I always wish we had x-ray vision AND a direct brain link to all available research on any given subject (well, why not wish big!)! As you have said there is some evidence both ways and no Standards now that speak against two lines or daily access.
Nancy Moureau, BSN, CRNI PICC Excellence, Inc. 888-714-1951 www.piccexcellence.com [EMAIL PROTECTED] -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ann Marie J. Frey Sent: Friday, April 21, 2006 11:33 AM To: [EMAIL PROTECTED]; [EMAIL PROTECTED] Subject: 2 IVs in 1 hand AND a port access question... There was a statement in the INS standards regarding using two veins in the same extremity for PIVs infusiing incompatible solutions because without the benefit of imaging, you can't tell if the infusions are mixing in the same vein or not. We actually adapted that statement into our procedure, but I think it was from one of the INS Standards versions in the 90s. It seems like there isn't evidence either way, but I could see the sense of not placing one IV above another and infusing incompatible meds/fluids. With the SVC, the flow is so great, the infusates supposedly get diluted. With peripheral IVs, the flow is slower, so more chance of complication....sometimes I wish we had x-ray vision! On another vein [pun intented], we have hematology docs that want an older hemophiliac's port accessed daily for factor because it is less risk of infection. When I talked to them, they said they were worried about blood sitting in the port being a nidus for infection or bleeding around the needle. I don't think there is evidence either way, but it would seem that accessing more often would increase the risk of bleeding and infection vs. once per week, which is our usual protocol. Let me know what you and anyone else on the list thinks.... Thanks, AM >>> Lynn Hadaway <[EMAIL PROTECTED]> 04/21/06 11:09 AM >>> Sorry but I don't even recall that such a statement was in a previous version of the standards. I have also seen the time when it was mandatory to have 2 sites in the same arm. Lynn At 8:31 AM -0400 4/21/06, Ann Marie J. Frey wrote: >Does anyone have evidence based info or remember the standard of care >where it mentions not to place two PIVs in the same extremity? I know >the basis for this is that veins all join eventually, so imcompatible >solutions, could, in effect, mix in the vein and cause phlebitis or >other complication. The INS Standards of Practice used to say this >statement, but I can't locate it now. Does anyone know where I can find >this info? We seem to have some MDs that think this is OK practice. >Thanks in advance, Anne Marie -- 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
