try the sterile k-y package, almost the same as ultrasound gel. --- "Erickson, Wendy" <[EMAIL PROTECTED]> wrote:
> About the non-sterile gel: be very careful using > that for any insertion > - we had an outbreak of infections that were all > linked back to the > ultrsound gel, and found that they were refilling > bottles, not using new > bottles when empty. They were very contaminated. > Wendy Erickson > > -----Original Message----- > From: [EMAIL PROTECTED] > [mailto:[EMAIL PROTECTED] On Behalf Of > Richard Pearson > Sent: Tuesday, May 16, 2006 2:45 PM > To: [EMAIL PROTECTED] > Subject: Re: Ultrasound for periphs > > At our hospital we are called on occasionally to > place peripheral IVs > using the Bard Site-Rite 3, and I have done about a > hundred or so of > these. You can use the site-rite just as you do to > start a PICC, but it > is more difficult for three reasons. > > reason #1: Difficulty threading: when doing a PICC > if the IV catheter > doesn't thread up the vein it is usually ok because > you can usually get > the wire to thread and thats all you need. If you > are starting an IV > you do need to get the IV catheter to insert fully. > You MUST use an IV > catheter that is 1 3/4 long (20 gauge); the regular > length catheter (1 > 1/4 in) is simply too short to reach. I think all > manufacturers have > the longer catheters. > > reason #2: infiltration: For more than short term > use an IV in the > upper arm seems less than satisfactory. I think its > because the normal > movement of the arm causes a lot of movement and > pistoning and then > infiltration. That is not a problem for PICC/Midline > because of the > flexibility of the catheter and the fact that it is > impossible to fall > out of the vein. So for a peripheral IV that needs > to be there 72 hours > I prefer to start it in the lower arm, just distal > to the antecubital > space. The veins in that area are often adequate > size and the IVs seem > to last longer. However, since the veins are not as > big as the upper > arm it does take more skill and luck to get it in, > so in some ways it is > harder than doing a PICC/midline. With the smaller > veins it is very > easy to go through the other side, so it takes some > practice to get it > just right. Sometimes when I go through I pull > back until I get blood > return, then advance it into the vein; that usually > works. > > #3. Sterile technique: we don't use a sterile > needle guide or cover. > Instead I find the vein with the bare probe and gel, > then mark the spot > with my pen with the point retracted, or a straw. > Then I prep w > chloroprep and use lidocaine if desired. Then I > place a small bead of > gel above the site, then insert the needle. If you > are careful the > probe/gel will not come into contact w the needle > site. There is no > need to wear sterile gloves--just as in a regular IV > stick. Some people > use sterile gel; I use regular gel since it doesnt > (usually) come into > contact w the catheter. > > > > Rich Pearson RN MS CCRN > Clinical Nurse Specialist > Intensive/Post Intensive Care > Alegent Health-Immanuel Medical Center > 572-3433 > > > >>> "Lawler, Maureen C." <[EMAIL PROTECTED]> > 5/16/2006 1:15 PM >>> > We are just beginning using US for PICCs. Ct Scan > does not want to use > power injector on veins in hand or wrist...don't > blame them. If they > can't gain access in a large vein they call us and > sometimes we can't > either. They have asked if it would be possible, > once we gain skill > with US, to place periphs in the upper arm with the > aid of US. Are any > of you able to do this and if not what do you do to > gain access for CT > power injections? > > > > > > > ********************Confidentiality > Notice******************** > > > > This message is intended for the sole use of the > individual and entity to whom it is addressed, and > may contain information that is privileged, > confidential and exempt from disclosure under > applicable law. Any unauthorized review, use, > disclosure or distribution of this email message, > including any attachment, is prohibited. If you are > not the intended recipient, please advise the sender > by reply email and destroy all copies of the > original message. Thank you. > > > __________________________________________________ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
