22 +0000
Hi I'm rather new to this blog. I enjoy reading and it's been helpful.
As far as how long to leave the needle in; I usually remove after 2 mins. for
no other reason than that is what I've been doing for 18-19 yrs.
As far as the what if's, I've never, knock on wood, ever, had a bad experience
where 25-50mg of Benadryl didn't take care of the problem.
The one guy that did pass out, did so before the stick. The one older lady
that did need EMS (per the M.D.) recovered as the EMS were entering the
building which they calculated was at the 40 min. mark of me giving her the
50mg of Benadryl. (not that they took 40 mins. to get there) And I'm not
saying the EMS shouldn't be called either, just sharing my only 2 bad
experiences in my 18 years of doing this.
Andres Sanchez, COA
Tech. Team Lead/Photographer/Angiographer
Department of Ophthalmology
UT Medicine - UCCH
210-358-7631 Phone
210-358-7630 Fax
sancheza6@xxxxxxxxxxx<mailto:sancheza6@xxxxxxxxxxx>
________________________________
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of Peterson John C
Sent: Thursday, June 09, 2011 11:10 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: When to remove needle
I can't match Peter or Tom's experience, but here's my take on this in re:
patients having problems.
If I'm injecting through a butterfly needle, and the patient begins to
collapse, the first thing I'm doing is removing the needle. I don't want a
piece of metal in their arm if or when they hit the deck. That, to me, is a
hazard.
If EMTs are needed, they have their own methods of getting a vein. By that
logic, in my opinion it's better to get the needle out and discarded into the
sharps box ASAP.
********
John C. Peterson, BS, CRA
Director of Ophthalmic Photography Services
UW Health Eye Clinic
2880 University Ave., Rm. 246
Madison, WI 53705
(608) 263-7163
________________________________
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of Breit, Peter
Sent: Thursday, June 09, 2011 9:42 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: When to remove needle
I totally agree with Dennis. If you have a patient faint or go into shock the
BP will drop and it will be almost impossible to insert another IV line. After
40 years doing IVFA I never had a problem with leaving a butterfly needle in
for a few minutes. The nurse or doctor can leave and the photographer can
remove the IV after the procedure.
Thanks
Peter
Peter L. Breit, CRA.
Director Ophthalmic Services
The Lankenau Hospital & Bryn Mawr Hospital
484-476-3338
484-476-8206 fax
484-437-3262 mobile
page 3707
________________________________
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of Dennis West
Sent: Thursday, June 09, 2011 10:28 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: When to remove needle
Richard,
For 30 years I've l kept the needle in place for first two minutes of the FA.
This for two reasons.
1. As you have talked about it is distraction to the patient to remove the
thing as the dye if just starting to flow into the eye.
2. More importantly, the need to have an open line for emergency. I have had
EMT's use my "metal needle butterfly" before especially for the patients with
very small veins.
Why would you remove the thing after struggling with a difficult stick only to
find out after you remove it that you need an open line.
Dennis M. West, CRA
Sent from my iPhone
On Jun 9, 2011, at 10:13 AM, Richard Morrone
<rmorrone@xxxxxxxxxxx<mailto:rmorrone@xxxxxxxxxxx>> wrote:
Hello all,
After decades of performing FA's I have recently received resistance from
nursing at one facility regarding my request that the nurse not remove the
butterfly during the first minute or two so as not to distract the patient
during the rapid sequence of flashes in an FA.
I have had patients look down at the arm or be startled or even say "ouch!"
when the needle is pulled. Nursing does not believe that that would occur.
They seemed concerned about the metal needle of our 23g butterfly being left
in, and they want to remove the needle immediately after injecting. They said
that to do otherwise would put the patient at risk. So much for getting the
A-V phase with all of that activity occurring.
I could suggest the use of angiocaths (with the soft plastic needle/sleeve) to
address the metal needle concern, but they do cost more.
Does anyone have a sample protocol that mentions when the "needle" is removed?
Or... can you just describe your procedure?
Thanks,
Richard Morrone, C.R.A.
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