I have always been taught that an IV site should be less than 24hrs old when administering vesicant chemotherapy. Is that still recommended in light of the new guideline of changing the IV only when indicated?
I have always been taught that an IV site should be less than 24hrs old when administering vesicant chemotherapy. Is that still recommended in light of the new guideline of changing the IV only when indicated?
INS Practice Criteria in S88 #62, F-3 States "a new access site should be initiate prior to any peripheral vesecant administration and documented." I firmly believe this is the safest and I would not want to be responsible for another nurses PIV. Hope this helps. And I feel it is so beneficial for all nurse performing infusion therapy to either purchase the INS Infusion Nursing Standards of Practice or at least have access to one.
Valorie Dunn, BSN, RN, CRNI
Valorie Dunn,BSN, RN, CRNI, PLNC
Also, I am fairly certain that ONS guidelines include this 24 hour limit. I am at AVA now so can't check that document. This is not related to the new standard for changing the PIV when clinically indicated. It is related to a higher rate of extravasation injury with catheters that have dwelled for longer periods. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Lynn is correct. ONS guidelines state that for ANY chemotherapy (not just vesicant) given via PIV, the site should be less than 24 hrs
Also included:
- no peripheral vesicant infusions for longer than 30-60 min and the nurse needs to stay with the pt.
- use gravity for vesicant PIV infusions--no IV pumps
- "remain with the patient during the infusion. Visually monitor the site for signs of extravasation while verifying blood return every 5-10 min."