Title: RE: RT's using US for ABG's
Could anyone share any info , or point me in the direction of using the ultrasound and assessing avoiding nerves during picc insertion.
 
  Are we just talking a knowledge of anatomy and where the nerves are located and accessing the vein properly to avoid the nerve where we would expect it to be located. OR is there a way toidentify these nerves  on the ultrasound.
 
thanks,  gina


From: [EMAIL PROTECTED] on behalf of Lynn Hadaway
Sent: Fri 9/15/2006 1:04 PM
To: Bev and Tim Royer; [EMAIL PROTECTED]
Subject: RE: RT's using US for ABG's

And I would agree with Tim and the others that have serious
reservations about this practice. Lynn

At 7:02 AM -0700 9/15/06, Bev and Tim Royer wrote:
>Another thing we need to think about is nerve damage.  My veins even on a
>good day at the antecub are not easy to find and I have had some probe and
>some extreme pain when they go deep.  I truly believe that ultrasound needs
>to be left those who use it all the time and have a deep knowledge of
>anatomy and physiology and aseptic technique.  This could end up with more
>facilities going to court over nerve damage and/or infection.  If a
>phlebotomist or RT has the same education as a RN with critical thinking
>skills in this area, I might think differently.
>
>Using ultrasound is not just a skill.
>
>Timothy Royer, BSN, CRNI
>Nurse Manager / Vascular Access / Diagnostic Service
>VA Puget Sound Health Care System
>Seattle, WA
>
>PS - AVA Conference in Indy was a great time and informative!  It has taken
>me a few days to rest up.
>
>-----Original Message-----
>From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]
>On Behalf Of Erickson, Wendy
>Sent: Friday, September 15, 2006 4:38 AM
>To: DAVID LONGSETH; [EMAIL PROTECTED]
>Subject: RE: RT's using US for ABG's
>
>Use caution!  We had an outbreak of infections related to contaminated
>ultrasound gel several years ago.  The bottles were being refilled from a
>large supply, rather than using a new bottle when empty.  I would be very
>concerned about using non-sterile gel anywhere near a venipuncture site.
>
>Wendy Erickson RN
>
>-----Original Message-----
>From: [EMAIL PROTECTED]
>[mailto:[EMAIL PROTECTED]] On Behalf Of DAVID LONGSETH
>Sent: Thursday, September 14, 2006 8:52 PM
>To: [EMAIL PROTECTED]
>Subject: RT's using US for ABG's
>
>Similar to the 'phlebotomists using US'  but different enough for another
>thread.
>A couple of our RT's are interested in using US for ABG's. The training and
>competencies shouldn't be too hard to do,and they have access to a Site-Rite
>2. What I'd like to do is a pre-audit of palpation ABG's in terms of time to
>get the sample and # of sticks,then train a few in US guidance and then see
>how the times,sticks to pt. and materials used compare.
>Now,the one thing that I still can't decide is whether to have them use a
>sterile sleeve over the probe or not. Drawing ABG's is not a sterile
>procedure per se,so my instinct is to have them disinfect the probe before
>and after the stick but maybe someone out there has other views.
>Thaks for any input,
>David
>
>
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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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