I looked but did not find any position that INS might have on using local for placing PIVs. I welcome any thoughts others may have about this. My department (IV Therapy), does not use local however our pre-op areas do. This brought up the question from them as follows. They currently draw up the lidocaine with a TB syringe and then change the needle to a 30 g 5/8" needle. They wanted to know if it was necessary to change the needle. My feeling was that it was not, that the TB syringe's needle could and should be used to give the intradermal injection. I did say however, that they should change thier practice to using single use vials of Lido.
We have been 'numbing' since around 1989. The IVT used NS instead of Lido when I was on it. I left there in '95 and now teach all Home RN's to numb. I will give testimony to the fact that NS is effective in making for a comfortable insertion. But it needs to be the vial with preservative as it is the Benzyl Alcohol preservative that causes the numbing effect. We use the same needle on the tb/insulin syringe that we used to draw up with. Hope this helps. Oh, and it doesn't sting like Lidocaine does.
Ann
Every time you use a needle to access anything the needle is dulled. Since the purpose of numbing is decrease discomfort the needle should be new IMO.
We use bacteriostatic NS to numb. It contains 0.9% (9 mg/mL) of benzyl alcohol added as a bacteriostatic preservative. The pH is 5.7 (4.5 to 7.0). We draw from a fill needle then inject with a 1ml syringe and 30 g needle. The patients often do not feel ANYTHING. I can then stick an 18 g PIV via ultrasound and they never feel it. The duration of the numb seems to be a little less.
This is the same drug we use in our cardiology bubble studies checking for PFO. 30ml max per adult recommended. We use between 20-30 ml in a rapid flush.
Great stuff , much better than lidocaine for PIV IMO. We use lidocaine for PICC due to the skin nick timing much later than the needle stick.
Thanks for the replies. I will share this with my colleagues.