[optimal] Re: When to remove needle
- From: Medphoms@xxxxxxx
- To: optimal@xxxxxxxxxxxxx
- Date: Sun, 12 Jun 2011 07:54:10 -0400 (EDT)
Not in NY - unless you have a lot of free time for court.
In a message dated 6/11/2011 9:34:35 P.M. Central Daylight Time,
raygardner99@xxxxxxxxx writes:
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@xxxxxxxxx
(mailto: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@xxxxxxxxxxxxxx (mailto:optimal-bounce@xxxxxxxxxxxxx)
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Dennis West
Sent: Thursday, June 09, 2011 10:28 AM
To: _optimal@xxxxxxxxxxxxxx (mailto: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@xxxxxxxxxxxx
(mailto: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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