We need to do a study with this population. They have so many rare reactions and sensitivities.
Cat Johnson RN
From: "Cindy Schrum" <[EMAIL PROTECTED]>
To: "[EMAIL PROTECTED]" <[EMAIL PROTECTED]>
CC: "Gwen Irwin" <[EMAIL PROTECTED]>, [EMAIL PROTECTED]
Subject: Re: Re: Do you notice the patient's reaction to vein entry?
Date: Sat, 12 Aug 2006 18:19:41 -0400
>Oh yes! Notorius!
>
>On 8/12/06, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:
>>
>>
>>Fair Skin Freckled Natural Redheads
>>
>>--
>>Robbin K. George RN
>>Vascular Access Resource
>>Alexandria Hospital Virginia
>>
>>
>>-------------- Original message --------------
>>From: "Gwen Irwin" <[EMAIL PROTECTED]>
>>
>>This may seem to be a weird topic, but with our years of ultrasound
>>insertion of PICCs, we have noticed that some patients really react
>>to vein
>>entry BEFORE we are close to entering the vein, while observing on
>>ultrasound the location of the needle in relation to the vein wall.
>> When we
>>proceed past that point, we are in the vein with excellent blood
>>return and
>>proceed to successful PICC insertion. Local anesthesia works only
>>on the
>>skin entry and doesn't prevent this reaction to vein entry. They
>>also react
>>differently to vein entry of the dilator/sheath introducer.
>>
>>This population of patients are also the ones that complain of the
>>most pain
>>with IV insertions. Most staff nurses give up before entering the
>>vein with
>>an IV catheter, when the patient complains of this pain. If we are
>>called
>>to do a PIV, we don't give up at that point, but believe that we
>>are right
>>on top of the vein and continue past the patient's complaint to
>>vein entry.
>>We have a successful PIV.
>>
>>This is so hard to measure for a study, but our observations have
>>led us to
>>believe that the innervation of the exterior of the vein is
>>different for
>>some people. We don't seem to see a large percentage of our
>>patients that
>>have this type of reaction, but it is noticeable, when it occurs.
>>Some of
>>these people call themselves "weenies" for IV starts. Based on the
>>years of
>>our observations, we don't believe that they are weenies, but that
>>they have
>>different innervation that actually gives them a pain signal before
>>vein
>>entry. We have been known to tell them that they have bad luck
>>with their
>>veins, since they feel the stick into the vein before it actually
>>occurs.
>>These also can be the patients that have more vasoconstriction
>>observed on
>>ultrasound, during PICC attempts. We have waited for as long as 10
>>minutes
>>to observe the vein stop its vasospasm, and see the dilation that
>>we
>>initially saw on our original asse ssment.
>>
>>I am wondering if anyone else is noticing this phenomenon. I am
>>really
>>thinking it would be useful information to share, but don't know
>>how to
>>study or report this subjective observation.
>>
>>I would love to hear from you, if you think we are crazy or if we
>>are
>>noticing something that has not previously reported or discussed.
>>We have
>>seen it so many times that we don't think we are crazy. Your
>>responses are
>>always appreciated.
>>
>>Gwen Irwin
>>Austin, Texas
>>
>>
>>
>>
>
