[OhbowhntrRN]

I do this all of the time. My ignorant manager printed off part of some article saying that you shouldn't be using peripheral IV's to draw blood with, but it also stated that you should make sure you're flushing them. EVERY STATE BOARD(8 that I've checked) RECOGNIZES DRAWING BLOOD FROM IV'S AS PART OF PRACTICE FOR BOTH RN'S AND LPN'S!!!! Not real sure it was a legitimate article, just one of her efforts to try to say what I do is wrong I think. I instruct most of my staff to draw from the IV if it is good enough to draw from, saving the patients extra sticks, and also ensuring that my staff are ensuring that they have patent IV's. I also NEVER flush with anything less than 5cc's, because a little 3cc flush can hide easily in a large patient, not letting you know that it's infiltrated. Though, if I don't get blood return, I flush cautiously anyhow. We have IV's go bad frequently, and I believe the major causative factor is lack of use. I've rarely had an IV that was continuously running go bad, only the ones that aren't being used. I also rarely place anything smaller than a 20g, because I may need that line for volume at any given time!!!!!

[MagRedC5]

Originally Posted by OhbowhntrRN

I do this all of the time. My ignorant manager printed off part of some article saying that you shouldn't be using peripheral IV's to draw blood with, but it also stated that you should make sure you're flushing them. EVERY STATE BOARD(8 that I've checked) RECOGNIZES DRAWING BLOOD FROM IV'S AS PART OF PRACTICE FOR BOTH RN'S AND LPN'S!!!! Not real sure it was a legitimate article, just one of her efforts to try to say what I do is wrong I think. I instruct most of my staff to draw from the IV if it is good enough to draw from, saving the patients extra sticks, and also ensuring that my staff are ensuring that they have patent IV's. I also NEVER flush with anything less than 5cc's, because a little 3cc flush can hide easily in a large patient, not letting you know that it's infiltrated. Though, if I don't get blood return, I flush cautiously anyhow. We have IV's go bad frequently, and I believe the major causative factor is lack of use. I've rarely had an IV that was continuously running go bad, only the ones that aren't being used. I also rarely place anything smaller than a 20g, because I may need that line for volume at any given time!!!!!

Great post! BTW, I love the 10cc prefilled saline syringes.

[Marie_LPN]

We draw blood off of an IV after doing a discard tube first.

[cassioo]

the 3cc syringes can cause too much pressure also blowing a site. (I think that's what happened to mine that also caused the clot in Nov) I know I saw 1 peson using a 3cc syringe a couple of times but I was trying to be a good patient and not say hey stop that

[OhbowhntrRN]

Originally Posted by cassioo

the 3cc syringes can cause too much pressure also blowing a site. (I think that's what happened to mine that also caused the clot in Nov) I know I saw 1 peson using a 3cc syringe a couple of times but I was trying to be a good patient and not say hey stop that

I've heard many people say this, BUT.....it's not true. The pressure exerted from a 10cc syringe will be much greater than that of a 3cc syringe. As far as what made an IV go bad....that could be anything, from bumping it on something, sleeping with it up under you, not being flushed regularly, etc.

[cassioo]

Originally Posted by OhbowhntrRN

I've heard many people say this, BUT.....it's not true. The pressure exerted from a 10cc syringe will be much greater than that of a 3cc syringe. As far as what made an IV go bad....that could be anything, from bumping it on something, sleeping with it up under you, not being flushed regularly, etc.

do you have any of the literature that says it doesn't because that's what I was taught and all of the hospitals I work(ed) at have a policy about the size of syringe for flushes as well as for wound irrigation with dressing changes because the fluid force. I started looking things up this morning before work but had about 3 minutes and didn't get a chance to look at work today...I had a running mid-line and wasn't moving much so didn't have my arm under me so didn't see any reason for it to suddenly just go bad then end up with a clot so accounted it to the syringe size..maybe it was just time.

[AmandaWIRN]

I agree that a 10cc syring will exert more pressure than a 3cc- I have worked in NICU in the past, and we always used 3cc syringes for line draws on neonates, because the pressure from a 10cc syringe is too great for their tiny vessels.

[cassioo]

I just want to see the literature we're rewriting many policies because the way policies were for the past couple of years (with new DON) they were kind of pushed to the wayside. (NICU is a whole different ball game) and does it make a difference if it's a running IV or SL? When I went to PICC class (to learn to put them in) many moons ago it made a difference (I don't do them anymore) and Ports we use 10cc's. I don't have reference to journal of IV therapy (really don't have time to go to the medical library right now) so if anyone does have the literature direct me there please.

[OhbowhntrRN]

Originally Posted by cassioo

do you have any of the literature that says it doesn't because that's what I was taught and all of the hospitals I work(ed) at have a policy about the size of syringe for flushes as well as for wound irrigation with dressing changes because the fluid force. I started looking things up this morning before work but had about 3 minutes and didn't get a chance to look at work today...I had a running mid-line and wasn't moving much so didn't have my arm under me so didn't see any reason for it to suddenly just go bad then end up with a clot so accounted it to the syringe size..maybe it was just time.

In all honesty, you could use a little pressure guage(A sphygmometer might be ideal.....actually I may try this at work, and report results now that I think of it)and attach it to check the exact difference, but easy as any way to tell, without actuall #'s on what the difference is, is to take a syringe, and seal it to your palm or forearm, and draw back, do this with each, and I promise you'll see a difference. There is a big difference between an irrigation syringe, and a an IV luer syringe as far as pressure that can be exerted. That's like comparing apples to watermelons, not even a fair comparison.

IV's go bad sometimes, but I'm a firm believer that regular flushing of IV's results in a decrease in the number of IV's that go bad, by keeping them rinsed. When I've worked with staff who are "anal" about flushing IV's, I notice that their IV's go bad much less often.

[hfergrn]

I would be careful returning any blood from your waste syringe. You can easily introduce a clot (espicially if your pt has any clotting factors). It is safer to pitch your waste than to give it back....