Many evidence-based documents are now available to guide your practice decisions. The 2016 Infusion Therapy Standards of Practice are now available from INS. ISMP issued a new guidelines document on I.V. Push Medications in 2015. APIC recently issued a new CLABSI Implementation Guide and the SHEA Compendium on CLABSI was updated in 2014. Add documents from ONS, ASPEN, AVA, and many others. Do you have questions about the content of a specific document? Concern about conflicting information between these documents? Issues with implementing these documents into your clinical practice? We can help! Join our monthly videoconference to participate in discussions to get your questions answered. This will not be a formal presentation followed by a short question and answer session. We want to meet your needs in a different way. Choose a date from the following list and register. Each session is planned for Thursday. Send your questions via email to Lynn Hadaway at lynn@hadawayassociates.com, preferably by Monday before the session. Lynn will organize the questions and facilitate the discussion. At the scheduled date and time, follow the directions for connecting your computer and join this discussion. It is that simple! Lynn is an excellent resource to facilitate this discussion. She has been an author of the INS standards for the 2006, 2011, and 2016 edition. She was a part of the consensus group that produced the ISMP paper and worked on the APIC and SHEA documents. Do not miss this opportunity to get your questions answered. Regular price - $195 - unlimited number of participants in one location with one Internet connection 20% discount in honor of I.V. Nurses Day - January 25 thru 31- $175 Sign up now! Paresthesia is defined as “a sensation of tingling, tickling, pricking, or burning on the skin with no apparent physical cause.” This word is found in the literature on nerve injury.
The 2016 Infusion Therapy Standards of Practice, due to be available by the end of January includes a new standard on Nerve Injury. This new standard uses “paresthesia” to describe this type of pain that can occur during venipuncture or associated with infiltration/extravasation. During catheter insertion, complaints of electrical shock-like pain going in either direction on the arm, tingling, feelings of “pins and needles” or numbness is an indication that a nerve has been damaged by the needle. Nerves and veins are located very close together, making it nearly impossible to choose a venipuncture site without some risk of nerve injury. The new standard will contain a list of nerves and anatomical locations where this problem is most frequently reported. This event must be managed by carefully removing the needle and finding another location for the venipuncture. The chance of permanent nerve damage and subsequent complex regional pain syndrome (CRPS) increases when the inserter ignores these patient complaints and continues with the procedure in the same location. Pay careful attention to the type of pain complaints during all venipuncture procedures and never assume that this is the typical discomfort felt with most venipunctures. Paresthesia may also occur when excessive fluid is accumulating in the tissue. Nearby nerves are compressed causing these sensations. The fluid could be infusing I.V. fluid, blood from hematoma formation, or edema from inflammatory processes such as thrombophlebitis. Again, this is a reason for immediate catheter removal. Failure to remove the catheter quickly also increases the risk of permanent nerve damage and CRPS. The bottom line is paying careful attention to the patient’s complaints, asking questions about the type of pain, and taking quick action to reduce the risk of nerve damage. Read this new INS standard when it is available to learn more details. Additionally, investigate our comprehensive online education course on Infiltration and Extravasation. Details are located here. |
Author: Lynn HadawayLynn Hadaway is an international thought leader in infusion therapy and vascular access, having been in this practice for more than 40 years. Her experience comes from hospital-based infusion teams, device manufacturers, and continuing education services. Her journal and textbook publications are extensive. She also maintains board certification in infusion nursing (CRNI) and nursing professional development (RN-BC). Categories
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May 2019
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