I do not know where you will find info to support the doc's needs but we have 
the same senario here.  Our anesthesiologist want an 18g catheter inserted for 
surgery.  If you don't feel you can get an 18g in they will accept a 20g.  
Their feel they want a large gauge if needed for resusitation if needed.  Also 
they free flow everything and they like a good rate, not that you can't do this 
with a smaller gauge.  About four years ago I got in 19g huber needles for our 
port patients who go to the OR.   Prior to this the anesthesiologists insisted 
on starting a separate peripheral line.   You know a lot of patients with ports 
do not have good veins for peripherals.
 
Margaret M Nicastro, CRNI, OCN
Coorordinator IV Therapy/Oncology
Gettysburg Hospital
147 Gettys Street
Gettysburg, PA 17325
Phone:  717-337-4312
Fax:  717-337-4485

________________________________

From: [EMAIL PROTECTED] on behalf of Heather Nichols
Sent: Thu 1/19/2006 7:37 AM
To: [EMAIL PROTECTED]
Subject: prescribed therapy?

 
I was reading through my INS Standards of Practice today ( no I was not bored) 
to try to get some info to decrease my anesthesiologist "bigger is better", way 
of thinking.  It is said that catheter selection should be the smallest gauge 
and shortest length, that will accommodate the prescribed therapy.  Could 
anyone tell me where I might find the "prescribed therapy" for the size of 
catheter needed for a patient going in for surgery?  Is there any info out 
there to support the doc's need for an 18 or 16 gauge short peripheral in a 
vein that is in no way big enough to support it?  The doc's tell me it is for 
possible resuscitation purposes, but the flow rates on the peripheral catheters 
we use do not make enough of a difference to support this either.  I know I am 
probably fighting a losing battle, but I need to know either way.  My patients 
are the one's being made to suffer for what seems to be archaic practice. 
 
Heather Nichols RN BSN CRNI 
Infusion Services
University of Louisville Trauma Institute
530 S. Jackson St.
Lou. Ky. 40202
(502)562-3530


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