[optimal] Re: When to remove needle
- From: Medphoms@xxxxxxx
- To: optimal@xxxxxxxxxxxxx
- Date: Fri, 10 Jun 2011 21:49:24 -0400 (EDT)
Is that the right math? 60,000 is roughly 10 FA's every day for 18.5
years.
In a message dated 6/9/2011 3:16:25 P.M. Central Daylight Time,
ekegley@xxxxxxxxxxxxxxxxx writes:
We typically "deneedle" the patient after the early phase of the
angiogram, approx. 1 minute after the start of the injection. I personally
have done
close to 60000 FA's without complications in the last 18.5 years.
EK
Eric Kegley, CRA, COA
Retina Consultants of Houston
6560 Fannin St., #750
Houston, TX 77030
Sent from my Palm Pre on AT&T
____________________________________
On Jun 9, 2011 2:46 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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