Our cardiologist also ask for an pherp. iv in each arm. was told this was for mapping the viens
Nancy Sullivan RN
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Note: forwarded message attached.
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--- Begin Message --- I asked one of our Cardiologist who places pacers about this and he said your physician may be doing a dye test prior to insertion of the pacer to check patency of the the vessels before threading the wires. Some times patients have occulsions and the pacer wires can't be threaded, but this is rare. Our guys don't do that, I sort of got the impression that it's not really necessary. That's probably just his thing.
Julie
DENISE GALLAGHER <[EMAIL PROTECTED]> wrote:
We are having a new cardiologist coming aboard and he is requesting 2
antecubital IVs be inserted prior to going for pacemaker insertion. Anyone
know the reason behind this practice? Thanks, Dee
>From: "Lynn Hadaway" <[EMAIL PROTECTED]>
>To: [EMAIL PROTECTED], [EMAIL PROTECTED]
>Subject: Re: [vascular] Ultrasound certification revisited
>Date: Tue, 2 May 2006 11:29:58 -0400
>
>Any nurses coming into your hospital representing a manufacturer can not
>touch your patients because they are employed by or contracted by the
>manufacturer. The state license is important but who is paying them is a
>critical issue in whether they touch patients or not.
>
>Regarding your chances for a lawsuit, no one can answer that question. That
>totally depends on you, your clinical decisions, and the level of risk you
>take when making certain decisions. For instance you could persist in
>making many venipunctures to access the vein using US and cause nerve
>damage. So the factors that would be considered by an expert would be the
>number of attempts you made, the amount of times you passed the finder
>needle, your expertise in identifying structures on the US, and your
>response when the patient complained of pain - did you keep going and
>ignore the patient complaints or did you abort the procedure? As long as
>you make wise clinical decisions based on your assessment of your knowledge
>and skill, you should lower your risk of a successful lawsuit tremendously.
>Nurses get into trouble when they don't know or ignore their own
>limitations and make clinical decisions based on a total lack of knowledge
>or they ignore patient complaints.
>
>Considering that it is reported to require about 50 attempts with US to
>feel comfortable with it, there is no way that a manufacturer or an
>employer could support all nurses through their entire process of attaining
>competency - the cost would be too great. So we must try without a
>preceptor on some of these.
>
>Also, it is not the responsibility of those outside contractors to state
>that you are or are not competent. This is the responsibility of your
>employer. So document your attempts, learn from each one and soon you will
>be proficient. Lynn
>
>
>At 7:36 AM -0500 4/28/06, Alma Kooistra wrote:
>>The messages that passed through yesterday re ultrasound certification got
>>me to thinking........
>>
>>I am crippling through the process of mastering PICC placement using
>>ultrasound. My training has consisted of having Boston Scientific send
>>down
>>a couple of Ultrasound trained nurses who accompanied me for one day.
>>Neither were licensed in our state so couldn't touch anyone and just
>>coached
>>at the bedside. They watched me during one insertion and a couple of our
>>other staff during one insertion as well. I had never seen a line placed
>>using ultrasound until the day I did it with them (and it wasn't
>>easy.........).
>>
>>Since that day I have been out there struggling to get through the
>>learning
>>curve on my own. I've read P/P for line insertion using ultrasound ad
>>nauseum. Beyond that I've had no other training.
>>
>>How well protected am I in case of a lawsuit? I'm starting to get a
>>little
>>nervous. I could hardly expect the staff who watched me though that one
>>first insertion to sign me off as competent......they would be crazy to do
>>that since I clearly was not competent. I have another trainer coming
>>next
>>week. Is it possible that this amount of training would cover me if I
>>have
>>a bad outcome? I don't know if there's anyone in our area (South Dakota,
>>Northwest IA) placing lines at the bedside using ultrasound so it's not
>>easy
>>for me to get training. My managed chuckled when I asked about getting
>>$$$
>>to go somewhere for training.
>>
>>Alma Kooistra RN, CRNI
>>
>>
>>
>>
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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
>__________________________________________________
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