We place blood drawing IVs all the time for short timed studies or
critical labs for short term patients, esp. not in ICUs where we would
do an arterial line for many kids...I can answer in between your
questions.  Keep in mind that INS standards still say that pivs should
not be used for obtaining routine lab studies.
anne marie

>>> "Fritz, Donna" <[EMAIL PROTECTED]> 11/23/05 12:25 PM >>>
We have initiated a process for tighter glycemic control during the
immediate post-operative period (until pts start eating).  Patients are
on insulin drips with sugars tested q30-60 min.  As you can imagine,
that's alot of finger sticks!  We were trying to come up with a way to
draw blood from 
1)      pre-exisiting lines [STUDIES SHOW DRAWING BLOOD FROM PIVs THAT
HAVE BEEN USED FOR INFUSION IS NOT A GOOD IDEA AS MANY LABS ARE
SKEWED...FROM A NEW IV IS OK
2)      dedicated PIV cath  WE PLACE 22 OR 20 GAUGE PIVS IN CHILDREN FOR
24-48 HOUR FREQUENT LAB DRAWS.  THESE ARE USUALLY HEPARIN LOCKED UNLESS
COAGS ARE BEING OBTAINED IF A CHILD IS ON HEPARIN FOR DVT FOR EXAMPLE.

so that we would not be sticking patients so often.  However, nurses
are worried about drawing discards that often from CVCs.  So relating to
a PIV site dedicated for blood draws, I have questions:

1.      How long will the site last (in your experience)?  We only need
it for 1-3 days.
OUR PIV SITES USUALLY LAST 1-3 DAYS, MOSTLY 1-2 AT MOST.
2.      Should heparin be used to flush this PIV cath with Clave
directly on the hub, since we're doing frequent blood draws?  WE FLUSH
WITH SALINE, THEN HEPARIN, UNLESS LABS ARE MORE FREQUENT THAN EVERY HOUR
OR SO.
3.      How much discard might we need to draw?  WE ABIDE BY THE 3X THE
DEVICE AND CONNECTOR TUBINGS RULE; IN OUR CASE, THIS IS ABOUT 1.5MLS.
THE 1.5 IS THREE TIMES THE VOLUME OF THE PIV AND T-CONNECTOR

TIA for your comments/answers.

Donna Fritz



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