[optimal] Re: When to remove needle
- From: "Curtis, Rhonda" <Curtis@xxxxxxxxxxxxxxxx>
- To: <optimal@xxxxxxxxxxxxx>
- Date: Tue, 14 Jun 2011 09:18:44 -0500
Absolutely !!! You have to apply pressure where the puncture is – cannot just
tell them to bend their arm – may not get the pressure at the pucture site…not
to mention hand veins. I have the patients apply pressure (if they can) until
I do the lates and have very few bruised arms and hands.
Rhonda
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of Ethan Priel
Sent: Tuesday, June 14, 2011 12:44 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: When to remove needle
Uh, many of our patients are on all kinds of anticoagulants, blood thinners and
what not.
It is a 'nice touch' to have them say next time –
' you know, this is the only place I did not have a large black and blue mark
after the blood test'…
Ethan
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On
Behalf Of Ray Gardner
Sent: 14 June, 2011 00:19
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: When to remove needle
Why apply pressure to injection sight when you can use a pressure patch. After
the transit phase I use 2x2 folded twice, apply light pressure, pull needle
out, the with tranpor tape pull skin tight and stick it down. Take about a half
a second or so.
Sent from my iPhone
On Jun 9, 2011, at 3:43 PM, Alexis Smith <alexis@xxxxxxxx> wrote:
I'm fast, but you have to press on the cotton ball for 30 seconds
before putting a bandaid on . . . that leaves you without an extra hand to hold
up eye lids on ptosis patients!
On Thu, Jun 9, 2011 at 4:18 PM, Tom Steele <tsteele@xxxxxxxxxxxxxx>
wrote:
Alexis,
You’ve got to be fast, like the old days when you had to shoot 2 frames
a second and you only had 17 seconds of film to a roll; it’s all in the timing.
Thank You,
Tom Steele, CRA
Midwest Eye Institute
200 West 103rd Street
Indianapolis, Indiana 46290
317.817.1018
tsteele@xxxxxxxxxxxxxx
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From: optimal-bounce@xxxxxxxxxxxxx
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Alexis Smith
Sent: Thursday, June 09, 2011 3:59 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: When to remove needle
My question is for those of you doing the injections yourself: how do
you capture a transit if you are removing the needle and pressing down on the
cotton for thirty seconds or so? I usually need both hands to capture and to
lift an eye lid; having one hand putting pressure on the injection site after
needle removal while taking photos, adjusting exposure, and potentially helping
with eyelids is tough! I've only taken the needle out right away on extremely
skittish or young patients who are moving around. Otherwise, I wait until I
have captured the transit.
Alexis
On Thu, Jun 9, 2011 at 3:46 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 <tel:%28608%29%20263-7163>
________________________________
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 <tel:%28608%29%20263-7163>
________________________________
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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