[optimal] Re: When to remove needle
- From: "Michael R. Turano Jr." <turano@xxxxxxxxx>
- To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx>
- Date: Fri, 10 Jun 2011 22:57:01 -0400
Or 20 for 9.25 years
Or 40 for 4.625 years
Math is fun.
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 9:49 PM, Medphoms@xxxxxxx wrote:
> 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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