[optimal] Re: When to remove needle
- From: "Peterson John C" <JPeterson@xxxxxxxxxxxx>
- To: <optimal@xxxxxxxxxxxxx>
- Date: Thu, 9 Jun 2011 11:10:10 -0500
I can't match Peter or Tom's experience, but here's my take on this in
re: patients having problems.
If I'm injecting through a butterfly needle, and the patient begins to
collapse, the first thing I'm doing is removing the needle. I don't want
a piece of metal in their arm if or when they hit the deck. That, to me,
is a hazard.
If EMTs are needed, they have their own methods of getting a vein. By
that logic, in my opinion it's better to get the needle out and
discarded into the sharps box ASAP.
********
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
________________________________
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]
On Behalf Of Breit, Peter
Sent: Thursday, June 09, 2011 9:42 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: When to remove needle
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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