Double the risk of complications happening in the same extremity including phlebitis, thrombophlebitis, infitration/extravasation, nerve injury, etc. I am not aware of any studies that show 2 sites in one arm produces any additional risks for a certain type of complication, etc. Having a venous and arterial line in the same extremity increases the risk of using the wrong one for injection. If you have 2 venous sites, there is probably an incompatibility issue that caused the need for 2 venous sites. I can not think of another reason for having this situation. So you could still have the risk of giving a drug through the wrong line and risk a drug precipitate in the line which would create particulate matter that ends up in the patient's lungs. This is the reason for tracing all IV sets from one end to the other before using either line. Have you seen something different that caused you to ask this question? Lynn
I have seen IV sites in the same arm and sharing the same vein with about 3 inches separating the IV sites. I have never seen an incompatability issue from the close proximity but was wondering if anyone else has seen such a problem?
My post did not mean that the incompatibility occurs because of 2 sites in the same arm. My thought was that a known incompatibility of 2 or more prescribed meds were incompatible, thus driving the need for 2 separate venous sites. Sorry for the confusion. Lynn
Thank you for your time. The question I would love answered-can two IV sites in the same arm, occupying the same vein, cause a precipitation inside the vein from two incompatible medications? I have never seen it happen but could it happen?
Yes, I think it could happen. Compatibility depends upon many factors - the amount of dilution, the type of diluent, pH changes especially, length of time in contact, etc. In the vein, it would depend upon the size of the vein and the volume of blood flow, the relationship of the catheter size to the vein diameter and volume of blood flowing around each catheter, along with the factors related to the drugs themselves. So I think it could happen. My question is how would a nurse know that it has happened? In a fluid container or IV set, you can see a color change, cloudiness, a visibile precipitate. But once the drugs have been in contact in the bloodstream, none of this would be visibile. The resulting particulate matter would end up on the patient's lungs and produce inflammatory responses there. Filter studies have also shown that this particulate matter can have an impact on patients that are immunocompromised for other reasons. I can't think of any studies that have documented this either. Lynn
Double the risk of complications happening in the same extremity including phlebitis, thrombophlebitis, infitration/extravasation, nerve injury, etc. I am not aware of any studies that show 2 sites in one arm produces any additional risks for a certain type of complication, etc. Having a venous and arterial line in the same extremity increases the risk of using the wrong one for injection. If you have 2 venous sites, there is probably an incompatibility issue that caused the need for 2 venous sites. I can not think of another reason for having this situation. So you could still have the risk of giving a drug through the wrong line and risk a drug precipitate in the line which would create particulate matter that ends up in the patient's lungs. This is the reason for tracing all IV sets from one end to the other before using either line. Have you seen something different that caused you to ask this question? 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 have seen IV sites in the same arm and sharing the same vein with about 3 inches separating the IV sites. I have never seen an incompatability issue from the close proximity but was wondering if anyone else has seen such a problem?
My post did not mean that the incompatibility occurs because of 2 sites in the same arm. My thought was that a known incompatibility of 2 or more prescribed meds were incompatible, thus driving the need for 2 separate venous sites. Sorry for the confusion. 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,
Thank you for your time. The question I would love answered-can two IV sites in the same arm, occupying the same vein, cause a precipitation inside the vein from two incompatible medications? I have never seen it happen but could it happen?
Yes, I think it could happen. Compatibility depends upon many factors - the amount of dilution, the type of diluent, pH changes especially, length of time in contact, etc. In the vein, it would depend upon the size of the vein and the volume of blood flow, the relationship of the catheter size to the vein diameter and volume of blood flowing around each catheter, along with the factors related to the drugs themselves. So I think it could happen. My question is how would a nurse know that it has happened? In a fluid container or IV set, you can see a color change, cloudiness, a visibile precipitate. But once the drugs have been in contact in the bloodstream, none of this would be visibile. The resulting particulate matter would end up on the patient's lungs and produce inflammatory responses there. Filter studies have also shown that this particulate matter can have an impact on patients that are immunocompromised for other reasons. I can't think of any studies that have documented this either. 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