[optimal] Re: When to remove needle
- From: "Peterson John C" <JPeterson@xxxxxxxxxxxx>
- To: <optimal@xxxxxxxxxxxxx>
- Date: Fri, 10 Jun 2011 08:25:32 -0500
Alexis, I'm referring to a case where I am injecting for a fellow
photographer. We do our FAs as a 2-person procedure.
********
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 Alexis Smith
Sent: Thursday, June 09, 2011 2:59 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 <tel:%28608%29%20263-7163>
________________________________
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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