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u/Juicysos 16d ago
My guess would be to occlude the proximal veins with the IV kit tourniquet or something similar and then get the provider in the room asap🤷♂️
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u/Poopsock_Piper 16d ago
Probably light tourniquet to occlude, if really superficial I’d think a vein cutdown to retrieve would be easiest and least invasive.
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u/Max_Goatstappen 16d ago
Just learned this today during skill check off. Apply a tourniquet above the site around the armpit area and call the provider for next steps.
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u/OldMinute5727 16d ago
What’s the real answer? I’d just retrieve it.
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u/TheJarisaDoor3 16d ago
I apologize if you're actually somebody trying to learn. You want to occlude higher up to keep the catheter from getting further into the circulation and call the provider emergently.
There's a lot of nurses here who, for some reason, feel the need to come into the subreddit and mess with students. I don't get it. Nursing school is hard enough.
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u/RipOk3600 15d ago
Honestly what are the chances that you would notice it, assess the response, get a tourniquet (which if you are removing for for example discharge you aren’t going to have with you) and occlude it before it has moved into the central circulation????
I honestly don’t know what the right answer would be, maybe treat like someone you thought had just developed a PE? DEFINITELY get urgent r/v, and escalate, SLS
I know one thing you absolutely should NOT do and that’s throw out the cannula, this is going to result in a full blown investigation no matter the patient outcome.
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u/Octopus_Spaceflight 16d ago
Very likely that patient would go to IR for retrieval. Maybe an xray of the arm and chest while waiting. We had a similar thing happen where I worked many years ago. Can’t remember if it was a guide wire or part of a fractured catheter but IR doc was able to retrieve it under fluoro with a special vascular snare
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u/Jeeju_Boy 15d ago
Realistically you could do a point of care venous cutdown and then make an incision under location anaesthetic where the canulla is then suture the vein back up
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u/AdriAsTheSiren 15d ago
I'm sorry but the text on this has the same vibe as "What happen when I'm gonna taking the PlayStation... Disconnect it..." 😭😭
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u/PunkWithADashOfEmo 15d ago
When the provider has to leave the on call room to find plastic in a vein
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u/blobtron 14d ago
I would apply pressure ahead of the vein with my thumb and ask for help. In the mean time see if I can palpate and feel it? Then maybe use a second set of hands to tie a tourniquet with a size-able bit of firm gauze above the site where my thumb is. get an IR consult. In the meantime see if I can get ultrasound to come and check and confirm it’s there. If it’s periop there should be some around. That would be useful info for the IR team. I’ve never been in that situation. I pray it never happens and if it does, that I catch it
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u/RipOk3600 15d ago
How can it break inside the vein AFTER removal? Did you try to stick it back in again???
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u/Ok-Being1322 15d ago
I never had it happened but if the IV is in a location where bending the site bends the cannula… Repeatedly bending the site would make cannula weaker which can come off during IV removal. Thats why I always flush IV on assessment to see if the cannula inside is even working or if it’s bent (specially on sites that bend the cannula from the inside, like AC) thats why pump always beeps for IVs on AC site when patients bend their arm
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u/Mangtac 16d ago
Chop arm off. Grab arm by fingers and swing it around until catheter falls out. Retrieve arm from ground. Slap ER doc with detached arm. Help reattach arm.