[optimal] Re: When to remove needle
- From: "Michael R. Turano, Jr." <turano@xxxxxxxxx>
- To: optimal@xxxxxxxxxxxxx
- Date: Sun, 12 Jun 2011 08:59:03 -0400
@ medphoms
This is an open forum where nearly all members reveal at a minimum their
first name and most their last. Your last two comments have been fairly
snarky which is fine and we welcome humor on the forum, however since this
forum has not traditionally been an anonymous forum it would be nice to know
your name and what your background is.
Also, I am pretty sure that Ray isn't pushing anything without the consent
and direction of a physician at the very minimum. You would also be
fairly surprised to know that I worked at a large medical center in NYC.
Lawyers found out we were performing our own injections of NaFL and stopped
our injecting for about a month. Then they came back and said they had ample
evidence that this was within the scope of practice for our position and
felt they could easily handle any legal challenges that would ever possibly
arrise. I would agree that one should always be wary of this as there are a
few cases of legal proceedings against opthalmic photographers. I would say
your exposure is fairly minimal as there have been so few cases.
Thanks and welcome to the forum.
Michael
Michael R. Turano, Jr., CRA, OCT-C
Imaging Specialist
c. 917.826.9506
f. 917.591.1841
e. turano@xxxxxxxxx
On Sun, Jun 12, 2011 at 7:54 AM, <Medphoms@xxxxxxx> wrote:
> 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@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>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>
> 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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