Just wondering does any of you experts uses any local anesthetics if you're trying to establish PIV by ultrasound especially the deeper vessels. What do you use. ? One facility had use a bacteriostatic sterile saline to numb the area prior, and I saw a reference in INS standard of one study using bacteriostatic saline but could not find the details of the study. What is in the bacteriostatic saline that has the numbing effect. I asked our pharmacy yesterday, they said there's nothing. Pls. advise. Thank you.
PICC RN
Benzyl alcohol is the preservative in bacteriosttatic NS that acts as a local anesthetic. 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
We ALWAYS numb with BSNS for EVERY US PIV we start, and have great success and patient satisfaction. We draw the bacteriostatic normal saline up in an insulin syringe, inject a 5mm wheal at the insertion site, then go thru the wheal with the IV needle. Patients frequently say they didn't feel anything except a little pressure. We also are using it for Midline placement with the same results. There are several articles regarding BSNS and Lidocaine in the literature. Good luck! I am a strong advocate of the use of numbing prior to any non-emergent PIV and am trying to get floor RNs to incorporate it in their practice!
Aileen Rogers RN BSN VA-BC
IV Team Resource Nurse
I have pulled and read articles on this subject. I think the conclusion I came to was the normal saline was not near as helpful as the lidocaine. However, it may be better than nothing.
We just started doing Midlines and when we do a Midline on a pt who is used to getting a PICC line that has been localized before the stick this is a big difference.
If we were to start utilizing an bacteriostatic sterile saline to numb the area would we need a doctors order for that?
I know we would need to add that to our protocol, process if we found it effective but......does normal saline injection require an order?
thanks, Gina
Gina Ward R.N., VA-BC
That would totally depend upon the policy set by your facility. 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
I work with Aileen who replied earlier. When we started placing midlines, we opted to use BSNS and have had very good results with this. We are currently placing PICC lines with BSNS as a local and have had minimal complaints. One patient, who has had multiple lines over the years, said that the placement of his PICC line with the use of BSNS for local was the least uncomfortable line placement he has ever had. We do not require an order for BSNS and it is stocked in our medication supplies on the floors.
Pam Weber, RN, BSN, VA-BC