[optimal] Re: When to remove needle
- From: Ray Gardner <raygardner99@xxxxxxxxx>
- To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx>
- Date: Sat, 11 Jun 2011 21:33:11 -0500
I've had may allergic reaction to the FA dye. I leave the line in until the
transit phase is over for those who have had previous angiograms without
incident. New patients or previous mild allergic, I leave the line in for five
minutes or the end of the test. I think it's common since. I do push 25mg IV
benadryl prior to infusion of dye for those with previous allergic reactions.
If they have ever had itching in the mouth throat I will not give them the dye
or history of severe reactions to it. I've had about three to four very severe
requiring a trip to the hospital. I was glad to have had IV access to push
benadryl and steroids. With this though I place a second IV catheter in then
remove the butterfly.
Sent from my iPhone
On Jun 9, 2011, at 9:42 AM, "Breit, Peter" <BreitP@xxxxxxxx> wrote:
> I totally agree with Dennis. If you have a patient faint or go into shock
> the BP will drop and it will be almost impossible to insert another IV line.
> After 40 years doing IVFA I never had a problem with leaving a butterfly
> needle in for a few minutes. The nurse or doctor can leave and the
> photographer can remove the IV after the procedure.
>
> Thanks
>
> Peter
>
> Peter L. Breit, CRA.
> Director Ophthalmic Services
> The Lankenau Hospital & Bryn Mawr Hospital
> 484-476-3338
> 484-476-8206 fax
> 484-437-3262 mobile
> page 3707
>
>
>
>
>
> From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
> Behalf Of Dennis West
> Sent: Thursday, June 09, 2011 10:28 AM
> To: optimal@xxxxxxxxxxxxx
> Subject: [optimal] Re: When to remove needle
>
> Richard,
>
> For 30 years I've l kept the needle in place for first two minutes of the FA.
> This for two reasons.
> 1. As you have talked about it is distraction to the patient to remove the
> thing as the dye if just starting to flow into the eye.
> 2. More importantly, the need to have an open line for emergency. I have had
> EMT's use my "metal needle butterfly" before especially for the patients with
> very small veins.
> Why would you remove the thing after struggling with a difficult stick only
> to find out after you remove it that you need an open line.
>
> Dennis M. West, CRA
>
> Sent from my iPhone
>
> On Jun 9, 2011, at 10:13 AM, Richard Morrone <rmorrone@xxxxxxxxxxx> wrote:
>
>>
>>
>> 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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