My additional concern for the port would be the number of times the
septum is punctured. Manufacturers test this and there is a limit.
For the small ports implanted in the arm the max number is around
750. For the larger chest ports it is usually in the area of 2000
punctures. You would need to check the number for the size and brand
you are using. Lynn
At 12:33 PM -0400 4/21/06, Ann Marie J. Frey wrote:
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
--
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
