[optimal] Re: When to remove needle
- From: "Michael R. Turano Jr." <turano@xxxxxxxxx>
- To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx>
- Date: Fri, 10 Jun 2011 09:55:00 -0400
I would leave it in during transit as I wa doing my own injection. Then during
wait time before miss I would remove,discard and tape or bandage gauze down and
fold patients arm up. Elbow resting on pad. Then resume photography. If I was
in the room with another photog I would remove for them while they were
shooting and usually push.
It shouldn't really distract the patient I would just use judgement. On an
unstable/easily distracted patient no issue leaving in. On a cooperative
patient remove when you can. It's just like anything else read the situation,
communicate with patient and with assistant if you are lucky to have one and go
from there.
Mike
Michael R. Turano, Jr., CRA, OCT-C
Imaging Specialist
C 917.826.9506
F 917.591.1841
turano@xxxxxxxxx
Sent from my iPhone
On Jun 10, 2011, at 9:25 AM, "Peterson John C" <JPeterson@xxxxxxxxxxxx> wrote:
> 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
>
>
>
>
>
> 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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