Re: Fwd: Re: RE: Midlines

[Heather Nichols]

Title: Re: Fwd: Re: RE: Midlines

Thank you for the support Lynn.  Informative as always.     Heather Nichols RN BSN CRNI Infusion Services University of Louisville Trauma Institute 530 S. Jackson St. Lou. Ky. 40202 (502)562-3530 >>> "Lynn Hadaway" <[EMAIL PROTECTED]> 02/06/06 11:36 AM >>> 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 Return-path: [EMAIL PROTECTED] Received: from ms-mta-01 (ms-mta-01-smtp [10.10.4.5]) by  ms-mss-05.tampabay.rr.com (iPlanet Messaging Server 5.2 HotFix 2.10 (  built Dec 26 2005)) with ESMTP id  <[EMAIL PROTECTED]> for [EMAIL PROTECTED]; Mon,  06 Feb 2006 09:55:10 -0500 (EST) Received: from kcmx01.mgw.rr.com (kcmx01.mgw.rr.com [24.94.163.190]) by  ms-mta-01.tampabay.rr.com (iPlanet Messaging Server 5.2 HotFix 2.10 (  built Dec 26 2005)) with ESMTP id  <[EMAIL PROTECTED]> for [EMAIL PROTECTED] (ORCPT  [EMAIL PROTECTED]); Mon, 06 Feb 2006 09:55:10 -0500 (EST) Received: from hrndva-mx-08.mgw.rr.com (hrndva-mx-08.mgw.rr.com  [24.28.204.27]) by kcmx01.mgw.rr.com (8.12.10/8.12.8) with ESMTP id  k16EsnMX006088 for <[EMAIL PROTECTED]>; Mon, 06 Feb 2006 09:55:08 -0500  (EST) Received: from mail.ulh.org (HELO GW7.umc.ulh.org) ([216.249.130.21]) by  hrndva-mx-08.mgw.rr.com with ESMTP; Mon, 06 Feb 2006 09:54:48 -0500 Received: from UmcGwia-MTA by GW7.umc.ulh.org with Novell_GroupWise;  Mon, 06 Feb 2006 09:54:31 -0500 Date: Mon, 06 Feb 2006 09:54:10 -0500 From: "Heather Nichols" <[EMAIL PROTECTED]> Subject: Re: RE: Midlines To: [EMAIL PROTECTED] Message-ID: <[EMAIL PROTECTED]> MIME-Version: 1.0 X-Mailer: Novell GroupWise Internet Agent 6.5.3 X-Virus-Scanned: Symantec AntiVirus Scan Engine Original-recipient: rfc822;[EMAIL PROTECTED] Content-Type: multipart/mixed;  boundary="Boundary_(ID_Zjx8Zx5i+Gz3Vw3YaDnmNA)" Content-Transfer-Encoding: 7bit Content-Type: text/html Content-Description: HTML 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 ----------------------------------------------------- Confidentiality Disclaimer This message, including any attachments, is confidential, intended only for the named recipient(s) and may contain information that is privileged or exempt from disclosure under applicable law, including PHI (Protected Health Information) covered under the Health Insurance Portability and Accountability Act (HIPAA) of 1996.  If you are not the intended recipient(s), you are notified that the dissemination, distribution, or copying of this message is strictly prohibited.  If you receive this message in error, or are not the named recipient(s), please notify the sender or contact the University of Louisville Health Care I.S. helpdesk at 502.562.3637 to report an inadvertently received message. ----------------------------------------------------- Attachment converted: G4 Laptop:Heather Nichols 49.vcf (TEXT/ttxt) (00151BD2) -- 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

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