Re: Fwd: Re: RE: Midlines

[Lynn Hadaway]

Title: Re: Fwd: Re: RE: Midlines

Gaharts Intravenous Medications states in the Precaustion section of the monograph on Vancomycin,"Determine absolute patency of the vein. Necrosis and sloughing will result from extravasation. Rotate injection sites every 2 to 3 days." So it is a vesicant. Lynn

At 10:15 AM -0500 2/6/06, [EMAIL PROTECTED] wrote:

Really?  I have plendy of references that say it is not.

Irritiating, yes, to some pts. 

Chris Cavanaugh, CRNI

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Date: Mon, 06 Feb 2006 09:54:10 -0500
From: "Heather Nichols" <[EMAIL PROTECTED]>
Subject: Re: RE: Midlines
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Vanc is a vesicant.  End

 

Heather Nichols RN BSN CRNI
Infusion Services
University of Louisville Trauma Institute
530 S. Jackson St.
Lou. Ky. 40202
(502)562-3530

>>> <[EMAIL PROTECTED]> 02/06/06 9:42 AM >>>

Heather and all,

I am not an idiot.  As I said, we use midlines all the time for HYDRATION AND ANTIBIOTICS. The occasional Midline gets placed when there are no more PIV sites and a PICC won't thread for 14 days or less of Vanco.  NO VESICANTS are ever given in LTC, as these LPNs do not have the knowledge base to give them.  Cancer pts receiving chemo usually have a port and go to the MD office or hospital for their treatments.  When therapy is to be longer than 14 days of Vanco, or 4 weeks for another drug, I ALWAYS recommend a central line.  However, not every facility will send their pt out, and they will just call the pharmacy the next day and get another nurse to place the line.  Not often, but I have seen it.

Can we end this discussion now please? 
Chris Cavanaugh, CRNI

----- Original Message -----
From: Heather Nichols <[EMAIL PROTECTED]>
Date: Monday, February 6, 2006 7:50 am
Subject: RE: Midlines
To: [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED], [EMAIL PROTECTED], Leigh Ann Bowe-geddes <[EMAIL PROTECTED]>, [EMAIL PROTECTED]

> I have to disagree with you here Chris. If you absolutely have to
> givea vesicant or extremely irritating drug/IVF without the aid of
> centralaccess, I would rather see it given through a peripheral IV
> site. You
> can see an extravasation/infiltration almost immediately with a
> peripheral site, but if the same thing happens with a midline, it
> couldtake days to see, therefore causing a whole lot more damage.
> That is why cytotoxic drugs are given through a peripheral IV site
> when central access is not an option,! with clo

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-- 

Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861