[optimal] Re: When to remove needle
- From: Alexis Smith <alexis@xxxxxxxx>
- To: optimal@xxxxxxxxxxxxx
- Date: Thu, 9 Jun 2011 16:43:13 -0400
I'm fast, but you have to press on the cotton ball for 30 seconds before
putting a bandaid on . . . that leaves you without an extra hand to hold up
eye lids on ptosis patients!
On Thu, Jun 9, 2011 at 4:18 PM, Tom Steele <tsteele@xxxxxxxxxxxxxx> wrote:
> Alexis,
>
>
>
> You’ve got to be fast, like the old days when you had to shoot 2 frames a
> second and you only had 17 seconds of film to a roll; it’s all in the
> timing.
>
>
>
> Thank You,
>
>
>
> Tom Steele, CRA
>
>
> Midwest Eye Institute
>
> 200 West 103rd Street
>
> Indianapolis, Indiana 46290
>
> 317.817.1018
>
> tsteele@xxxxxxxxxxxxxx
>
>
>
>
>
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> *From:* optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]
> *On Behalf Of *Alexis Smith
> *Sent:* Thursday, June 09, 2011 3:59 PM
>
> *To:* optimal@xxxxxxxxxxxxx
> *Subject:* [optimal] Re: When to remove needle
>
>
>
> My question is for those of you doing the injections yourself: how do you
> capture a transit if you are removing the needle and pressing down on the
> cotton for thirty seconds or so? I usually need both hands to capture and
> to lift an eye lid; having one hand putting pressure on the injection site
> after needle removal while taking photos, adjusting exposure, and
> potentially helping with eyelids is tough! I've only taken the needle out
> right away on extremely skittish or young patients who are moving around.
> Otherwise, I wait until I have captured the transit.
>
> Alexis
>
> On Thu, Jun 9, 2011 at 3:46 PM, Peterson John C <JPeterson@xxxxxxxxxxxx>
> wrote:
>
> You remove a butterfly needle once the syringe is empty because a butterfly
> needle is not intended for extended placement. Two minutes seems not
> unreasonable. We've had no problems taking it out right away, and our
> skittish patients are happy to hear us say "needle's out!". Flinching has
> never been an issue
>
> Just my inflation-adjusted 3 cents....
>
> ********
> 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 *Ethan Priel
> *Sent:* Thursday, June 09, 2011 1:49 PM
>
>
> *To:* optimal@xxxxxxxxxxxxx
> *Subject:* [optimal] Re: When to remove needle
>
>
>
> Follks,
>
>
>
> We have been using metal butterflies for decades. Thousands a month.
>
>
>
> We use the plastic catheters for all first-timers, anyone with history of
> allergy or serious medical conditions.
>
>
>
> We NEVER take the needle out 'immediately' for the highly-intelligent
> reasons listed earlier –
>
>
>
> - Secure open vein in case
>
> - Discomfort that can cause patient to balk (I guess the Bostonians
> are hardier stock)
>
> - If it ain't broke, don’t fix it.
>
>
>
>
>
> Now, I think that the sharp is in the other court –
>
>
>
> WHY take the needle out right away ?
>
>
>
> Ethan
>
>
>
> *From:* optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]
> *On Behalf Of *Cavicchi, Robert
> *Sent:* 09 June, 2011 17:32
> *To:* optimal@xxxxxxxxxxxxx
> *Subject:* [optimal] Re: When to remove needle
>
>
>
> We use the same procedure as John describes below…
>
>
>
> Removal of the needle immediately following the injection and we don’t have
> any patient complaints about stinging/pain.
>
>
>
> No problems acquiring the A-V phase either.
>
>
>
> bob
>
>
>
> *From:* optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]
> *On Behalf Of *Peterson John C
> *Sent:* Thursday, June 09, 2011 10:27 AM
> *To:* optimal@xxxxxxxxxxxxx
> *Subject:* [optimal] Re: When to remove needle
>
>
>
> We always remove the needle right away. I believe that some of the "ouch"
> you describe is the sting from FA dye left in the needle. We routinely draw
> back a bit of blood to clear the dye out of the needle bore.
>
>
>
> No complaints from our patients so far.
>
>
>
> ********
> 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 *Richard Morrone
> *Sent:* Thursday, June 09, 2011 9:14 AM
> *To:* optimal@xxxxxxxxxxxxx
> *Subject:* [optimal] When to remove needle
>
> 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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