[optimal] Re: When to remove needle

  • From: "Breit, Peter" <BreitP@xxxxxxxx>
  • To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx>
  • Date: Thu, 9 Jun 2011 10:42:12 -0400

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<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.


Other related posts: