Q&A: When is a single use syringe considered used?

Q:  You will think I am a complete idiot but please explain when is a single use syringe considered used? I need to explain to my practice manager why I can’t re-use a syringe while reconstituting a powdered medication for injection. My practice manager is complaining that I am using too many syringes and needles which…

Why do nurses use the same alcohol swab over and over?

I know, this may come as a surprise to all of you, but the truth is, I have seen many nurses (even those highly trained and specialized) both in hospitals and outpatient settings, use the same alcohol swab over and over. Imagine this scenario where a nurse is ready to withdraw medication from several vials.…

What do you think…

Q:  We have a 24/7  vascular access team, yet we find that an ultrasound machine  in a medical floor is used for PIV insertion by untrained nurses and residents. The machine is there for other purposes but is being used for hard IV sticks. A:  There is increasing evidence to show the use of ultrasound or…

Large Volume IV Solution Shortages

It just doesn’t seem right that the national crisis with “drug shortages” would include  large volume (1000mL) IV solutions we commonly administer to our patients: 0.9% Sodium Chloride Injection 0.45% Sodium Chloride Injection Lactated Ringer’s Injection 5% Dextrose Injection   But the reality is there is a shortage, IV saline solution, in particular is on…

Vesicants and Extravasation

These two terms defined by the Infusion Nurses Society means: Vesicant – an agent capable of causing blistering, tissue sloughing or necrosis when it escapes from the intended vascular pathway into surrounding tissue. Extravasation – the inadvertent infiltration of vesicant solution or medication into surrounding tissue. There are several chemotherapeutic agents with vesicant properties, and…

SPC Insertion Guide Card Deck

There is a great resource available to nurses and other healthcare providers. It is the SPC insertion guide card deck. The Short Peripheral Catheter (SPC) Insertion Card Deck provides step-by-step instruction for successful venipuncture in children and adults. The deck highlights proper site selection, insertion techniques, as well as care and maintenance methods. It also…

Short Peripheral Catheter Checklist

This great resource in available free to download to INS members from the INS website – SPC  Checklist. SPC means short peripheral catheter, which man y of us call “peripheral IV catheter” or “PIV”. This checklist was part of the IV Safety Task Force position paper project on Recommendations for Improving Safety Practices for Short…

Think Safety, Insert Safely

In June of 2013, I was honored to chair a national task force for the Infusion Nurses Society’s (INS) project on Short Peripheral Catheter Safety (SPC).  Along with five other colleagues, we embarked on a task  to identify the safety and practice issues and  look at ways to promote safety in the insertion and management…

Q&A: IO and Blood Transfusion

Q:  A twitter colleague posted:  Can you give blood through an IO? A:  IO as in intraosseous access. An old concept that is now getting more attention as an alternate access for infusion therapy in emergent and non-emergent situations. IO access uses the intraosseous space that contains thousands of non-collapsible intertwined blood vessels that absorbs any fluids.…

Q&A: Tips to improve IV insertion skills

Q: Do you have any tips on how to improve my IV insertion skills? A: This is one of the FAQ and often comes from new blog readers. I have blogged about this many times before but I thought I’d post it again. To some of my long time readers, this may not be new…