paramedix
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We would like to gather some thoughts on the use of placing two intravenous lines (IV) unilateral vs placing bilateral intravenous lines for the severely hemo-dynamically compromised patient. Currently, in the pre-hospital setting, our training does not provide a clear yes "do it" or no "don't do it" answer. We have searched on the internet but failed to find any definitive or conclusive information.
The areas of discussion surrounding the topic (Two IV lines on one arm) are as follows:
1. Should you elect to place two intra venous lines unilateral, do you start placing them distal to proximal as per usual, or do you place them from proximal to distal??, as the latter appears to be the sensible choice in this case scenario. Should you however place the 1st IV line distal, you have a chance of compromising the 1st distal IV line if you perform an unsuccessful veni-puncture at a site proximal to the 1st IV line.
2. Does it not make sense to have have the IV lines on one side of the patient as it allows for a less cluttered scene?? You will only need to watch out for one side, with regards to pulling out already successfully placed IV lines, by hooking them etc. You would also only need one IV stand or holder.. Both the flow controls will be next to each other which will allow for easy management there of, and preventing trying to find the other one.
3. On how many occasions have you taken a patient the to emergency department and the staff complains as you have now left them without any veins to perform their veni-punctures for blood samples. By performing 2 IV lines unilateral, you will leave the hospital staff an arm with intact veins.
4. Anything else???
The areas of discussion surrounding the topic (Two IV lines on one arm) are as follows:
1. Should you elect to place two intra venous lines unilateral, do you start placing them distal to proximal as per usual, or do you place them from proximal to distal??, as the latter appears to be the sensible choice in this case scenario. Should you however place the 1st IV line distal, you have a chance of compromising the 1st distal IV line if you perform an unsuccessful veni-puncture at a site proximal to the 1st IV line.
2. Does it not make sense to have have the IV lines on one side of the patient as it allows for a less cluttered scene?? You will only need to watch out for one side, with regards to pulling out already successfully placed IV lines, by hooking them etc. You would also only need one IV stand or holder.. Both the flow controls will be next to each other which will allow for easy management there of, and preventing trying to find the other one.
3. On how many occasions have you taken a patient the to emergency department and the staff complains as you have now left them without any veins to perform their veni-punctures for blood samples. By performing 2 IV lines unilateral, you will leave the hospital staff an arm with intact veins.
4. Anything else???
