Re: RE: Midline guidelines from AVA roundtable

[sascrni]

Dear Heather

    Please have a more forgiving heart for nurses who are less educated than yourself.  A person can only do their best, based on the knowledge they have at any given moment.  I used to get very aggravated by such nurses, but let's face it...not all nurses get the same education. I have heard others speak on this listserve of MD who need IV education as well.  Yet those same persons do not disrespect MD.  Let us SUPPORT and EDUCATE our young/old/less knowledgable nurses....not eat them for breakfast!  Too many times in my career I have seen nurses get blamed and disciplined for not knowing something they should have.  Why is it nurses can be our own worst enemy??? 

    Until we can get nursing programs to require Infusion therapy as a SEPARATE course aand not integrated into other things like pharmacy, ICU and Medsurg classes...we will continue to see nurses who have little knowledge in the Infusion therapy area.  Also facilities think any nurse can insert an IV.  There are many MD offices that have the med techs start the IV when they draw blood and then expect the nurses to give vesicant chemotherapy thru these lines. They see starting IVs as a skill....a skill can be learned by most any professional willing to learn.

          We need the rest of the world (outside IV teams and IV nurses) to realize is that infusion theapy is an ART, not everyone is good at it.  Nor should they be expected to perform a skill they are not comfortable or competent to perform.

 

end of soapbox, thank you for reading my rant!

--
Susan Schuetrumpf, CRNI
VASPRO
Atlanta, GA
cell-404-606-1194

 

-------------- Original message --------------
From: "Heather Nichols" <[EMAIL PROTECTED]>

Victoria,

   I feel you do them a favor by calling them "professionals" if they do not realize this on their own.

 

 

Heather Nichols RN BSN CRNI
Infusion Services
University of Louisville Trauma Institute
530 S. Jackson St.
Lou. Ky. 40202
(502)562-3530

>>> "VICTORIA SALLESE" <[EMAIL PROTECTED]> 10/17/2006 9:19 AM >>>

Correct, Vanco is not appropriate for a midline. End of discussion. If only we could get professionals to realize this.

Victoria Sallese
VAT
Johns Hopkins Hospital

----- Original Message -----
From: "Kokotis, Kathy" <[EMAIL PROTECTED]>
Date: Saturday, October 14, 2006 10:14 pm
Subject: RE: Midline guidelines from AVA roundtable
To: Bev and Tim Royer <[EMAIL PROTECTED]>, Kelly Murphy <[EMAIL PROTECTED]>, Chris Cavanaugh <[EMAIL PROTECTED]>, [EMAIL PROTECTED]

> I will discourage anyone from running Vancomycin thru a midline period
> It is a vesicant
> My mother thrombosed in seven days of Vanco via a midline placed
> in a
> physician infusion office
> The nurse's answer was to give the vanco every other day to rest the
> arm.  I stopped that as soon as I got home four days later
> I ran into a major University Hospital go ing u n-named this week that
> does vanco via midlines for two weeks of therapy
>
> Tom Lawson who did a wonderful paper back in the old days on infusates
> via midlines (mid 90's) indicated that the complication rate with
> Vancowas over 30%.  That is way higher than the complication rate
> of PICC
> lines with vanco.  I need to pull out that old paper done on landmark.
> It was a great paper on all drugs given via midlines and their
> complication rates
>
> Kathy
>
>
>
>
>
>
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>
> From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED] On Behalf Of Bev and Tim Royer
> Sent: Saturday, October 14, 2006 9:52 AM
> To: 'Kelly Murphy'; 'Chris Cavanaugh'; [EMAIL PROTECTED]
> Subject: RE: Midline guidelines from AVA roundtable
>
>
> Kelly,
>
> Our experience has been the same.  Have had some minimal success with
> midlines in those patients in our long term facilities that needed
> access for every other day hydration and slow rates (these sometimes
> last up to 3 weeks).  Everything else usually starts leaking at
> the site
> in a week or under, which could mean the vein thrombosed off above the
> tip.  Also, they stop aspirating after 4-5 days.
>
> Chris brings up an interesting point though - catheter size.  For
> midlines we are using 4fr silicone catheters with the tip terminating
> just before the axillary vein.
>
> Chris,
>
> What size midline catheter are you using?
>
> Looks like a great subject for research - Midline catheter size and/or
> material.
>
> Timothy Royer, RN, BSN, CRNI
>
> ________________________________
>
> From: [EMAIL PROTECTED]
> [mailto:[EMAIL PROTECTED] On Behalf Of Kelly Murphy
> Sent: Saturday, October 14, 2006 7:29 AM
> To: Chris Cavanaugh; [EMAIL PROTECTED]
> Subject: Re: Midline guidelines from AVA roundtable
>
>
> This is a little off the original subject, but I have not seen a
> midlinethat has lasted t he length of treatment ye t.  Just
> yesterday, a patient
> came to the ED with a midline that was placed 2 weeks ago.  It was
> leaking at the insertion site.  I spoke with ID and they said he
> needed10 more days of IV antibiotics and no, we couldn't change
> him to PO.
> Originally, I was talked into the midline because they weren't
> sure if
> he needed 2-3 days or 2-3 weeks, with the promise from both the MD and
> the PA that if the treatment lasted 2 weeks, the patient would be
> readmitted.  Being the patient advocate I am, I opted for a midline.
> Long story short, I ended up putting a PICC in him yesterday in
> the ED.
> This just reconfirms my belief that midlines are relatively useless
> except maybe in CMO cases.  Almost every midline I've inserted for
> homecare has come back through the ED for replacement.  Does
> anyone e lse
> feel the same way or have the same experience?
> Not trying to start an argument, just wondering if anyone else is
> havingthe same results with midlines as me.
>
> ----- Original Message ----
> From: Chris Cavanaugh <[EMAIL PROTECTED]>
> To: [EMAIL PROTECTED]
> Sent: Saturday, October 14, 2006 6:54:25 AM
> Subject: Midline guidelines from AVA roundtable
>
>
>
> For those who could not open the original document posted, here is one
> as a word document.  Thanks
>
>
>
> Chris Cavanaugh, CRNI
>
> 3606 Molona Dr.
>
> Orlando, FL 32837
>
> 407-928-9297
>

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