Re: RE: FW: Million Dollar Nurse

[ccavrn]

Yes, that is correct. According to INS standards, nothing with a pH   below 5 should be given via Central line. I have had this FIGHT with MDs often in homecare and LTC because the hospital sends them out with a PIV, and we request a PICC, the MD says " they gave it in the hospital that way...."  I have personally seen a phlebitis that went from wrist to shoulder from Vanco given through a midline. Perhaps you have been lucky, perhaps the damage from 1-2 doses is not yet visable, or perhaps your peds tolerate it better, more resilliant veins. But that does not mean the damage has not been done.  I wonder if you have ever tried to place a PICC after Vanco given peripherally in the same arm and had trouble?  The vanco may be why.  INS standards apply to ALL of us in a court of law, and best practice is expected in all settings.

Chris Cavanaugh, CRNI

----- Original Message -----

From: Raye Dillon <[EMAIL PROTECTED]>

Date: Wednesday, January 18, 2006 1:59 pm

Subject: RE: FW: Million Dollar Nurse

> so am i to understand that every patient who gets vanc ordered
> gets a
> central line of some type or are others just not speaking up.
> maybe its
> because kids have such great vein integrity but its a fact that we
> justdont see problems with vanc administration peripherally and we
> give it
> fairly often or maybe its because its only given short term
> peripherally.
>
> >>> "Autym Didsbury" <[EMAIL PROTECTED]> 1/18/2006
> 1:54:21 PM >>>
> We run in to this issue often in home care... One pharmacist
> tries to
> justify this by saying "they do it that way at the hospitals." Bottom
> line, we are each responsible for our own nursing practice, regardless
> of what "everyone else" does. I can easily imagine an attorney saying
> "so as a CRNI you were aware that Vancomycin can cause tissue necrosis
> ! with extr