Can someone please lead me to a standard or documentation to enforce that the nurses do not use a guidewire only without fluoro. I can't believe that they want to do this. Does anyone know if the manufacturers have it in their instructions. Can't find this in new standards but did see statement in INS textbook.
Thanks,
Chris Thomas
I am not aware of any studies supporting the safety of this practice, therefore a standard can not be written. This means that knowledge and critical thinking must guide this decision. Knowledge of anatomy and where the catheter can go meaning the wire can follow this same pathway. Knowledge of the potential for vein irritation from the wire, knowledge of the manufacturer's IFU, etc. What instructions are provided for using the wire? Does it talk about use of fluoro when the wire is inserted? If it does, and no fluoro is being used, and there is a lawsuit, your liability goes up dramatically. The absence of any statements or instructions stating this can be done does not mean that it is acceptable practice that should be done. In fact, I would agrue the opposite that absence of supporting instructions means that it should NOT be done without fluoro guidance. 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
Chris,
Why does this scare you so?.....I'm not sure where your coming from. The wires that are used beyong the axilla, are floppy wires and could in no way "puncture" anything. I've been using Nitinol 018 wires 70-80 cm for over a decade on thousands and thousands of insertions without incident. I also feel completely confident I'm using this wire correctly and safely. So I guess I would recommend to you NOT to use the wire because it sounds like your not very confident with using it. That's OK but if you have doubts ...Don't use it.
Jack
Chris long time no see. Call me 219-730-8927 and lets catch up. I missed you at the last conference
Kathy Kokotis
Bard Access Systems